Get Covered. Stay Covered. A social marketing initiative to encourage community college students to sign up for insurance under ACA

An important objective of the Affordable Care Act (ACA) is to enroll uninsured young adults (ages 18 to 34 years) in health insurance through the Health Insurance Marketplace. Enrollment of young adults is needed to balance the costs of caring for older, and comparatively less healthy, non-Medicare eligible adults.  However, persuading young adults to enroll is challenging because of their perceived invincibility to getting sick and the perception that insurance is cost-prohibitive.

To meet this challenge, we designed and implemented a social marketing initiative to encourage community college students to sign up for insurance in the year 2 enrollment period, November 2014-February 2015.  Using the revised reasoned action approach of Fishbein and colleagues, we first conducted formative research to better understand the attitudes, subjective norms, perceived behavioral control, and intentions of community college students (N= 847) in rural Illinois to enroll and maintain insurance. Based on the formative research, we developed key messages for the 4-month campaign at four community colleges.  We used a product, price, place, and promotional strategy, employing the same key messages for all the colleges, but varied in the channel delivery:  traditional media only, social media only, in-person information plus radio ads, and a combined media and in-person intervention.     

To evaluate the initiative, we are conducting a baseline and follow up survey at the four colleges plus a control college site. The findings have implications for future enrollment efforts in the ACA Health Insurance Marketplace.