The Affordable Care Act (ACA) marketplace has seen exceptional growth, with enrollment reaching a record 24.3 million in 2025, more than doubling since 2020. While this signals tremendous demand for ACA plans, it also underscores a critical challenge. And with federal subsidies set to end in 2025, fostering trust and delivering year-round value is more critical than ever.
The marketplace is vast, highly competitive, and diverse, creating the need for health insurers to rethink their approach. Traditional broad-stroke strategies no longer cut it. To succeed, precision marketing needs to take center stage, leveraging targeted outreach, personalized messaging, and member-centric strategies to identify, convert, and nurture high-value ACA leads.
Connect with MERGE to discover practical strategies that help you excel in the hyper-competitive ACA marketplace
The Limits of Broad-Stroke ACA Marketing
Broad, indiscriminate marketing strategies fail to meet the challenges of today’s ACA market. Traditionally, health plan marketers have relied on price and use of complex language to communicate benefits, creating a “sea of sameness” where health plans appear indistinguishable to consumers, creating consumer fatigue that results in disengagement. Members demand simplicity and guidance to help them navigate the complicated health insurance process.
Price and provider networks dominate purchasing decisions but do little to differentiate a brand. To stand out, health insurers should aim to go beyond the basics, clearly articulating their value propositions and guiding consumers to action with clear messages. Neglecting this can lead to higher marketing costs, lower conversions, and ultimately, lost market share.
Focusing solely on Open Enrollment Period (OEP) is another common pitfall. While OEP is akin to the Super Bowl for health plan marketers, restricting efforts to this window weakens momentum built during this time period. Special Enrollment Period (SEP) is available throughout the year for those who undergo a life event and may change or enroll in a health insurance plan. This is an opportunity to capture new members. New member onboarding and member education touchpoints should be included in your marketing plans to boost engagement and loyalty.
Non-personalized digital tools can also add frustration. Overcomplicated language and poor design can alienate consumers. By simplifying and personalizing touchpoints based on consumer data, insurers can build trust and make interactions feel seamless.
Understanding ACA Consumers to Develop Smart Strategies
Effective ACA marketing strategies begin with understanding and addressing diverse consumer needs. Data-driven approaches, including propensity and likely buyer models, risk adjustment frameworks, and lifetime value modeling, empower marketers to identify and target the right audiences for outreach, driving stronger results.
For example, ACA consumers can be segmented based on how they enrolled for their individual health insurance:
On-exchange consumers – those who have purchased their insurance through the exchange and are receiving financial assistance – are price-sensitive and are more likely to switch plans during OEP. Insurers can appeal to them by highlighting affordability and offering personalized guidance, such as connecting them with representatives who can help optimize their financial assistance and simplify decision-making.
Off-exchange consumers – those who purchased insurance directly from the insurer and who are not receiving financial assistance – are less price-driven and typically more loyal. Strengthen these relationships by emphasizing value-added benefits like virtual care, online portals to manage their plan benefits, and auto bill pay to enhance satisfaction and engagement.
Precision Marketing Strategies for Better Lead Conversion
Precision marketing blends data, personalization, and a mix of online and offline channels to boost lead conversions. Here’s how to optimize your strategy:
1. Personalized Messaging: Use consumer data to create relevant, impactful communications.
- For members, tailor messages using plan name/details, portal registration, billing preferences, and language needs to acknowledge their status and make it easy for them to manage their plan.
- For prospects, leverage demographics like age, gender, income, and marital status for targeted, appealing outreach. This approach strengthens connections, driving engagement and conversions.
2. Strategic Outreach Channels: A mix of direct mail and digital channels (email, search, display, and Google’s Performance Max, to name a few) ensures messages reach consumers effectively. Using first-party data (e.g., member purchase behaviors) significantly improves targeting accuracy. Lifecycle marketing enhances results by aligning outreach with consumer habits, from pre-OEP education to urgent final reminders near the end of OEP, maximizing campaign impact.
3. Simple Enrollment Paths: User-friendly digital tools, like cost estimators and guided support, streamline decision-making and reduce confusion. Phone-based enrollments offer a personal touch, increasing conversions and trust.
4. Year-Round Engagement: Sustained efforts post-OEP, including onboarding materials, education, wellness tips, and SMS or email updates, build loyalty. Monitoring feedback ensures outreach remains valuable, not intrusive.
The Case for Smart ACA Growth
Precision marketing isn’t just about better returns; it’s about meeting the demanding and changing needs of ACA consumers. Identifying high-value leads, delivering tailored experiences, and maintaining ongoing engagement will determine which payers thrive in a crowded marketplace.
Organizations must frequently assess their strategies critically. What’s working? What’s not? What’s missing? Missed opportunities or gaps in targeting, tactics, or messaging can be detrimental, but MERGE is here to help you assess, optimize, and elevate your ACA marketing efforts.
*Suzanne Velonis, MERGE Account Director, also contributed to this article.
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