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Table 1 Description of enrollment strategies from selected studies between January 2010 and December 2020

From: Health insurance enrollment strategies during the Affordable Care Act (ACA): a scoping review on what worked and for whom

Author Location Description
Individual assistance
 Call et al. [16] Minnesota (statewide) ▪ Located in various locations.
▪ Provided education on coverage options.
▪ Provided support throughout the enrollment process.
 Getrich et al. [17] New Mexico (urban & rural areas) ▪ FQHCs and community health centers, (academic health centers, faith-based clinics) had navigators to provide in person assistance.
 McGeehan et al. [18] New York (New York City) ▪ Social workers determined individuals’ insurance eligibility.
▪ Referred individuals to a facilitated enroller from a local non-profit organization for additional support.
 Orzol & Hula [19] Arizona, Florida, Georgia, Illinois, Michigan, New Jersey, North Carolina, Ohio, Pennsylvania, Tennessee, Texas ▪ Collected individual contact to follow-up and provide information on health insurance coverage, enrollment, and key deadlines.
▪ Collaborated with local organizations to extend reach.
 Politi et al. [20] Missouri (St. Louis region) ▪ Online decision aid called “Show Me My Health Plan” (SMHP).
▪ SMHP aimed to 1) simplify written information and graphics 2) activities to assess understanding of health insurance information 3) Financial calculator for plans 4) assess appropriateness of selected plan based on need.
 Raymond- Flesch et al. [21] California (urban & rural areas) ▪ Provided in-person assistance for people enrolling for coverage (Medicaid or private insurance) and other entitlement programs.
 Viramontes et al. [22] California (southern) ▪ Offered in-person enrollment support.
Community outreach
 Call et al. [16] Minnesota (statewide) ▪ Organized outreach events in community centers, places of worship, townhalls.
▪ Collaborated with small business groups and healthcare providers.
 Getrich et al. [17] New Mexico (urban & rural areas) ▪ Outreach activities that aimed to disseminate information on health insurance.
▪ Outreach events occurred in different forms (e.g., workshops, health sessions) in communal settings.
 Orzol & Hula [19] Arizona, Florida, Georgia, Illinois, Michigan, New Jersey, North Carolina, Ohio, Pennsylvania, Tennessee, Texas ▪ Field outreach to communities in 11 states that did not expand the Medicaid program.
▪ Disseminated information about private insurance.
 Viramontes et al. [22] California (southern) ▪ Organized workshops and community events (e.g., health fairs, 5K races, school site visits) to disseminate information and resources in communities.
Health Education & Promotion (HE&P)
 Call et al. [16] Minnesota (statewide) ▪ Developed educational and promotional materials.
▪ Organized print and social media campaigns.
 Getrich et al. [17] New Mexico (urban & rural areas) ▪ Disseminate information on health insurance in multi-language and various advertisement campaigns.
 Marzilli-Ericson et al. [23] Colorado (statewide) ▪ Enhanced nudging system (included paper-based letters and emails) in the state marketplace website to encourage people to shop and change their plan.
 Karaca- Mandic et al. [24] Nationwide (represented 80% of the US population) ▪ Televised advertisement on health insurance directed to uninsured adults under age 65 during open enrolment.
▪ Advertisement came from various sources: insurance advertisements, political advertisements, and local news coverage.
 Orzol & Hula [19] Arizona, Florida, Georgia, Illinois, Michigan, New Jersey, North Carolina, Ohio, Pennsylvania, Tennessee, Texas ▪ Online media campaigns to inform people about the ACA and resources available on their website to enroll for coverage.
 Viramontes et al. [22] California (southern) ▪ Multi-channel advertisement campaign (e.g., billboards, digital marketing, and radio) to disseminate information about the ACA and enrolling for coverage.
 Wright et al. [25] Oregon (statewide) ▪ Enhanced materials and nudges that aimed to improve Medicaid enrollment.
▪ Developed simplified information on health insurance, enrollment, and deadlines.
▪ Provided generic and personalized messaging (letter, emails, telephone calls) during key deadlines.