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CMS proposes rule to build on ACA

Article

The rule includes provisions aimed at expanding access to healthcare.

CMS proposes rule to build on ACA

The Centers for Medicare & Medicaid Services (CMS) has releasees a proposed rule aimed at building on the Affordable Care Act (ACA).

According to a news release, the proposed rule includes provisions to extend the annual open enrollment period for 2022 by 30 days and creating a new special enrollment period for some low-income patients, and expanding the duty of federally facilitated exchange navigators to offer additional help to patients enrolling in health plans.

“With the ACA and American Rescue Plan, the Biden-Harris Administration is expanding access to affordable health insurance coverage for millions – for many, perhaps for the first time. The success of the special enrollment period opportunity clearly shows the demand for quality, affordable coverage,” CMS Administrator Chiquita Brooks-LaSure says in the release. “These latest steps aim to better fund outreach efforts and eliminate barriers to coverage. We’re making high-quality, low-cost coverage more accessible than ever.”

The proposed rule is built on and revisits many of the policies in the 2022 Notice of Benefit and Payment Parameters, the release says.

Some of the key provisions of the new rule include:

  • Giving exchanges the option to offer a special enrollment period for low-income patients
  • Streamlining operations of the federally facilitated exchanges, health insurers, and other stakeholders
  • Extending the annual open enrollment period in 2022 and all future years by 30 days
  • Modifying policies related to state innovation waivers like statutory guardrails and public notice flexibilities, as well as changes to the process of amending or extending the waivers
  • Increasing user fee rates for insurers in federally facilitated exchange states and state-based exchanges on the federal platform to fund patient outreach and education
  • Reinstituting expanded duties for navigators in federally facilitated exchanges to ensure patients have access to skilled assistance

More information on the proposed rule can be found in this factsheet from CMS, or in the full text of the proposed rule.

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