CMS directing $20M in ARP funding to improve access to state-based marketplace coverage
States with marketplaces will be enrolling more consumers and reassessing current enrollees' eligibility for financial assistance.
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The Centers for Medicare and Medicaid Services is directing $20 million in American Rescue Plan funding to support state-based marketplaces in a bid to improve affordable access to health coverage.
States can apply for funding to help modernize or update their systems, programs or technology to comply with federal marketplace requirements, including the recent provisions of the ARP that increased the financial assistance available to certain consumers.
SBMs that operate their own eligibility platforms have collectively enrolled more than 3.8 million consumers in marketplace coverage thus far for the 2021 plan year, according to CMS. Most consumers are now eligible for increased savings to reduce monthly premium payments, and many may be eligible for lower out-of-pocket costs, as in lower deductibles, due to changes made through the ARP.
This means states with marketplaces will potentially be enrolling more consumers and reassessing current enrollees' eligibility for financial assistance as consumers seek to access this broader financial help.
WHAT'S THE IMPACT?
Under this funding opportunity, up to 21 cooperative agreement grants can be awarded to currently-approved state-based marketplaces that meet the application requirements, including those that use the HealthCare.gov website for eligibility and enrollment.
SBMs can prioritize funding to make modifications to systems or technology infrastructure related to the implementation of federal requirements. This includes changes needed to ensure consumers can quickly receive a new eligibility determination in order to access the increased premium tax credits and cost-sharing reductions available through the ARP.
States may also use the funds for program policies or procedures that are required for the implementation of the federal requirements. This includes consumer notifications, consumer education or other assistance, stakeholder education or training, state and federal reporting, call center or appeal supports, staff training, and oversight and monitoring activities.
Applications from eligible SBM applicants will be due on July 20. CMS anticipates it will begin issuing grant awards in early September. The period of performance for the grant will be from the date of the award through September 9, 2022.
THE LARGER TREND
The Biden Administration, CMS and the Department of Health and Human Services have distributed billions in funds from the $1.9 trillion ARP in recent months. In May, the White House said it was investing $7.4 billion in ARP funds to hire and train more public health workers in order to better prepare for future pandemics, expecting this will create "tens of thousands of jobs."
It turns out May was a busy month for ARP funding allocations, as the Substance Abuse and Mental Health Services Administration said it was distributing $3 billion in funding – the largest aggregate amount of funding to date for its mental health and substance use block grant programs, according to HHS.
Meanwhile, HHS said it would make $1 billion available to strengthen the COVID-19 response and vaccination efforts in rural communities, meaning the Health Resources and Services Administration, a part of the HHS, will increase the number of vaccines sent to rural communities, expand testing and other COVID-19 prevention services, and work to increase vaccine confidence by partnering with local voices and community organizations.
HHS has also made $14.2 million available to expand pediatric mental healthcare access by integrating telehealth services into pediatric primary care, and $150 million to community-based healthcare providers to use for COVID-19 response for underserved communities.
ON THE RECORD
"Our state-based marketplaces are the gateway to quality, affordable healthcare for millions of consumers and these investments will make it even easier to sign up for coverage," said CMS Administrator Chiquita Brooks-LaSure. "This funding available to states will help them to provide consumers with swift eligibility determinations and enrollment into comprehensive healthcare plans. We applaud state-based marketplaces – many of which have provided opportunities for special enrollment periods during the COVID-19 Public Health Emergency – for their hard work."
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com
