New CMS guidelines will extend ACA open enrollment, boost fees for insurers
The rule would extend the open enrollment period on federally run exchanges to January 15.
ACA open enrollment is being extended by one month under new guidelines from the Centers for Medicare & Medicaid Services (CMS), Fierce Healthcare reported. The fees that insurers pay for participating in the exchanges also will increase slightly.
The third part of the 2022 Notice of Benefit and Payment Parameters lays out standards and regulations for the ACA exchanges for the 2022 coverage year. The rule builds on previous final rules governing ACA exchange insurers and related stakeholders in January and May of this year.
Related: Here’s what ACA plans cost in 2021 without subsidies
The rule would extend the open enrollment period on federally run exchanges to January 15. Open enrollment for the federal exchanges still starts on November 1. For 2022, insurers will face an increase in the federally run marketplace user fee rate to 2.75% of their premiums and to 2.25% in state-run exchanges.
CMS said the goal is to enable more customers to get help picking a plan, especially since the agency has boosted the number of navigators available for assistance. The number of navigators increased to 1,500 because of an $80 million grant provided by CMS earlier this year. The regulation also will enable navigators to give consumers information and assistance on topics they may need to know after they choose a plan, such as how to make an appeal for marketplace eligibility and the components of reconciling premium tax credits.
The increased user fee funding will go toward this additional outreach. The goal is to target people who could be eligible for higher subsidies that were included in the American Rescue Plan Act but expire after the 2022 coverage year. Congress is debating whether to extend those subsidies as part of a $3.5 trillion infrastructure package.
CMS also seeks to roll back guidance released in 2018 under the Trump administration that changed guardrails for Section 1332 waivers that enable states to make changes to individual and small-group insurance markets. The waivers have key guardrails that prevent states from significantly altering major ACA coverage requirements.
The final rule is the latest attempt by CMS to roll back several Trump administration policies about the ACA exchanges.
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