CMS: KY, ME, NM Will Launch State-Based Marketplaces in 2022

Three states will launch their own state-based marketplaces in 2022, the Department of Health and Human Services (HHS) announced through CMS.

Kentucky, Maine, and New Mexico will each bring have their own Affordable Care Act marketplace platforms in the coming year. According to CMS and HHS, a state-based exchange allows states to take a more localized approach to Affordable Care Act marketplace coverage.

Kentucky’s state exchange will be called kynect, Maine’s state exchange will be CoverME.gov, and New Mexico’s site will be beWellnm.

Individual health insurance marketplace open enrollment for plan year 2022 will start at the same time for these states as it does for states on the federally facilitated exchange: November 1, 2021. The window shopping period starts on October 15, 2021 for Maine and Kentucky’s state-based marketplaces and it started on October 1, 2021 for New Mexico.

Consumers in Kentucky, Maine, and New Mexico who are currently covered by an Affordable Care Act marketplace plan obtained through the federally facilitated marketplace will be able to renew their coverage through the state-based marketplace for 2022.

“Quality health care is a basic human right–and never has that need been more evident than during the COVID-19 global health pandemic,” said Kentucky Governor Andy Beshear. “Kentucky’s economy has caught fire and we’ve just landed the largest economic investment in the state’s history, but we can’t succeed in building a better Kentucky if our people are not healthy and ready to work.”

The state of Kentucky is not new to the state-based marketplace concept. From 2013 through 2015, kynect was considered one of the best performing state-based marketplaces. However, in 2016, the state began to transition to the federally facilitated marketplace. Enrollment on the Affordable Care Act marketplaces plunged as a result.

“kynect was a lifesaver for so many when it was first offered in 2013 and we’re excited to work with the U.S. Department of Health and Human Services to bring it back and make sure all Kentuckians can easily access the health plans and benefits they deserve,” Beshear said in the CMS announcement.

For Maine and New Mexico, the strictly state-based exchange is a fairly new endeavor. However, both states were considered state-based marketplaces on the federal platform. Additionally, each state has used the Affordable Care Act marketplace and Medicaid to extend access to care to more residents.

Maine expanded its Medicaid program, MaineCare, in 2020. As of the time of the CMS announcement that Maine would be starting its CoverME.gov site, MaineCare boasted 85,000 enrollees. Maine Governor Janet Mills cited this growth as a reason for starting the state’s own exchange.

New Mexico has also expanded its Medicaid program, Centennial Care Medicaid, and found other ways to extend coverage and affordable care to its residents.

“Our state also created a Health Care Affordability Fund that will provide further subsidies to uninsured New Mexicans to reduce out-of-pocket health care costs, which we expect will work in concert with the efforts of the Biden-Harris Administration to make healthcare accessible and affordable to everyone,” shared New Mexico Governor Michelle Lujan Grisham.

State-based health insurance marketplaces allow states to take a more localized approach to outreach which can result in cost-savings. 

However, states that pursue this route also face challenges, according to a report from the Center for Budget and Policy Priorities (CBPP). For example, the technology demands may be difficult for some states to meet.

In June 2021, CMS offered $20 million in grant funding to help states with state-based marketplaces improve enrollment processes and technologies. 

All of the state-based marketplaces followed the federal government’s lead in opening a special enrollment period due to the coronavirus pandemic. That special enrollment period proved overwhelming for some states, resulting in a backlog of eligibility determination processes.

In 2022, Kentucky, Maine, and New Mexico will join 15 other states that have already transitioned into state-based marketplaces.