Affordable Care Act changes proposed to help boost enrollment. Here’s what to know
President Joe Biden’s administration has proposed changes to the Affordable Care Act to increase coverage access.
The Centers for Medicare and Medicaid Services on Monday outlined a new proposed rule, which, if it takes effect, would expand the Affordable Care Act, or ACA’s, open enrollment period, create special enrollment periods for some Americans and aim provide more support for those enrolling in a plan.
The proposed rule was required to be published in the Federal Register to give the public an opportunity to submit comments, a CMS spokesperson told McClatchy News. Comments must be submitted by July 28, and a “final rule” will be released sometime after that.
CMS Administrator Chiquita Brooks-LaSure said in a news release that the latest proposals “aim to better fund outreach efforts and eliminate barriers to coverage.”
“With the ACA and American Rescue Plan, the Biden-Harris Administration is expanding access to affordable health insurance coverage for millions — for many, perhaps for the first time,” Brooks-LaSure said.
Expanding enrollment opportunities
Open enrollment is the period each year when people can enroll in a health insurance plan through the ACA’s marketplaces. Currently the period runs from Nov. 1 through Dec. 15.
The proposal would extend the ACA’s open enrollment by a month, through Jan. 15 of the next year, starting 2022 and in future years.
CMS says the expansion would “allow consumers more time to review plan choices, seek in-person assistance, and enroll in a plan that best meets their needs.”
Another proposed change would give marketplaces the option to create a special enrollment period for some low-income Americans.
Currently, people are eligible for a special enrollment period and can enroll at any time if they lose coverage or experience a life event such as getting married, having a baby or moving.
Biden signed an executive order in January creating a special enrollment period from Feb. 15 to May 15 in response to the COVID-19 pandemic. It’s since been extended through Aug. 15.
“The success of the special enrollment period opportunity clearly shows the demand for quality, affordable coverage,” Brooks-LaSure said.
The new rule would allow for a monthly special enrollment period for those eligible for “advance payments of the premium tax credit” and with a household income of no more than 150% of the federal poverty line.
The premium tax credits were included in the $1.9 trillion American Rescue Plan signed into law in March. They’re designed to reduce the premiums that eligible American pay for health care through the Affordable Care Act. Those who qualify can use the credit in advance to lower their premium payments.
Increasing outreach and enrollment support
The agency’s changes, if finalized, would also reinstate requirements for the Federally-facilitated Exchange Navigator Program to “ensure consumers have access to skilled assistance beyond applying for and enrolling in health insurance coverage.”
“The Federally-facilitated Exchange (FFE) Navigator Program reaches vulnerable and underserved populations and is important to increasing awareness of coverage options available through the Exchanges, helping new consumers find affordable coverage that meets their needs and narrowing health disparities,” CMS says.
Former President Donald Trump’s administration cut the program’s funding and dramatically scaled it back, MedCity News reports. But CMS said in April it was providing the program with $80 million in funding for the 2022 plan year.
Now, CMS says it’s proposing a reinstatement of “previous requirements that FFE Navigators provide consumers with information and assistance on post-enrollment topic,” including help with eligibility appeals, understanding coverage and how to use it and the the premium tax credit reconciliation process.
CMS says these proposals will “further support the (Biden administration’s) efforts to build on the successes of the ACA to meet health care needs created by the COVID-19 public health emergency, reduce individuals’ health care costs and make our health care system less complex to navigate.”
This story was originally published June 30, 2021 at 2:10 PM with the headline "Affordable Care Act changes proposed to help boost enrollment. Here’s what to know."
