This week, Medicare Rights submitted comments on a proposed rule from the Biden administration that would make several important changes for Affordable Care Act (ACA) marketplaces. The updates include extending the open enrollment period, increasing outreach and education efforts, creating a special enrollment period for people with lower incomes, and eliminating harmful options that states could use to deny their residents access to unbiased and complete coverage information. We applaud these proposals.
When first implemented in 2014, the ACA open enrollment period (OEP) ran for 180 days. The OEP was condensed to 90 days the following year. This timeline held until 2018, when the Trump administration sharply reduced it to 45 days while also cutting back on outreach and education funding and efforts. In our policy recommendations to the Biden-Harris administration, we urged an extension of the enrollment period and a focus on outreach efforts to ensure people who qualify for ACA coverage assistance get the information they need. The proposed rule would help meet those goals by extending the current OEP to 75 days, from November 1 to January 15, beginning in 2022.
We support this improvement and continue to urge the administration to similarly ease enrollment into other programs, including Medicare. Most immediately, this means helping older adults and people with disabilities access their earned benefits more quickly during the pandemic and its aftermath by reinstating two critical coverage pathways—Equitable Relief for Premium Part A and Part B and a Special Enrollment Period for Part C and Part D—and by allowing people to correct pandemic-related Medicare enrollment errors whenever they are discovered.
The proposed rule would also create a monthly special enrollment period for individuals or dependents of individuals who are eligible for tax credits and whose household income is expected to be no greater than 150% of the federal poverty level. We support this proposal to better ensure individuals with lower incomes have access to care and coverage and can enroll as soon as they understand their options.
Importantly, the proposed rule would also reverse the Trump administration’s improper decision to allow states to shift away from unbiased, complete health coverage information in favor of enrollment controlled by private entities. As we explained when this policy was first announced, the ACA statute does not permit such state flexibility, and the administration did not have the power to ignore the statute. We strongly approve of this proposed rule that would undo these impermissible administrative acts.
While our focus is on ensuring older adults and people with disabilities have access to high-quality and affordable care and coverage, we understand that Medicare does not operate in a vacuum. Policies that affect Medicaid or ACA coverage also affect the Medicare program and its beneficiaries. For that reason, we support changes in the proposed rule that would increase coverage, affordability, and outreach and education while reducing bureaucratic burden.