- The Biden administration is allocating $20 million to build up state-based Affordable Care Act marketplaces, CMS said Monday.
- States can apply for the funding provided by the American Rescue Plan to modernize or update their marketplace systems to comply with federal requirements, including some in the ARP increasing subsidies available to certain types of consumers.
- States that operate their own eligibility platforms enrolled more than 3.8 million people in marketplace plans so far for the 2021 plan year. Many of those consumers are now eligible for lower out-of-pocket costs or increased savings to lower monthly premium payments due to the ARP, meaning states with their own marketplaces will be enrolling more people and reassessing current eligibility. The grants should help with that, CMS said.
Currently, 13 states and Washington, D.C. run their own exchanges, while another six have their own exchanges but use the federal Healthcare.gov platform for open enrollment and subsidy eligibility determination.
The newly enhanced subsidies under the ARP, passed in March, are temporary and scheduled to expire after the 2022 coverage year. The White House has said, however, it would like them to be made permanent.
Under the new $20 million funding opportunity, up to 21 grants will be awarded to state-based marketplaces that meet application requirements, including those using Healthcare.gov. The marketplaces can use the money to modernize their systems or technology infrastructure, including changes to make sure consumers can receive a new eligibility determination quickly to access the cost-sharing reductions or increased premium tax credits under the ARP.
States can also use the grants to build up program implementation procedures, like consumer notifications, education or assistance, state and federal reporting, call center or appeal supports, staff training or oversight and monitoring activities, CMS said.
Applications for the grants are due July 20, and CMS plans to begin issuing grants by early September.
It's the latest round of funding the Biden administration has allocated to bolster the exchanges, a key tenet of President Joseph Biden's healthcare agenda. Earlier this month, CMS announced $80 million to nonprofits helping consumers navigate the exchanges. Those so-called navigators saw their funding plummet under the Trump administration, which focused on chipping away at key pieces of the ACA.
CMS is also currently holding a special enrollment period for consumers to sign up for ACA coverage due to the pandemic, open through August.
The ACA has faced a slew of legal and congressional challenges since it was passed roughly a decade ago, but now appears to be on the stablest footing it's enjoyed in a while. Last week, the Supreme Court decided to uphold the law following a drawn-out legal challenge from red states seeking to find it unconstitutional.
Experts think that decision and the ongoing support of the Biden administration will result in more consumers taking part in the exchanges. Private payers are investing more heavily in their exchange offerings as a result.