The Biden administration is proposing some major changes to the Affordable Care Act marketplaces. That included expanding the enrollment period by 30 days in 2022 and beyond.
In a major development, CMS has suggested steps to increase American’s access to health coverage. That would impact the Navigator program, special enrollment periods, and even open enrollment.
According to details, the proposed rule included a variety of provisions. Which are aimed to protect and expand Americans’ access to high-quality, affordable health insurance.
The provisions include:
- Lengthen the annual open enrollment period for 2022 by an additional 30 days.
- Create a new special enrollment period opportunity for certain low-income consumers.
- Expand the duties of Federally-facilitated Exchange Navigators to offer additional help to consumers enrolling in plans.
The core objective behind proposing these rules is to make sure that a large number of Americans get healthcare coverage as well as quality medical care. It’s pertinent to mention here that this change would impact not only 2022. But rather it would be a permanent fixture of the enrollment cycle.
In an official statement, CMS Administrator Chiquita Brooks-LaSure said that: it might be the first time that the Biden Administration is expanding the healthcare insurance coverage of millions of people. Through significant changes in the ACA and American Rescue Plan.
She further elaborated that the success of the special enrollment period opportunity clearly demonstrates that the quality and affordable coverage is in high demand among people. While shedding light on the aim of this program, she made it clear that: CMS is working diligently to break the coverage barriers. And make the high-quality, low-cost coverage more accessible than ever.
What’s the Impact?
In addition, CMS has recommended the implementation of an income-based regular special enrollment period. Which aims to increase access to coverage through the Affordable Care Act.
In this scenario, those who wish to enrol in an ACA health plan could receive an advance payment of the premium tax credit (APTC). If their incomes are 150 percent of the federal poverty level (FPL) or below.
In addition to this, a 2.75 percent boost in user fees for health plans is also recommended. Eventually, that will contribute towards outreach and Navigator expenses. The proposed update also clarified some of the confusion around APTC eligibility and medical billing regulations for abortion services.
Furthermore, CMS recommends repealing the exchange direct enrollment option to reduce the strain on the federal platform. Earlier, the Trump administration enhanced direct enrollment pathways for the 2019 open enrollment season.