In order to give people more time to sign up for quality and affordable health coverage. The Centers for Medicare & Medicaid Services (CMS) has extended the open enrollment period under the Affordable Care Act by 30 days. The initiative has been taken in the wake of_worsening situation of the job market(where many get health insurance), due to the ongoing pandemic. It will eventually reduce health disparities in communities across the United States.
According to the official press release issued by the federal authority. Healthcare consumers are given extra 30 days, starting from November 1, 2021, through January 15, 2022. In this way, they will get more time to carefully review and choose health plans through Open Enrollment. Individuals can enroll themselves on HealthCare.gov. In addition to this, CMS is all set to expand the services of Federally-facilitated Marketplace (FFM) Navigators. They are experts who help patients_particularly those who belong to the underprivileged areas in understanding their rights, available options, and getting enrolled in Marketplace coverage.
Furthermore, the Centers for Medicare & Medicaid Service will re-launch its “Champions for Coverage” program. Which represents the uninsured communities to educate them about the process of: how can they enroll in coverage through HealthCare.gov, Medicaid, or the Children’s Health Insurance Program (CHIP). Currently, over 1000 local organizations are working under the banner of this program to outreach depriving communities. Eventually, the expansion of the enrollment period and Navigator’s duties will play an active role in minimizing the burden and confusion of the people.
Moreover, this initiative is a clear depiction of the Biden-Harris Administration’s objective to enhance healthcare affordability & and expansion to coverage. Health and Human Services Secretary Xavier Becerra in an official statement said that: the HHS is committed to addressing the public concerns regarding affordable and accessible care. Moreover, while talking about the US government’s historic investments to expand the communities healthcare coverage. He made it clear that the Biden-Harris Administration continues to build a policy framework to support this momentum. And helping the communities in need.
In addition to this, CMS Administrator Chiquita Brooks-LaSure has said that no doubt healthcare is a basic human right. So, in order to ensure the accessibility of this right to every American. The Affordable Care Act and the American Rescue Plan have brought a drastic transformation in the US healthcare industry. These programs have helped millions of people to get healthcare coverage. And the majority of the consumers have insurance for the first time. While backing the HHS decision to extend the enrollment period by a month and extending local health navigators. She said that this move will help to reach many low-income people to connect to coverage.
The key provisions of this final rule include the following:
Improving Access to Coverage
The services of Federally-facilitated Marketplace (FFM) Navigators witnessed an expansion. Which aims to reach vulnerable and underserved populations to reduce the health disparities. These navigators will create awareness among people and provide them assistance in understanding certain post-enrollment topics. Such as; marketplace-eligibility appeals process, marketplace-related components of the premium tax credit reconciliation process, basic concepts & rights of health coverage_and how to use it, and finding affordable coverage that meets the consumers’ needs.
Additionally, the rule also incorporates the check and balance to know that: what activities or initiatives are being taken to provide the people with information and needed assistance_ related to the rights of health coverage and how to get benefitted.
2022 Open Enrollment:
According to this rule, healthcare consumers get a 30 days extension in the Open Enrollment Period for 2022. So they become better able to get extra time for reviewing health coverage plans, making choices, and seeking in-person assistance. And enroll in a plan that best meets their individual needs.
State Marketplaces not using the federal eligibility and enrollment platform maintain flexibilities regarding effective date rules and Open Enrollment end dates, provided the Marketplace’s Open Enrollment end date is no earlier than December 15 of the calendar year preceding the relevant benefit year. Monthly Special Enrollment Period (SEP) for Advance Payments of Premium Tax Credits (APTC)-Eligible Consumers with Household Income up to 150% of the Federal Poverty Level (FPL) whose Applicable Taxpayer has an Applicable Percentage of Zero.
- To enhance the healthcare coverage and ensure its availability to the vulnerable communities. CMS intends to connect this work to the Champions for Coverage program. It’s a community initiative to spread awareness about Open Enrollment. Which will be executed with the help of educational resources and “event-in-a-box” materials.
- Along with expanding the duty of the navigators as well as giving an extension to the Open Enrollment period. CMS has also established a new monthly special enrollment period. Which is designed while keeping in mind the low-income individuals in Marketplaces. In this way, a vast majority of eligible healthcare consumers can get themselves enrolled in free or very low-cost. It’s pertinent to mention here that: the American rescue Plan has significantly contributed to achieving the health equity targets.
- Furthermore, the federal agency has also allowed state partners having their own eligibility and enrollment platforms, to set their own annual Open Enrollment Period end dates.
- The rule repeals the Exchange Direct Enrollment option. This option permitted a state Marketplace, SBM-FP, or an FFM state to facilitate enrollment of qualified individuals into individual market QHPs primarily through private-sector direct enrollment entities, including QHP issuers, web brokers, agents, and brokers, rather than the Marketplace’s centralized website.
- The final rule has also repealed a separate billing regulation that required individual market qualified health plan (QHP) issuers to send a separate bill for that portion of a policyholder’s premium attributable to coverage for abortion services for which federal funding is prohibited.
The Centers for Medicare & Medicaid Services has also invited the local organizations. That is working closely with the uninsured communities to join hands with the federal government in order to expedite the process of providing health coverage to the consumers on a large scale. The representatives of the CMS made it clear that: the federal agency is committed to listening and working with the navigators as well as community partners to ensure robust outreach to the uninsured people.
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