The Centers for Medicare & Medicaid Services (CMS) announced that it will be making $20 million in American Rescue Plan Act (ARPA) funding available to State-Based Marketplaces (SBMs) by way of up to 21 cooperative agreement grants. These grants aim to help states “modernize or update their systems, programs, or technology to comply with federal Marketplace requirements, including the recent provisions of ARPA that increased the financial assistance available to certain consumers.”1 The grants will also be available to states that operate an SBM but use Healthcare.gov for eligibility and enrollment. 

Marketplace enrollments have greatly increased due to the COVID-19 pandemic and the subsequent American Rescue Plan, which offered larger tax credits to help lower health insurance premiums. For instance, Pennsylvania residents saw dramatic decreases in monthly premiums, which drove additional enrollments.2   

wdt_ID Premium Before ARPA After ARPA
1 Premiums Under $1 13 percent  53 percent
2 Premiums Under $10 16 percent  66 percent 
3 Premiums Under $50 25 percent  71 percent 
4 Premiums Under $100 39 percent 76 percent

CMS recognizes that updated systems will help states to better handle the increased traffic and will speed up the eligibility and enrollment processes, helping even more Americans enroll in coverage.    

“For GetInsured state clients, we were able to implement two phases of the American Rescue Plan faster than healthcare.gov,” said Shankar Srinivasan, General Manager, GetInsured. “This enabled millions of Americans to access their savings faster than they would have in other states. The CMS grants will allow more states to respond faster to policy changes that impact consumers.” 

SBMs can use these funds to: 

  • Update systems and/or technology infrastructure to support the implementation of applicable federal requirements, which includes changes that help consumers quickly access increased premium tax credits and cost-sharing reductions available through the ARP.  
  • Expand consumer notifications, consumer education or other assistance activities, stakeholder education or training, state and federal reporting, call center or appeal supports, staff training, and oversight and monitoring activities. 

“Our State-Based Marketplaces are the gateway to quality, affordable health care for millions of consumers and these investments will make it even easier to sign up for coverage,” said CMS Administrator Chiquita Brooks-LaSure. “This funding available to states will help them to provide consumers with swift eligibility determinations and enrollment into comprehensive health care plans.”3 

Applications from eligible SBM applicants are due on July 20, 2021. Awards are expected to be issued in early September 2021.  

 

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1,3 https://www.cms.gov/newsroom/press-releases/cms-announces-20-million-american-rescue-plan-funding-available-improve-access-state-based 

2 https://agency.pennie.com/wp-content/uploads/20210617-Pennie-BOD-Deck.pdf