On September 17, 2021, the Biden-Harris Administration and the Centers for Medicare & Medicaid Services (CMS) finalized a series of provisions that build on the Affordable Care Act (ACA). These policy updates advance health equity by making it easier for Americans to sign up for quality, affordable health insurance coverage and reducing health disparities in communities across the country. These provisions include:
Extended Open Enrollment Period
CMS is extending the annual individual market Open Enrollment Period by 30 days for 2022 and future benefit years, which will now run from November 1 to January 15, giving consumers more time to renew and choose health plans through HealthCare.gov. The former enrollment period was November 1 through December 15.
NOTE: Direct Enrollment (DE) and Enhanced Direct Enrollment (EDE) will be fully available for the upcoming 2022 Open Enrollment Period for Federally-facilitate Exchange (FFE) states. There are no changes to the current operations of the federal DE and EDE pathways.
Expanded Navigator Services
CMS is expanding services provided by Federally-Facilitated Marketplace (FFM) Navigators – experts who help consumers, especially those in underserved communities, understand their benefits and rights, review options, and enroll in marketplace coverage on Healthcare.gov.
FFM Navigators will now provide consumers with information and assistance on certain post-enrollment topics, such as the marketplace eligibility appeals process and marketplace-related components of the maximum advance premium tax credit (APTC).
Monthly Special Enrollment Period
CMS established a new monthly Special Enrollment Period targeting certain low-income individuals on Healthcare.gov. This opportunity provides one or more options to enroll in free or very low-cost plans, as well as advance payments of Premium Tax-Credits (APTC), to the vast majority of eligible consumers whose household income does not exceed 150% of the federal poverty level.
Increased FFM & SBM-FP User Fee
CMS will also enact what it calls modest increases to marketplace issuer fee rates, with the goal of enhanced outreach and engagement. All 2022 marketplace user fee rates remain lower than those for 2021, which the agency expects will keep premiums low for consumers.
For more information on these ACA updates, please refer to the following CMS resources:
- Press Release: https://www.cms.gov/newsroom/press-releases/cms-extends-open-enrollment-period-and-launches-initiatives-expand-health-coverage-access-nationwide
- Fact sheet: https://www.cms.gov/newsroom/fact-sheets/patient-protection-and-affordable-care-act-updating-payment-parameters-section-1332-waiver
- Final Rule: https://www.cms.gov/files/document/cms-9906-f-nbpp-webposting-version.pdf