CMS Seeks to Increase Affordable Care Act Enrollment

Each year, the federal government implements certain strategies to increase enrollment in Affordable Care Act health plans.

Each year, the federal government implements certain strategies to increase enrollment in Affordable Care Act health plans. With the uninsured rate the lowest it has ever been, the US Centers for Medicare and Medicaid Services (CMS) created new ways to engage individuals who are still uninsured.

A lack of insurance can result in poor health outcomes and large financial burdens. A large majority of uninsured adults are unaware of their coverage options, or are unaware of financial assistance.

Approximately half of uninsured adults are unaware of financial assistance options, even though 85% of Marketplace-eligible uninsured individuals are qualified to receive subsidies, according to CMS.

A strategy that has been successful in the past has been reaching out to uninsured adults to inform them of their options to enroll them in a plan. CMS expects that this upcoming open enrollment will be the most successful due to testing, data, and analysis of previous strategies.

During the upcoming open enrollment period, CMS will be sending more than 10 million pieces of direct mail to uninsured individuals. This increased substantially from the 800,000 pieces sent for the previous enrollment period.

These mailings will be targeted to individuals who are uninsured, have recently lost coverage, or have been insured through Affordable Care Act marketplaces or Medicaid. Also included will be individuals who started signing up for coverage, but did not complete the process. CMS also partnered with the IRS to conduct outreach to uninsured individuals who paid a penalty or claimed exemption in the past year.

More people than ever will also be reached through email. has increased their email list by more than 30%, and it now includes more than 20 million individuals who have signed up to receive information.

This channel is the most efficient way to reach younger individuals who are twice as likely to enroll from emails compared with older individuals, according to CMS. CMS is also planning on improving their messages to include information that people care about. For example, a main concern of uninsured individuals is how much these plans cost.

A common misconception is that these plans cost hundreds of dollars per month, which is inaccurate for a majority of plans that cost between $50 and $100.

Last year, email reminders about financial assistance increased enrollment by 17% compared with emails that left out that information. Emails that discuss increased costs of the individual’s current plan, but encouraged them to shop around, increased active renewal rates by 279%, according to the CMS.

Mentioning deadlines and penalties were also drivers of enrollment.


previously announced

efforts to reach younger uninsured individuals through social media and a social video platform and community for gamers called Twitch. They also plan to increase YouTube outreach including taking over the homepage with information. Image and video ads will also be run on Instagram, a platform that reaches 48.2 million millennials.

Video, image, carousel, and canvas posts will be used to promote content to Facebook users. Optimized searches will also be implemented by the CMS to make sure individuals seeking information are directed to

CMS will still employ TV advertising, which has shown to be especially effective closer to deadlines.

By enhancing their approaches, the CMS is hopeful that even more uninsured individuals will enroll in a health plan.

“Americans deserve affordable coverage, and we are running a data-driven program to better connect eligible people with health insurance,” said Kevin Counihan, CEO. “This year, we’ll be putting that knowledge to work with smarter targeting and new tactics. I’m confident our outreach campaign will give more consumers the information they need and help us continue our historic progress in reducing the number of uninsured.”