Automating benefits delivery: lowering health insurance costs for unemployment insurance recipients.

To provide financial relief to those affected by the COVID-19 pandemic, from July to December 2021, the American Rescue Plan Act temporarily expanded eligibility for cost-sharing reduction (CSR) silver 94 plans that cover 94% of medical costs for unemployment insurance (UI) recipients enrolled in the Affordable Care Act (ACA) Marketplaces. In June 2021, California's ACA Marketplace automatically redetermined eligibility and enrollment for 79 645 UI recipients so the enhanced subsidies would be applied without any action required among program participants. Using administrative data from California and a difference-in-differences design, we found that enrollees automatically moved to CSR silver 94 plans for the second half of 2021 saved $295 in premiums and $180 in out-of-pocket expenses (or $475 in total). These findings can inform state and federal policymakers exploring ways of automating benefits delivery for consumers already engaging with other safety-net programs to increase health insurance affordability.