Easy Enrollment in Health Care Act
Sponsored By: Representative Bera
Introduced
Summary
Use tax returns to enroll people in public and subsidized health coverage. This bill would create a secure, consent-based system that uses tax return and other federal data to determine eligibility and automatically enroll household members into Medicaid, CHIP, or subsidized marketplace plans when possible.
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- Families and households: Consenting taxpayers could have Exchanges use their tax return data to qualify household members for Medicaid, CHIP, or advance premium tax credits and trigger a special enrollment period tied to tax filing dates.
- Low-income applicants and marketplace consumers: Exchanges would identify "zero net premium" qualified health plans and may default-enroll eligible people into the highest-value zero-cost options, while providing notices, opt-out rights, and a reconsideration window of up to 30 days.
- States, Exchanges, and administrators: The bill authorizes broader data matches including the National Directory of New Hires and IRS return information, offers states multiple verification procedure options, and funds IT and data-sharing infrastructure through transfers and appropriations.
Effective dates include SSA-related changes starting January 1, 2027 and applicable-taxable-year changes taking effect January 1, 2028 with a transition through December 31, 2034.
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Bill Overview
Analyzed Economic Effects
6 provisions identified: 5 benefits, 0 costs, 1 mixed.
New rules and payback shield for ACA credits
If enacted, the tax year used to figure marketplace premium tax credits would change. For Jan–May coverage months, the law would look back to a tax year that ended at least 12 months before Jan 1 of the plan year. For other months, it would use the most recent year that ended before Jan 1. A safe harbor would also limit how much you must repay if your advance credits matched the income and family size on your return or the Exchange’s finding. The shield would not apply if false statements were intentional or grossly negligent. These changes would run Jan 1, 2028 through Dec 31, 2034.
Easier Medicaid checks: SNAP and last-year income
If enacted, States would need to accept recent SNAP or TANF findings to prove income, citizenship, and residence for Medicaid/CHIP. This required rule would apply to kids under 19 and some other groups named in law; States could choose to use it for others. Starting Jan 1, 2027, States would also use your prior calendar-year income for eligibility if your date falls in Jan–Apr. States would still have to use your current income if that gives you more help or lower costs.
Faster help after your life changes
If enacted, you could file a one-page change form after you apply to ask for more help. The marketplace would use tax and other data to see if a change, like income loss, qualifies you for more premium tax credits, bigger cost-sharing reductions, or Medicaid/CHIP. Decisions would come with normal notice and appeal rights. This would run from Jan 1, 2028 through Dec 31, 2034 and aims to get you added help faster.
Get coverage when you file taxes
If enacted, when you file your taxes and give consent, the marketplace would open a special sign-up window. It would use your return and trusted data to check Medicaid, CHIP, and premium tax credits. If you qualify for a $0 plan, the marketplace could pick a default plan and enroll you unless you opt out. You would get 30 days to switch or disenroll in certain cases. Sharing your tax data would also satisfy the Social Security number requirement for Medicaid/CHIP checks, and the law would define “zero net premium” and which programs count for this help.
Broader data sharing and state verification options
If enacted, agencies and trusted private data sources could share information needed to check eligibility for coverage help. HHS could let programs use National Directory of New Hires data, like employer and wage records, to verify offers and income, with programs repaying HHS’s added costs. Programs would have to follow strict Social Security Act privacy and penalty rules. HHS would also give States at least three sets of verification and processing options for Medicaid/CHIP, and choose a default if a State does not pick one. This would not force States to change benefit levels or income limits.
Build the tech to link taxes and coverage
If enacted, the government would give HHS as much money as needed to build and run secure data systems for this program. HHS could transfer funds to IRS, child support, State programs, Exchanges, and trusted data sources. The money would be available until spent, and HHS would set rules for requests, approvals, appeals, and audits. This would start upon enactment.
Sponsors & CoSponsors
Sponsor
Bera
CA • D
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
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