MODEL BILLS
Easy Enrollment Health Insurance Act
Summary: The Easy Enrollment Health Insurance Act creates a system to use information from state individual income tax return forms to help uninsured individuals obtain health care coverage.
Based on Colorado HB 1236 (2020) and Maryland HB 814 (2019) This legislation has also been enacted in Massachusetts, New Jersey and Virginia. For more information, see a Pew Stateline news story here with much more coverage and analysis here.
SECTION 1. SHORT TITLE
This Act shall be called the “Easy Enrollment Health Insurance Act.”
SECTION 2. PURPOSE
This law is enacted to make health insurance more accessible to uninsured residents.
SECTION 3. EASY ENROLLMENT
After section XXX, the following new section XXX shall be inserted:
(A) DEFINITIONS—In this section:
1) “Creditable coverage” has the same meaning as set forth in [cite the section the describes minimum standards for a health plan].
2) “Department” means the [Health].”
3) “Exchange” means the state Health Benefit Exchange created in [cite].
4) “Health care coverage affordability program” means a medical assistance program under [cite the state’s Medicaid program], [cite the state’s CHIP program], or [cite health benefits, tax credits or cost-sharing reductions available under the Exchange or other programs].
5) “Uninsured individual” means an individual who does not have creditable coverage.
(B) EASY ENROLLMENT PROGRAM
1) [Within the Department of Health], there is created the Easy Enrollment Program. Its purpose is to use the individual income tax filing process to maximize the enrollment of eligible uninsured individuals in a health care coverage affordability program.
2) An Easy Enrollment Advisory Committee shall guide the implementation and administration of the program. This committee shall be comprised of [Secretary] of the Department or the [Secretary’s] designee as Chair and ten additional members who shall be knowledgeable about state health coverage programs and/or the process of state income tax collection, and represent the geographic, economic and ethnic diversity of the state.
3) The members of the advisory committee shall include:
a) The [Director] of the Department of [Revenue] or the [Director’s] designee;
b) A representative of consumer advocacy groups;
c) A representative of small business employers;
d) A representative of health insurers;
e) A health care consumer;
f) A health insurance consumer assistance professional; and
g) A provider of income tax preparation services.
4) The members shall normally be appointed for four-year terms by [the Governor with the advice and consent of the Senate], but half of the initial appointees shall be appointed for two years so membership replacement is staggered thereafter. [NOTE, this language makes the committee ongoing but it could be changed to a committee that goes out of existence after about two years.]
5) In notice, recordkeeping, quorum, open meetings, discipline and reimbursement for expenses, the advisory committee shall comply with the requirements of [cite existing laws applicable to such public bodies].
6) The advisory committee shall, at a minimum, decide: [NOTE, “decide” could be changed to “advise about.” It’s a question of how much authority you want to give the committee.]
a) The wording of a question on the state tax return asking if the tax filer wants the Exchange to assess whether uninsured individuals in the tax household are potentially eligible for a health care coverage affordability program or other credible coverage using information from the tax filer’s state individual income tax return and other sources available to the Exchange;
b) The wording of a question on the state tax return asking tax filers who want the Exchange to assess potential eligibility which requests additional information about the uninsured that is not otherwise available to the Exchange and that is deemed essential for making assessments of potential eligibility, except that the request for additional information shall not include requests for citizenship, immigration, or health status;
c) The procedures that will be used to transfer tax filer information from the Department of [Revenue] to the Exchange in order to facilitate the program;
d) Needed revisions to the state individual income tax form, supplemental schedules, or both.
e) Needed revisions to tax form instruction booklets that explain how to answer the questions added to the tax return form or schedules and the effects of indicating that the tax filer would like the Exchange to assess the eligibility of uninsured household members;
f) The process that the Exchange will use under the program to assess potential eligibility for and assist with enrollment in a health care coverage affordability program or other creditable coverage including:
i) a timeline for assessing each individual’s potential eligibility for a health care coverage affordability program or other creditable coverage;
ii) a process to notify individuals regarding the outcomes of assessments of potential eligibility, which process is designed to maximize health care coverage enrollment levels;
iii) a process for handling uninsured individuals whose United States citizenship or immigration status cannot be verified through information available to the Exchange; and
(vi) a determination of the feasibility of and, if feasible, recommendations for a process for automatic enrollment through the program of eligible uninsured individuals in a health care coverage affordability program or other creditable coverage.
7) Procedures for the program that require affirmative consent from any individual before inquiring into that individual’s United States citizenship or immigration status.
SECTION 4. STATE INCOME TAX FORM
After section XXX, the following new paragraph XXX shall be inserted:
(A) For income tax years commencing on or after January 1 [2021], the state individual income tax form must allow tax filers to:
1) Request that the Exchange assess whether uninsured tax household members are potentially eligible for free or lower-cost health coverage under a health care coverage affordability program using information from their tax return and other sources available to the Exchange; and
2) Identify uninsured household members and provide other information determined necessary to facilitate the Easy Enrollment Program.
(B) The associated tax form instruction booklet must explain how to answer the questions added to the state individual income tax form or schedules pursuant to this section and the effect of asking the Exchange to assess whether uninsured household members are potentially eligible for free or lower-cost health coverage under a health care coverage affordability program.
(C) In implementing this section, the Department of [Revenue] shall comply with the determinations and consider the recommendations developed by the Advisory Committee pursuant to [cite].
(D) The [Executive Director] of the Department of [Revenue] shall promulgate rules as necessary to implement the tax forms and schedules required by this section and to implement the sharing of information authorized by this section with the Exchange and the Department of [Health].
SECTION 5. OPEN ENROLLMENT
At the end of section XXX, [Health benefit plan open enrollment periods], the following new paragraph XXX shall be inserted:
A triggering event occurs when:
(X) The Exchange notifies the individual based on information provided through the Easy Enrollment Program created in section [cite], concerning the individual’s potential eligibility for a health care coverage affordability program.
SECTION 4. EFFECTIVE DATE
This law shall become effective on July 1, 20XX.