ACA navigator funds get massive boost to record level

Dive Brief:

  • CMS is increasing the amount available for Affordable Care Act navigators by eight-fold — the largest amount for that part of the program ever allocated at $80 million.
  • The agency also said Wednesday about 12 million people enrolled in an ACA plan during the 2021 open enrollment period, a 5% increase from the year prior. That does not include the ongoing special enrollment period. About a fifth of those enrollees were new to the exchanges, down slightly from that metric for the 2020 plan year.
  • The number of enrollees that received financial assistance was stable year over year at a bit less than 90%. Average monthly premiums were also consistent to 2020 at about $600 a month, CMS said.

Dive Insight:

The massive increase in funding to the system of people helping potential enrollees understand and select ACA plans is another sign from the Biden administration that a key healthcare policy priority is shoring up the law after four years of destabilization from the Trump administration.

President Joe Biden announced a special enrollment period for the exchanges because of the COVID-19 pandemic and related economic fallout — a measure the previous administration declined to take. The SEP started Feb. 15 and has been extended to run through Aug. 15. CMS said Wednesday that so far more than 500,000 people have signed up in the period.

The recently signed American Rescue Plan included a number of provisions to bolster that ACA, one of Biden’s core campaign promises. It included a temporary boost to the financial aid for those who qualify and also broadens the pool of people eligible for those subsidies.

The Congressional Budget Office has estimated that help will put 1.7 million more people in the exchanges, and the $1.9 trillion bill was cheered by the payer lobby.

The 12 million enrollees for the 2021 plan year is the second-highest in the past five years, coming in just under 2017.

Retrieved from CMS on April 22, 2021

Consumers have said they want enrollment assistance, as many find the process and terminology complicated. In 2017, the Trump administration cut funding from $63 million to $36.1 million before further reducing it to just $10 million in later years.

But as the Biden administration takes further steps to expand on the ACA, it still faces a threat at the Supreme Court, which heard arguments last year on a case seeking to overturn the law and declare it unconstitutional without its individual mandate. The decision is expected in the coming weeks or months.

Posted in Law