Easy Enrollment in Health Care Act
The Easy Enrollment in Health Care Act aims to greatly simplify and accelerate how people get insured through health coverage programs. By 2028, the bill would let taxpayers who are not yet enrolled in minimum essential coverage (MEC) and certain household members elect, when they file their tax return, to have their eligibility for insurance affordability programs determined and, if eligible, enrolled in MEC through a zero net premium plan. This process would rely on a secure data exchange between the Treasury (tax data) and health program administrators (the Exchanges and HHS), with protections around sensitive information. The act would also create automatic enrollment pathways (including a default enrollment option into a high-value, zero-net-premium plan) and a special enrollment period triggered by consent, while preserving the right to opt out or to seek alternative plans. In addition, the bill would modernize how eligibility is determined for Medicaid and CHIP by allowing income and eligibility verifications to be aligned with other programs (e.g., SNAP/TANF) and by providing multiple verification options for states. It also imposes safeguards to ensure privacy, limit data use to eligibility/enrollment purposes, and give consumers notice and appeal rights when errors affect their coverage eligibility. Overall, the measure is designed to reduce barriers to enrollment, expand coverage through automatic or near-automatic means, and streamline administrative processes across federal and state health coverage programs.
Key Points
- 1Use of tax returns to facilitate enrollment: By 2028, taxpayers not enrolled in MEC (and certain non-covered household members) can elect to have their eligibility for insurance affordability programs determined and, if eligible, enrolled in a zero-net-premium MEC plan when they file their taxes for years beginning after 2026.
- 2Consent and streamlined enrollment process: Taxpayers can consent to disclose relevant return information to the Exchange to determine eligibility and enroll in zero-net-premium coverage, with a supplemental form collecting required information (while excluding citizenship/health status questions) and ensuring accessibility.
- 3Secure, fed-backed data interface: The Secretary must create a secure, interagency data-exchange interface to transfer relevant return information to Exchanges, with data security safeguards and options for immediate determinations/enrollment during electronic tax filing.
- 4Auto-enrollment and default options for zero-net-premium plans: If eligible for a zero-net-premium QHP and consented, the Exchange will identify plan options, possibly enroll the individual by default into a high-value zero-net-premium plan, and provide notice and reconsideration options if the enrollees wish to change plans or disenroll.
- 5Medicaid/CHIP modernization and state options: The bill requires creating multiple sets of verification options for determining Medicaid/CHIP eligibility, allows adjustments to enrollment procedures, and requires states to enroll eligible individuals (with opt-out protections) while preserving existing rights and rules.
- 6Protections and error handling: The act mandates procedures to address errors in transferred data that affect eligibility, with notice and correction processes, and strengthens privacy safeguards around the use and disclosure of return information.
- 7Optional paths for non-filers: The bill preserves a pathway for applications without tax returns, detailing methods to determine household income and family size for eligibility in such cases.
- 8Expanded eligibility criteria linkage: Section 5 proposes modernizing Medicaid/CHIP income determinations by incorporating cross-program eligibility findings (e.g., SNAP, TANF) to streamline and potentially expand eligibility determinations.