CMS extends open enrollment period, launches initiatives to expand health coverage
CMS is also expanding services provided by federally-facilitated marketplace navigators, who help consumers understand benefits.
Photo: Alex Wong/Getty Images
In an effort to expand health coverage and access, the Centers for Medicare and Medicaid Services is extending regular open enrollment by 30 days, which will now run from November 1 to January 15, 2022, giving consumers more time to review and choose health plans.
The former enrollment period was November 1 through December 15.
CMS is also expanding services provided by federally-facilitated marketplace navigators – experts who help consumers, especially those in underserved communities, understand their benefits and rights, review options, and enroll in marketplace coverage.
Finally, the agency announced it's relaunching its "Champions for Coverage" program. The program currently includes more than 1,000 local organizations that are active in providing outreach and education about the Health Insurance Marketplace and how consumers can enroll in coverage through HealthCare.gov, Medicaid or the Children's Health Insurance Program (CHIP).
WHAT'S THE IMPACT?
CMS' stated goal in initiating these steps is to make it easier for consumers to sign up for affordable health coverage and to reduce health disparities in various communities nationwide.
In a bid to help reduce those disparities, the final rule on the 2022 Payment Notice expands Navigator services. Navigators in FFMs 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 premium tax credit reconciliation.
CMS also will 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.
On top of that, four times as many Navigators – 1,500 in all – will be available for consumers who use HealthCare.gov for the 2022 plan year thanks to $80 million in grant funding provided earlier this year by CMS.
The agency intends to connect this work to the Champions for Coverage program, a community initiative to spread the word about Open Enrollment with educational resources and "event-in-a-box" materials.
CMS has also established a new monthly special enrollment period targeting certain low-income individuals in marketplaces through HealthCare.gov. This, CMS said, provides most eligible consumers with one or more options to enroll in free or especially low-cost plans due to provisions in the American Rescue Plan.
The provisions also include flexibilities for state partners. For example, state marketplaces with their own eligibility and enrollment platforms will be able to set their own annual Open Enrollment Period end dates, so long as these dates are on or after December 15.
THE LARGER TREND
According to CMS data, about 8.3 million people selected individual market plans through the marketplaces using the federal platform during the 2021 open enrollment period.
This total enrollment is nearly the same as enrollments during the 2020 open enrollment period, despite the fact that New Jersey and Pennsylvania transitioned to state-based exchange platforms starting with the 2021 open enrollment period.
After removing these states from the total plan selection totals in the 2020 open enrollment period and comparing year-over-year trends, the results show plan selections this year increased by 7% from 2020, despite a decline in new consumers. Also, for the fourth straight year, the consumer satisfaction rate at the call center remained high – averaging over 90% – throughout the entire stretch.
The data indicates enrollment remained stable, and, with the investments over recent years to improve the stability and experience on the HealthCare.gov platform, more consumers were able to actively enroll or re-enroll in coverage this year without the need for waiting rooms, CMS said.
ON THE RECORD
"Healthcare is a basic human right, and the Biden-Harris Administration is committed to making health coverage more accessible than ever," said CMS Administrator Chiquita Brooks-LaSure. "With the Affordable Care Act and the American Rescue Plan, the president has brought affordable health coverage to millions – many of whom now have insurance for the first time.
"Today's action to extend the Open Enrollment Period by a month, to continue our investment in local healthcare Navigators, and to establish a special enrollment period for many low-income people, further demonstrates our commitment to connect families to coverage."
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com
