June 2021

The American Rescue Plan is a new law to address the COVID-19 public health and economic crisis. It dramatically reduces premiums for people through additional premium tax credits (PTCs), expands eligibility for PTCs to higher-income people, and gives many people receiving unemployment benefits access to plans with $0 premiums. These changes impact HealthCare.gov and all state-based marketplaces.

This brief explainer summarizes these new changes.

This FAQ provides comprehensive information about these new changes.

Additional Resources

Yearly Income Guidelines and Thresholds | View Reference Guide

May 2021

The American Rescue Plan (ARP) is a new law to address the COVID-19 public health and economic crisis. It includes a provision that provides temporary COBRA subsidies.

This FAQ includes information about how these subsidies work.

The FAQ was updated on May 5, 2021 to reflect new guidance which clarified that individuals receiving the temporary COBRA subsidy will qualify for a Special Enrollment Period once the subsidy ends.

Additional Resources

American Rescue Plan FAQ | View FAQ

Developed as part of the Consumer Assistance Coordination Hub (CACH), the National Health Law Program developed a fact sheet for assisters that lays out the grounds for appeals and explains where individuals should go for assistance: Marketplace Casework, Complaints and Appeals.

Depending on the situation, individuals may have four options for obtaining relief:

• Request for Casework – for help with a complex case, access to certain special enrollment periods or Form 1095-A that cannot be resolved through other resources;
• Appeal to Marketplace – for help with problems related to a final Marketplace eligibility determination;
• Appeal to Insurer – for help with problems related to a decision by an insurer or participating provider in a health plan; and
• Complaint to Department of Insurance – for help with problems related to an insurer’s decision, discrimination by an insurer, or fraudulent selling of insurance.

The fact sheet breaks down what situations and issues are appropriate for each process.

↓ View Marketplace Casework, Complaints and Appeals

On October 12, the Trump administration announced that they were discontinuing reimbursements to insurance companies for cost-sharing reduction (CSR) plans offered through the Marketplace.

An October 27th blog from The Commonwealth Fund outlines the different approaches states took to try to mitigate the damage caused by the termination of the CSR payments. The termination in funding caused a lot of uncertainty in the Marketplace, but importantly, people who are eligible for CSR are still be able to enroll in a plan with CSR.

↓ View the Commonwealth blog

Developed as part of the Consumer Assistance Coordination Hub (CACH), the National Association of Health Access Assisters developed a resource for assisters: Incorporating Volunteers into Outreach and Enrollment Work.

This resource outlines how enrollment assister organizations can utilize volunteers to help spread the word and ensure people enroll in coverage to make the most of this open enrollment period.

↓ View Incorporating Volunteers into Outreach and Enrollment Work

Developed as part of the Consumer Assistance Coordination Hub (CACH), the National Immigration Law Center developed a resource for assisters: Tips for Addressing Immigrant Families’ Concerns When Applying for Health Coverage Programs.

This resource includes suggestions on how to address concerns when talking to families, information on protections for household members not applying for coverage, and lists additional resources.

↓ View Tips for Addressing Immigrant Families’ Concerns When Applying for Health Coverage Programs

Georgetown University’s Center on Health Insurance Reforms (CHIR) has updated and improved their comprehensive resource manual: the Navigator Resource Guide. The Guide is a practical, hands-on resource with over 300 frequently asked questions (FAQs) on topics such as marketplace eligibility, premium and cost-sharing assistance, the individual mandate, and post-enrollment issues for individuals. It also provides answers to commonly asked questions for small businesses and individuals with employer based coverage.

Researchers at CHIR will periodically update the Navigator Resource Guide to capture emerging issues and questions from the field.

↓ View the Navigator Resource Guide 

On January 30, 2015, and February 6, 2015, the Center on Budget and Policy Priorities, the National Immigration Law Center, and Georgetown University Center for Children and Families presented two updated webinars for the Centers for Medicare and Medicaid Services (CMS) assister network that reviewed immigrant eligibility policies for health insurance affordability programs and the application process for families that include immigrants.

Application Process for Families that Include Immigrants

• View slide deck

Overview of Immigrant Eligibility Policies for Health Insurance Affordability Programs

• View slide deck

On January 30, 2015, the Center on Budget and Policy Priorities, the National Immigration Law Center, and Georgetown University Center for Children and Families presented an updated webinar for the Centers for Medicare and Medicaid Services (CMS) assister network that takes an in-depth look at the application process for health insurance affordability programs for families that include immigrants and addresses unique concerns for families that include immigrants about applying for health coverage.

Resources from the presentation:

• Slide Deck

A companion webinar, which will provide an overview of immigrant eligibility policies for health insurance affordability programs, will be presented to the CMS assister network on February 6, 2015.

Below are two resources from the Center for Health Care Strategies (CHCS) on assisting American Indians/Alaska Natives:

Consumer Assistance Resource Guide: American Indians and Alaska Natives – A resource guide, developed by the CHCS, to help answer some of the most common eligibility and enrollment questions related to coverage for American Indians and Alaska Natives (AI/AN).

Implications of Health Reform for American Indian and Alaska Native Populations – This brief prepared by CHCS and the National Academy for State Health Policy (NASHP) outlines provisions that uniquely affect AI/ANs, and provides strategies to help states and other stakeholders realize the potential of the ACA to improve the health and health care of AI/AN individuals. Areas addressed include: (1) coverage expansion; (2) state outreach to and engagement with federally recognized tribal groups; and (3) opportunities to fill gaps in the organization and financing of care.