CMS To Congress: ‘Time Is Of The Essence’ On Extending Boosted ACA Subsidies

Affordable Care Act officials need to start letting consumers know that enhanced subsidies will be in place for next year, the head of the Centers for Medicare & Medicaid Services (CMS) said.

But Congress has yet to pass legislation extending the boosted subsidies past this year, causing new alarm from CMS and state-run exchanges as open enrollment for the 2023 coverage year starts in November and plans are already creating their rates.

“Time is of the essence,” CMS Administrator Chiquita Brooks-LaSure told reporters Wednesday. “It is really now where we want to make sure that people know that the subsidies will be in place.”

The American Rescue Plan Act boosted subsidies from 2021 through 2022, ensuring that some low-income customers receive zero-dollar or $10-a-month premiums.

The enhanced subsidies helped fuel a record 14.5 million enrollment on the ACA exchanges for the 2022 coverage year.

While the House passed legislation last year to extend the subsidies through 2025 as part of the Build Back Better Act, that $1.75 trillion package has stalled in the Senate due to opposition from Sen. Joe Manchin, D-West Virginia.

As Democrats scramble to figure out their next steps, regulators and insurance plans are left in limbo. Colorado’s ACA exchange, for example, is going through insurer rate reviews currently, and officials said they would like to know sooner rather than later about the fate of the insurance subsidies.

If the exchange knows later, then “we can make that work, but it creates confusion for the consumer to explain to them why they are seeing this big difference” in their rates, said Kevin Patterson, CEO of Connect for Health Colorado, during the call with reporters.

Brooks-LaSure didn’t say whether there is a hard and fast deadline for Congress to approve the subsidies. She said the agency can “pivot as quickly as we need to” if Congress approves the subsidies in the fall.

However, if Congress acts during open enrollment, it would be difficult to relay to consumers about the changes to their rates while they are shopping for plans, Brooks-LaSure said.

Previous estimates have shown that more than 3 million people could lose coverage next year if the subsidies aren’t renewed. Some state exchanges have also said that consumers used the new premiums to buy a more expensive plan such as a gold tier plan and may narrow their coverage options if the subsidies go away.

During the last open enrollment, CMS and other stakeholders devoted a lot of energy to help consumers understand the reason for the lower prices for plans.

“We don’t want to do that in the middle of open enrollment,” she added.


Source Link

Recommended Articles

AI in Healthcare: Calls for Stricter Standards Amid OpenAI Leadership Shuffle

Recent disruptions in OpenAI’s top brass have sparked intense dialogue within the healthcare sector, emphasizing the urgent need for robust standards governing the implementation of generative AI technologies. With Microsoft recruiting former OpenAI executives Sam Altman and Greg Brockman, concerns are growing that few corporations may soon dictate the trajectory of healthcare AI, potentially molding ...

Read More

2024 FSA, HSA, and HDHP Plan Limits

A health Flexible Spending Account (FSA) is an employer-sponsored benefit that allows eligible employees to save pre-tax dollars to pay for qualified medical expenses. Employees can elect a specific dollar amount, up to a certain limit, to set aside annually.

Read More

Proposals On PBMs And Medical Devices Advanced By House Subcommittee

The House Committee on Energy and Commerce health subcommittee pushed forward 21 proposals on Tuesday, some of which will restrict the power of pharmacy benefit managers (PBMs). Democrats supported many of the proposals put forward by Republicans, including legislation reining in PBMs that had support from 60 organizations representing patients, providers, pharmacists, small businesses and ...

Read More

CMS Tightening Network Adequacy Standards For Exchange Plans

Beginning in 2025, health plans sold in state-run insurance exchanges would be required to meet time and distance standards that are at least as adequate as mandated on federal marketplaces, according to a rule released by the Centers for Medicare & Medicaid Services (CMS) on Wednesday. Time and distance standards would be calculated at the ...

Read More