CMS Shares Affordable Care Act Marketplace Open Enrollment Details

With the Affordable Care Act marketplace open enrollment season around the corner, CMS has announced changes to its outreach and enrollment processes in a marketplace 2022 open enrollment fact sheet.

The agency noted certain upgrades on the HealthCare.gov site. For open enrollment 2022, the site will provide more detailed guidance about what consumers need for enrollment and what to expect in the application process.

Additionally, the site will now nudge consumers toward the plan information that might be most useful for them as the compare health plan options. For instance, these plans might highlight distinctions between health plans with similar premiums or direct individuals who are eligible for lower out-of-pocket healthcare costs to the lower cost silver plan options.

“The site now also includes educational information on key types of plan costs consumers may want to consider beyond the monthly premium when choosing a plan, such as deductibles, copays and coinsurance, and out-of-pocket maximums,” the fact sheet explained.

The site will undergo maintenance periods during Sunday mornings during the open enrollment period in order to keep the site updated and efficient.

CMS also worked to streamline healthcare coverage enrollment processes. These efforts started with expanding the role of Navigators to encompass promoting health equity. 

While Navigators already played a critical role in reducing enrollees’ confusion around open enrollment season and helping ensure that enrollees understood their health plan options, Navigators will now be able to address more specific subjects like appeals processes and premium tax credit reconciliation related to federal tax filings.

“In addition to an increased staffing capacity, Navigators will be offering more non-traditional appointment hours, bringing in-person assistance to consumers through the use of mobile units, and offering virtual appointments aimed at reducing transportation barriers,” the fact sheet detailed.

Given this new function, CMS also substantially increased the number of Navigators. In 2022, over 1,500 Navigators will serve enrollees.

In August 2021, the agency announced that it would offer $80 million in grants for Navigator programs with the goal of improving the programs’ capacities for reaching underserved populations. The funding is multi-year to help programs build long-term, equitable outreach strategies.

Another 4,550 assisters and 44,000 agents and brokers will fortify the Navigators’ efforts. Enrollees will have quick access to all of these professionals through a service that allows brokers and enrollees to connect by phone to receive enrollment and application assistance.

The agency will also continue to leverage the “Champions for Coverage” program that CMS re-launched during the special enrollment period.

CMS also noted that current enrollees who did not make any changes to their Affordable Care Act marketplace plan selection would be automatically re-enrolled in their marketplace plan. 

In 2020, CMS considered changing the automatic re-enrollment policy in the Notice of Benefit and Payment Parameters for 2021. Commenters almost unanimously opposed that suggestion and it did not become part of the finalized rule.

In 2022, enrollees will be automatically re-enrolled unless they take action to change their Affordable Care Act marketplace health plan selection, in accordance with the long-standing procedure.

HHS and CMS officials lauded the role that the American Rescue Plan played in lowering premiums on the marketplace.

“Thanks to enhanced subsidies in the American Rescue Plan, quality health care coverage is more affordable and accessible than ever on HealthCare.gov and state-based Marketplaces. Consumers can preview plans and prices now to find coverage that best meet their needs,” said CMS Administrator Chiquita Brooks-LaSure in a separate press release.

In light of the lower marketplace premiums, experts have been exploring the downstream impacts of making permanent the American Rescue Plan Act subsidies.