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Feds Plan to Add Extra Month to ACA Open Enrollment

Proposed rule changes would also expand access to health insurance for low-income Americans

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The annual Affordable Care Act (ACA) open enrollment period would be extended by an extra month — lasting from Nov. 1 through Jan. 15 — under a proposed Centers for Medicare and Medicaid Services (CMS) regulation.

Open enrollment for ACA plans had been reduced from three months to 45 days in 2017. Narrowing the enrollment period to between Nov. 1 and Dec. 15 was something that AARP said at the time would “impact the ability of people to get coverage.” Federal officials say that the reduction in the annual window people have had to enroll in an ACA health plan or change their coverage since 2017 has negatively affected consumers who do not have enough time to see if they can get a health insurance plan that they can afford and that meets their needs. The proposed regulation also says that the shortened period hasn't left enough time for consumers to get the enrollment help they need from insurance navigators, agents and brokers.

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"The additional time for enrollment assistance provided by this proposal may be particularly beneficial to consumers in underserved communities who may face time or language barriers in accessing health coverage,” the proposal says.

AARP strongly supported the current special enrollment period that the federal government created in light of the increased needs for coverage during the COVID-19 pandemic. Consumers have until Aug. 15 this year to enroll in an ACA plan or change their coverage. (Some states that run their own ACA marketplaces have even later deadlines.) And as part of the American Rescue Plan, the federal government is temporarily offering more financial assistance to people with ACA plans.

"From what we have seen during the current special open enrollment period, there has been a tremendous appetite to get health coverage through the health insurance marketplace,” says Glen Fewkes, AARP's director of health care access and affordability. “There are so many millions in the country who may qualify for premium tax credits, especially those in the 50-to-64 age group.” During the first six months of the pandemic, workers age 55 and older were 17 percent more likely to lose their jobs than employees who were just a few years younger. And that job loss meant that many of those workers found themselves without health insurance.

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Expanded access for low-income Americans

The proposed rule would also create a monthly special open enrollment period for individuals without insurance whose household income is no more than 150 percent of the federal poverty level ($19,320 for an individual and $39,750 for a family of four in 2021). This means people in that income category would not have to wait for the annual open enrollment period to get coverage.

"Given the established challenges with promoting awareness of access to coverage among low-income consumers, we believe additional enrollment opportunities for low-income consumers are appropriate and in the best interest of low-income consumers,” the proposed rule says. The proposal would especially help consumers who lose their Medicaid coverage to get alternative coverage. This will be particularly important after the COVID-19 public health emergency ends because states have generally suspended disenrolling Medicaid recipients during the pandemic whose incomes are now too high to qualify for Medicaid.

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"The incomes for folks at that lower income level can often change very quickly,” Fewkes said, “and so there is some level of churning between Medicaid and the private market. To give people increased opportunities to adjust their coverage is a good development."

Dena Bunis covers Medicare, health care, health policy and Congress. She also writes the “Medicare Made Easy” column for the AARP Bulletin. An award-winning journalist, Bunis spent decades working for metropolitan daily newspapers, including as Washington bureau chief for the Orange County Register and as a health policy and workplace writer for Newsday.

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