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Biden administration to extend Affordable Care Act sign-up period by 30 days

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The annual open-enrollment period on the federal exchange,, will run from Nov. 1 through Jan. 15, 2022, according to a decision by the Centers for Medicare and Medicaid Services. Open enrollment traditionally has ended in mid-December.

“The rule extends the annual individual market Open Enrollment Period for 2022 and future benefit years to allow consumers more time to review plan choices, seek in-person assistance, and enroll in a plan that best meets their needs,” CMS said in a statement.

The administration is also taking other steps aimed at boosting enrollment. CMS will let marketplaces offer a monthly special enrollment for certain low-income people who are eligible for subsidies that reduce premium costs. The agency will also boost funding support for navigators—individuals and organizations that help people enroll in coverage—by raising user fees on health insurers to 2.75% of premiums from 2.25%, according to the rule.

The agency is also repealing a rule that required insurers to send a separate bill to consumers for portions of a policyholder’s premium related to abortion services.

The Republican Trump administration completed a rule in 2019 requiring insurers to send a separate bill to patients for abortion services. Officials at the time said they were seeking to enforce existing laws that require separate billing for abortion services, but women’s reproductive-rights group said consumers would be confused by multiple bills.

President Biden has sought to build on the ACA as a key means of increasing health coverage in the U.S. Enrollment in recent years has largely held steady, with about 11.4 million consumers signing up for coverage for 2020 under the Obama-era health law Democrats enacted when Mr. Biden was vice president.

“Today’s action to extend the open enrollment period by a month, to continue our investment in local health care navigators, and to establish a special enrollment period for many low-income people further demonstrates our commitment to connect people to coverage,” CMS Administrator Chiquita Brooks-LaSure said in a statement.

Agency officials said four times as many navigators, or 1,500 in all, would be available in the fall open-enrollment period for consumers who use, under $80 million in grant funding the agency provided earlier this year.

Navigators that help with sign-ups will now provide consumers with information and assistance on certain post-enrollment topics, such as help with eligibility appeals, CMS officials said. State-run exchanges will be able to set their own annual open-enrollment-period end dates, so long as those dates fall on or after Dec. 15, 2021.

Congressional Democrats and the Biden administration took a number of actions this year to make it easier and cheaper to get coverage under the law, including by providing larger subsidies, more time to sign up for plans and greater outreach and marketing around the enrollment period.

The sign-up window on stretched from Nov. 1 through Jan. 15, about a month longer than in previous years. The expanded time followed a special sign-up period from mid-February through Aug. 15, when more than 2.5 million people signed up for coverage.

In the biggest change to the ACA since its passage in 2010, Congress in March increased subsidies to people who buy health plans on the law’s exchanges. The legislation provided two-year, temporary expanded subsidies as part of Democrats’ $1.9 trillion Covid-19 relief package, which lowered premium costs for millions of consumers. The law also provided subsidies to more people earning above the federal poverty level, without requiring them to pay a specific percentage of their income on healthcare.

Prices for many fell. A 60-year-old earning $55,000 annually paid 56% less for the most popular midprice health plan, or $390 compared with $887 a month, according to an analysis by the Kaiser Family Foundation.

Democrats are now weighing whether to make the temporary boost in subsidies permanent as part of a $3.5 trillion budget package. Republicans remain opposed to the 2010 health law, saying its requirements for minimum benefit standards have led to higher premiums. They also say the law has usurped too much state authority over health plans.

Open enrollment also coincided with a pandemic that has seen major upheaval in the job market where about half of Americans obtain health coverage. An estimated six million people who got health benefits sponsored by their employers experienced layoffs, according to an analysis by the Urban Institute.

Still, the percentage of adults with health insurance remained largely unchanged at 11% in the first year of the pandemic, based on the analysis.

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