“President Biden promised to build on the success of the Affordable Care Act, and just one year into his Administration, we have already broken records with all-time high enrollment numbers and all-time low prices,” said HHS Secretary Xavier Becerra. “We will continue working to deliver on that promise until we make health care a right for all.” 

During the first full year of the Biden-Harris Administration, nearly 6 million new consumers signed up for coverage through the Marketplaces nationwide during the 2021 Special Enrollment Period (SEP) and this year’s Open Enrollment Period (OEP). This includes 2.8 million people who newly enrolled during the SEP and more than 3 million who newly enrolled during the OEP. Thanks to the ARP, Marketplace plans were more affordable than ever, contributing to a record-breaking 14.5 million consumers nationwide signing up for health care coverage – a 21 percent increase from last year. 

“On the 12^th Anniversary of the ACA, it is clear that the Affordable Care Act and the American Rescue Plan are working to expand access to health care coverage and have been critical to advancing health equity,” said CMS Administrator Chiquita Brooks-LaSure. “The Biden-Harris Administration’s ARP subsidies were successful and ensured that more Marketplace consumers than ever had access to quality, affordable health care and the peace of mind that comes with having health care coverage that best fits their needs.” 

A report released by the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) showed that more Americans have gained coverage during 2021, as the ARP and other Administration policies took effect. In addition, without the ARP, the average monthly premium after Advanced Premium Tax Credit (APTC) for HealthCare.gov enrollees would have been $59 per month higher, or 53 percent higher. According to a new ASPE report released today, an estimated 3.4 million Americans currently insured in the individual market would lose coverage and become uninsured if the ARP’s premium tax credit provisions are not extended beyond 2022. 

Finally, the uninsured rate fell after implementation of the ARP, the 2021 SEP, and expanded outreach efforts. The uninsured rate for the U.S. was 8.9% for the third quarter of 2021 (July – September 2021), down from 10.3% for the last quarter of 2020. 

The Biden-Harris Administration has made it a priority to continue to strengthen the ACA. President Biden is committed to building on the progress made by the ACA by reducing premiums for the millions of Americans enrolled in Marketplace coverage and closing the Medicaid coverage gap, which would lead to four million uninsured people gaining coverage. Over 18.7 million adults are now covered across 39 states (including the District of Columbia) due to Medicaid expansion, though 12 states have not expanded.  

The Biden-Harris Administration also recently announced a new SEP opportunity for low-income consumers with household incomes under 150% of the Federal Poverty Level who are eligible for premium tax credits under the ACA and ARP, which is approximately $19,000 for an individual and $40,000 for a family of four in 2022. In states that use the HealthCare.gov platform, 45% of consumers who signed up for health coverage during the 2021 SEP had household incomes under 150% of the Federal Poverty Level. This new SEP will make it easier for low-income people to enroll in Marketplace coverage throughout the year and benefit from the ARP savings.

HHS is hosting a week-long celebration of the 12-year anniversary of the ACA, from March 21 through March 25, highlighting the impact of the law and the Biden-Harris Administration’s commitment to building on its success. The theme of this week-long celebration is: “ACA: 12 Years of Advancing Health Equity for All Americans.” During the week, each day, HHS will spotlight ways in which the ACA has made gains in addressing health disparities of women and families, kids, older adults, people with disabilities, LGBTQI+ and communities of color.  

Please view the State of the ACA Report here.

To view the 2022 Open Enrollment Report, visit: https://www.cms.gov/files/document/health-insurance-exchanges-2022-open-enrollment-report-final.pdf.

 To view a comprehensive Briefing Book on the ACA, highlighting HHS reports from the past year, visit: https://aspe.hhs.gov/reports/aca-accomplishments.

 High resolution photographs are available from the recent commemoration of the 12th Anniversary of the ACA and may be accessed here: https://cmsbox.app.box.com/s/t83tnhtwk9ahg6pprgcfxow4bkl6f04m/file/934549102386.

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“We are committed to providing equitable access to quality health care and removing any barriers to quality health care,” said Health and Human Services Secretary Xavier Becerra. “We want to hear directly from stakeholders so we can strengthen our programs for the more than 80 million Americans with Medicaid or CHIP health insurance. Together, by advancing health equity, we can ensure quality health care is within reach for everyone who needs it.”

 “Medicaid and CHIP provide essential health coverage for over 80 million individuals and families,” said CMS Administrator Chiquita Brooks-LaSure. “Ensuring every eligible person can access the coverage and care to which they are entitled is a foundational principle of health equity and our work at CMS. We invite interested stakeholders and individuals with lived experience to join us in this mission, starting by responding to the request for information.”

“With this RFI, we are taking a first step towards a broader perspective of what ‘access’ to Medicaid means,” said CMS Director of the Center for Medicaid and CHIP Services Daniel Tsai. “Ensuring access to Medicaid includes addressing a range of barriers current and potential Medicaid beneficiaries may experience, from enrolling in Medicaid to maintaining coverage, to accessing care across both fee-for-service and managed care delivery systems. Access must also cross physical health care, behavioral health, and home and community based services. We look forward to capturing a wide range of perspectives from different stakeholders with this RFI.”

Feedback obtained from the RFI announced today will aid in CMS’ understanding of enrollees’ barriers to enrolling in and maintaining coverage and accessing needed health care services and support through Medicaid and CHIP. This information will help inform future polices, monitoring, and regulatory actions, helping ensure beneficiaries have equitable access to high-quality and appropriate care across all Medicaid and CHIP payment and delivery systems, including fee-for-service, managed care, and alternative payment models. The RFI submissions will also inform CMS’ work to ensure timely access to critical services, such as behavioral health care and home and community-based services. 

Evidence shows that while Medicaid and CHIP generally provide comprehensive coverage for health care services, some enrollees still experience challenges accessing providers and medical services despite statutory access protections in Medicaid. CMS’ access RFI aims to gather information to help understand many of these concerns with feedback from experts, beneficiaries, and community members with lived experience of the agency’s programs.

The RFI seeks feedback from a diverse set of stakeholders on a broad set of topics from ensuring adequate payment rates to encouraging provider availability and quality, to culturally and linguistically competent care and reducing gaps in health care coverage. Interested parties may access the RFI questions and provide comment on Medicaid.gov.  The RFI is open for a 60 day public comment period beginning February 17, 2022.

To read the RFI, visit: https://cmsmedicaidaccessrfi.gov1.qualtrics.com/jfe/form/SV_6EYj9eLS9b74Npk

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This is the first time that Medicare has covered an over-the-counter test at no cost to beneficiaries. There are a number of issues that have made it difficult to cover and pay for over-the-counter COVID-19 tests. However, given the importance of expanding access to testing, CMS has identified a pathway that will expand access to free over-the-counter testing for Medicare beneficiaries. This new initiative will enable payment from Medicare directly to participating pharmacies and other participating entities to allow Medicare beneficiaries to pick up tests at no cost. CMS anticipates that this option will be available to people with Medicare in the early spring.

Until then, people with Medicare can access free tests through a number of channels established by the Biden-Harris Administration. Medicare beneficiaries can:

Request four free over-the-counter tests for home delivery at covidtests.gov. Access COVID-19 tests through healthcare providers at over 20,000 free testing sites nationwide. A list of community-based testing sites can be found here. Access lab-based PCR tests and antigen tests performed by a laboratory when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional at no cost. In addition to accessing a COVID-19 lab test ordered by a health care professional, people with Medicare can also already access one lab-performed test without an order, also without cost sharing, during the public health emergency.

In addition:

Medicare Advantage plans may offer coverage and payment for over-the-counter COVID-19 tests as a supplemental benefit in addition to covering Medicare Part A and Part B benefits, so Medicare beneficiaries covered by Medicare Advantage should check with their plan to see if it includes such a benefit. All Medicare beneficiaries with Part B are eligible for the new benefit, whether enrolled in a Medicare Advantage plan or not.

For more information, please see these Frequently Asked Questions, https://www.cms.gov/files/document/covid-19-over-counter-otc-tests-medicare-frequently-asked-questions.pdf (PDF)

www.cms.gov | Contributed

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“By supporting conversations between families and health care providers and answering parents’ questions, we can connect more children to effective vaccines,” said CMS Administrator Chiquita Brooks-LaSure. “The Biden-Harris Administration is requiring states to cover vaccine counseling through Medicaid to create the space for children and parents to ask questions, get answers, and receive the information they need from trusted partners.”

CMS will now consider certain COVID-19 vaccine counseling visits for children and youth to be COVID-19 vaccine administration, for which state expenditures can be federally matched at 100% through the last day of the first quarter that begins one year after the end of the COVID-19 public health emergency, under the American Rescue Plan (ARP).  CMS will match COVID-19 vaccine counseling-only visits at the ARP 100% federal match rate only when they are provided to children and youth under age 21 as part of the Medicaid Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit.  

Additionally, moving forward, CMS will require that states cover stand-alone vaccine counseling visits related to all pediatric vaccines under the EPSDT benefit. These state expenditures will be matched at the state’s regular federal medical assistance percentage.

This action not only underscores the importance of vaccination education, but is also a critical step towards protecting families by increasing their access to information from providers as they make informed decisions concerning vaccinations for their children.

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This guidance furthers the Biden-Harris Administration’s efforts to improve Medicaid and CHIP beneficiaries’ health outcomes and reduce health disparities.  

In addition to issuing today’s Medicaid and CHIP guidance, CMS recognizes and applauds the efforts that many private issuers have taken to waive cost sharing for COVID-19-related treatment in the commercial market. Along with today’s guidance, CMS encourages private health plans to continue to take steps to ensure consumers have coverage for treatment for COVID-19, including for long COVID, without cost barriers.

“The American Rescue Plan expanded coverage for COVID-19 care. The pandemic has exacerbated the inequities that underlie our health care system, and we must continue to work on both the federal and state levels to improve access to and quality of care for everyone,” said CMS Administrator Chiquita Brooks-LaSure. “This guidance will guarantee COVID treatment for people with Medicaid coverage, including those who have been disproportionately harmed by COVID-19. Now that people with Medicaid and CHIP coverage have the comfort in knowing that their COVID treatment is covered, we encourage private health plans to take steps to ensure cost is not a barrier for consumers’ access to treatment for COVID-19, including for long COVID.”

Under the ARP, states are required to cover COVID-19 treatments without cost-sharing, including preventive therapies and specialized equipment, beginning March 11, 2021 and generally ending over a year after the COVID-19 public health emergency ends. This coverage also includes treatments for post-COVID conditions, which are often described as “long COVID.”  Long COVID includes a range of symptoms that can last weeks or months after infection. Additionally, during the same time frame, states are required to cover, without cost-sharing, treatments for conditions that may seriously complicate the treatment of COVID-19 for individuals who have or are presumed to have COVID-19, if otherwise covered under the state plan (or waiver of such plan, including a section 1115 demonstration), during the period when they are diagnosed with or presumed to have COVID-19. 

In accordance with these provisions of the ARP, states must cover drugs that have been approved, or authorized by the U.S. Food & Drug Administration (FDA) to treat or prevent COVID-19, consistent with the applicable authorizations.

CMS continues to work to expand coverage, increase benefits, and improve care for beneficiaries across Medicaid, CHIP, Medicare, and the Marketplaces.

For more information on Medicaid and CHIP coverage of COVID-19-related treatments, visit: : https://www.medicaid.gov/federal-policy-guidance/downloads/sho102221.pdf

For more information on Medicare and Marketplace coverage of COVID-19-related treatments visit:

Medicare:  https://www.medicare.gov/coverage?coverage_search=covid

Marketplace:  https://www.healthcare.gov/coronavirus/

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The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), is awarding $20 million in American Rescue Plan (ARP) grant funding to State-based Marketplaces (SBMs) to increase consumer access to affordable, comprehensive health insurance coverage. The grants will be used by 21 SBMs to modernize IT systems and/or conduct targeted consumer outreach activities to help make health care coverage enrollment smoother. As a result, consumers will have access to increased financial assistance and eligibility determinations will be made faster.

“It should be easy and convenient for anyone to sign up for a health care plan,” said Health and Human Services Secretary Xavier Becerra. “This investment from the American Rescue Plan will help states cover more uninsured residents while providing a smooth transition to other sources of health coverage for Medicaid enrollees who may lose coverage. The Biden-Harris Administration is committed to ensuring access to health care for everyone is possible, and will continue to make improvements in the system.”

The grant funding issued today not only helps states provide swifter eligibility and enrollment processes for new consumers purchasing Marketplace coverage, but also helps states to reassess current enrollees’ eligibility for increased savings made available through the ARP. The ARP reduced health coverage costs for consumers with many consumers finding plans for $10 or less per month. As a result of the ARP, most consumers purchasing Marketplace coverage are now eligible for increased Advance Payments of the Premium Tax Credit (APTC) that reduce their portion of monthly premiums.

“When we improve access to quality, affordable health coverage – people sign up. With these American Rescue Plan funds, we are investing in increasing consumer education and awareness about the greater financial assistance now available,” said CMS Administrator Chiquita Brooks-LaSure. “Producing consumer notices in additional languages and targeting outreach to the underinsured and uninsured are just a few approaches states will use to connect members of these communities, particularly vulnerable and underserved populations, to affordable health coverage.”

The 21 SBMs that received the ARP grant funding include the District of Columbia and the following states: Arkansas, California, Colorado, Connecticut, Idaho, Kentucky, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, and Washington. States with a Federally-Facilitated Marketplace (FFM) were not eligible for this funding opportunity. Grant award amounts range from $500,000 to $1,107,392, and are based on the SBM model and number of successful applicants. The period of performance is from September 10, 2021 through September 9, 2022.

For more information on the 21 SBMs that received the funding and use of the funds, please visit:

https://www.cms.gov/files

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The Biden-Harris Administration is expanding the number of Navigator organizations to help people enroll in coverage through the Marketplace, Medicaid, or the Children’s Health Insurance Program (CHIP) in 30 states with a Federally-Facilitated Marketplace. Through $80 million in grant awards for the 2022 plan year, 60 Navigator awardee organizations will be able to train and certify more than 1,500 Navigators to help uninsured consumers find affordable and comprehensive health coverage.

The Navigator awardees include community and consumer-focused non-profits, faith-based organizations, hospitals, trade and professional associations, and tribes or tribal organizations. Navigators help families and other underserved communities gain access to health coverage options through the Marketplace, Medicaid, or CHIP. They can assist with enrollment applications and help consumers receive financial assistance through HealthCare.gov. With the additional funding, more Navigator organizations can provide assistance to people with limited English proficiency in multiple languages. They can also provide more assistance to rural areas and communities of color.

“Our local partners are crucial in helping people get covered. By expanding our pool of Navigators, we will reach more underserved communities, and grow our network of trusted experts who can help people across the country navigate their health care options,” said U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra. “Thanks to President Biden, health care is more affordable than ever on HealthCare.gov – and with this historic investment, we’ll be making it even easier for people to enroll in coverage through the Marketplace, Medicaid, and the Children’s Health Insurance Program.” 

“Local health coverage experts have worked hard to build relationships and trust in the communities in which they serve. These Navigators consistently help consumers understand their options, helping with potential language and other barriers, so they can find health coverage that best fits their needs,” said CMS Administrator Chiquita Brooks-LaSure. “With this additional grant funding, even more Navigators will be able to provide comprehensive assistance through customized educational and outreach activities, especially to underserved communities.”

The 2021 Navigator awardees will focus on outreach to particularly underserved communities. Awardees will focus on outreach to people who identify as racial and ethnic minorities, people in rural communities, the LGBTQ+ community, American Indians and Alaska Natives, refugee and immigrant communities, low-income families, pregnant women and new mothers, people with transportation or language barriers or lacking internet access, veterans, and small business owners.

The 2021 Navigator awards are for a 36-month period of performance, funded in 12-month increments known as budget periods. This multi-year funding structure is designed to provide greater consistency for Navigator awardee organizations, reducing yearly start-up time and allowing more efficient use of grant funds.

Navigator grant applicants were asked to detail their outreach and enrollment efforts to the underserved or vulnerable population(s), while still assisting other consumers. The 2021 Navigator awardees must comply with the terms and conditions of the award, including submission of regular reports to CMS documenting their progress and activities. CMS will work closely with the awardees to ensure they are meeting these goals. 

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The “Humanists for Biden” group, a project of the Secular Democrats of America, unveiled its plans on Monday (Sept. 28). The group is chaired by Greg Epstein, the humanist chaplain at Harvard University and the Massachusetts Institute of Technology.

“The humanist and nonreligious community is poised to be a very significant part of this presidential election in that we represent maybe 30% or so of Democratic voters,” Epstein told Religion News Service.

The group also announced a slate of co-chairs that includes Sarah Levin, who also co-chaired the Democratic National Convention’s Interfaith Council and heads Secular Strategies, an organization that mobilizes secular voters.

“Humanists for Biden marks the first time representatives of the nation’s growing number of secular Americans have been invited to participate in a coalition of communities of faith and conscience, working together on a Presidential campaign,” read a press release from the group.

“The Biden-Harris campaign is working to create the most inclusive campaign and administration in the history of American politics, and we are honored to take part in this effort.”

Epstein said Humanists for Biden hopes to reach a broad swath of atheists, agnostics and other religiously unaffiliated voters who make up the largest belief group in the Democratic Party, constituting around 28% of its members, according to political scientist Ryan Burge.

While some are atheists and agnostics, other unaffiliated Americans still believe in God or pray regularly, according to a 2019 Pew Research study. Even so, Epstein argued that the many nonreligious Americans are united by “humanistic values,” such as a belief in science as “the best tool that we have to create a healthy world,” as well as support for racial justice, pluralism and inclusion. “We stand as humanists and people united by humanistic values for basic human decency, empathy and compassion that we feel that the Biden-Harris campaign represents far more than its competition,” he said.

Religiously unaffiliated voters, despite backing Democrats over Republicans in the 2018 midterms 75% to 22% according to Pew, have been criticized in the past for relatively low turnout on Election Day compared to other groups. But Epstein pointed to new research that suggests religiously unaffiliated turnout is heavily impacted by the fact that it is largely made up of young voters who are also known for underperforming on Election Day.

What’s more, he said the group can only benefit from targeted mobilization, something Democrats have rarely done in the past. “With a group like that that supports you so strongly and leans so heavily in your direction, you want to mobilize that group as much as possible,” he said. Humanists for Biden is not officially part of the presidential campaign, but Epstein said campaign staff — including national faith outreach directors for both the Biden-Harris campaign and the Democratic Party — are slated to appear at the group’s first official event on Thursday.

“We feel supported and valued, and that has absolutely never been the case before for our community at this level,” he said, adding that Rep. Jared Huffman, a California Democrat and humanist, will also speak at their upcoming event.

The group has even selected a swing state where it can target its efforts: Arizona, where around 27% of the population is unaffiliated, according to Pew. Epstein pointed out that Arizona is home to lawmakers such as Athena Salman, a state House member who identifies as an atheist and as a humanist.

The state is also represented by Kyrsten Sinema, a Democrat and the only U.S. Senator who identifies as religiously unaffiliated. The ultimate goal of the initiative, Epstein insisted, was not only to generate “historic turnout” among secular and nonreligious Americans, but also to build a stronger coalition with religious liberals.

“We recognize that their deeply held religious values resonate strongly with our humanist values,” he said. “We simply want to be a part of the conversation. We want to be in the tent. We want to be able to fully help as equals.”

-Jack Jenkins – RNS

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