- President Joe Biden will declare a new enrollment period for the Affordable Care Act exchanges this week, an action health policy and patient advocates have been hoping for under the new leadership, as reported by The Washington Post and confirmed to Healthcare Dive by advocacy group Families USA.
- The administration will also begin the process of rolling back restrictions on Medicaid enrollment imposed by states under the former administration, according to the Post, which cited unnamed sources within HHS.
- While most state-based exchanges created special enrollment periods earlier in the COVID-19 pandemic, CMS under former President Donald Trump resisted calls to do so as his administration fought in court to overturn the landmark law that created the marketplaces.
The new administration is expected to take multiple steps to rebuild the ACA, which was steadily pared down under Trump. A special enrollment period will make signing up for federal exchange plans easier as many in the U.S. face the possibility of losing job-related coverage due to the economic upheaval from COVID-19.
Loss of income such as a change in job status will qualify someone to obtain ACA coverage even outside of a special enrollment period, but experts say opening up the exchanges to not require documentation of such a qualifying event will lower barriers to signing up.
Research has shown many consumers aren't aware of the annual open enrollment period at the end of the year. A Kaiser Family Foundation brief posted Monday noted ACA navigators have said investment in outreach and communication about a special enrollment period will be necessary for it to be effective.
"Navigators noted the importance of targeted outreach strategies to reach some consumers, including those who do not speak English, non-citizens, and those who have been uninsured for a longer period of time," according to the brief.
Estimates vary on how many people have lost employer-sponsored coverage over the past several months as the recession took hold in the U.S., but one analysis suggests as many as 14.6 million.
The number of people who bought an ACA plan over the regular sign-up period was about the same for 2021 as it was for the previous year at 8.3 million, CMS said earlier this month.
Other ways the Biden administration could shore up the ACA include increasing tax credit and subsidies as well as restricting the availability of non-compliant plans.
The extent of the executive actions expected on Medicaid is unclear, but under the previous administration, CMS took numerous steps to change the way some state plans worked. Eight states attempted to require people to work or volunteer a certain number of hours a month in order to qualify for the safety net coverage.
But those changes were routinely knocked down in lower courts, and the U.S. Supreme Court agreed last month to hear a consolidation of those cases.
The Trump administration also touted block grants for the program, and Tennessee was the first state to have such changes approved after Oklahoma backed off on its plan amid the pandemic. Those who support block grants say they will help control costs but opponents contend the format would severely curtail benefits.