The American Rescue Plan Act’s Marketplace Provisions

Brief

The American Rescue Plan Act’s Marketplace Provisions

Early Implementation Experiences and Lessons Learned from Three State-Based Marketplaces

Abstract

Included in the wide-ranging American Rescue Plan Act of 2021 (ARPA) are several provisions that expand the Affordable Care Act’s premium tax credits for families and individuals who have coverage through health insurance Marketplaces. Importantly, these ARPA provisions are temporary and last through 2022, unless Congress makes them permanent. To provide some insight into early lessons learned by state-based Marketplaces (SBMs) implementing the new provisions, we interviewed state Marketplace officials, representatives from navigator organizations, and Marketplace health insurers in California, New York, and Washington State. The following lessons learned could be useful to other SBMs and the federally facilitated Marketplace as the 2022 open enrollment period approaches and could inform future Marketplace improvements:

  • Centering how the ARPA’s new and expanded financial help makes insurance more affordable for more people is essential for ARPA messaging. To help overcome long-standing beliefs that health insurance is unaffordable, ARPA messaging could focus on how the enhanced subsidies are new and make health insurance more affordable than ever.
  • To raise awareness about the ARPA’s enhanced subsidies, marketing and consumer outreach can be conducted via communication strategies including direct mail or print or digital campaigns. An effective communication strategy reaches people multiple times through different communication channels.
  • Establishing partnerships with other state agencies (e.g., state unemployment agencies and Medicaid) is crucial to helping promote the Marketplace generally and raising awareness among potential enrollees about the availability of new financial help for purchasing coverage. Now that Marketplace coverage is more affordable, partnering with state Medicaid agencies is especially important to prepare for when the public health emergency ends and people are disenrolled from Medicaid.
  • Engaging Marketplace partners (e.g., health plans, brokers, and navigators) helps with conducting direct outreach and education to current and potential Marketplace enrollees about the financial assistance the ARPA offers.
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