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.

 

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