CMS Expects More Americans Will Qualify for Affordable Care Act Coverage in 2023

Consumers can start checking out Affordable Care Act marketplace health plans ahead of the 2023 open enrollment season, the Biden Administration announced.

“All families have the right to quality, affordable health care coverage. During this Open Enrollment period, consumers will have access to a variety of quality plan options at an affordable price.  We encourage consumers to visit HealthCare.gov and their state-based Marketplaces to preview plans and premiums now so that they’re ready to make selections when Open Enrollment begins on November 1,” said CMS Administrator Chiquita Brooks-LaSure.

CMS reported that 13 million Americans save on average $800 per year on health insurance. Through American Rescue Plan Act subsidies which have been extended for the next three years due to the Inflation Reduction Act, most consumers have access to health plans with a monthly premium of $10 or less.

The announcement also noted that the Affordable Care Act marketplace is more competitive this year. More than nine out of ten enrollees on the Affordable Care Act marketplace have access to health plans from three or more insurance companies (92 percent).

CMS expected more Americans would have access to Affordable Care Act marketplace plans in 2023 due to a number of changes.

For instance, new policies have provided a way for enrollees to access standardized plan options for 2023. In April 2022, CMS and HHS finalized a rule that requires federally-facilitated marketplaces and state based marketplaces on the federal platform have to offer standardized plans. Payers have expressed concerns that this approach will stifle innovation.

“Most of these standardized plan options offer many services pre-deductible, including primary care, generic drugs, preferred brand drugs, urgent care, specialist visits, mental health and substance use outpatient office visits, as well as speech, occupational, and physical therapy,” the announcement explained.

Additionally, more Americans will have access to Affordable Care Act marketplace plans due to a rule finalized earlier in October 2022 that aims to solve the family glitch. The rule allows families that cannot access affordable employer-based health plan coverage for the entire family to leverage premium tax credits to gain coverage on the Affordable Care Act marketplace.

The CMS announcement also shared that the Biden administration has significantly bolstered Navigator program investments. After increasing investments in outreach programs for the 2022 open enrollment season, the Affordable Care Act marketplace saw a record-breaking number of enrollees.

“We are delivering what Americans deserve: high-quality health care at affordable cost. We have been tireless in our efforts to increase competition, drive down costs, and connect people to coverage. We urge everyone to visit HealthCare.gov and find an affordable health plan that best meets their needs,” said HHS Secretary Xavier Becerra.