Reducing Administrative Barriers Increases Take-Up of Subsidized Health Insurance Coverage: Evidence from a Field Experiment

Keith M. Marzilli Ericson; Timothy Layton; Adrianna McIntyre; Adam Sacarny

doi:10.1162/rest_a_01573

Reducing Administrative Barriers Increases Take-Up of Subsidized Health Insurance Coverage: Evidence from a Field Experiment

Keith M. Marzilli Ericson¹; Timothy Layton²; Adrianna McIntyre³; Adam Sacarny⁴

¹ Boston University and NBER [email protected] · ² Harvard University and NBER [email protected] · ³ Harvard University [email protected] · ⁴ Columbia University and NBER [email protected]

The Review of Economics and Statistics 2025

Abstract Administrative barriers to social insurance program take-up are pervasive, including in subsidized health insurance. We conducted a randomized controlled trial with Massachusetts' Affordable Care Act marketplace to reduce these barriers and other behavioral frictions. We find that a “check the box” streamlined enrollment intervention raises enrollment by 10.5%, more than personalized reminder letters (7.6% increase) or generic reminder letters (4.3% increase). Effects are concentrated among individuals eligible for zero-premium plans, who faced no further administrative burdens of setting up payments. Producing this enrollment effect through premium reduction would cost about $7 million in subsidies, highlighting the importance of these burdens.

DOI: 10.1162/rest_a_01573
Pages: 1-32
Language: en
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