October 19, 2021

Van Hollen, Bera Introduce New Bicameral Bill to Make it Easier for Americans to Sign Up for Health Care, Close Massive Enrollment Gap

Today, U.S. Senator Chris Van Hollen (D-Md.) and Congressman Ami Bera, M.D. (D-Calif.) introduced new legislation to simplify health care enrollment for Americans. The lawmakers’ innovative new bill, The Easy Enrollment in Health Care Act, will streamline health care enrollment for uninsured families and help close the massive gap in eligible but uninsured Americans. This legislation, modeled off a program already successfully in place in Maryland, would provide Americans the opportunity to receive health care plan information and enroll through their federal income tax returns.

“The idea behind this bill is simple but powerful: millions of Americans who already qualify for free or very low-cost health coverage don’t receive it because they are not enrolled in plans for which they are eligible. Closing this gap and getting more people enrolled in plans they already qualify for is key to providing better care to families and our communities. That’s why I’m introducing this legislation to make it easier for Americans to sign up for existing health plans and to boost enrollment. This bill is based off of the success we’ve seen in Maryland and would help expand on and extend this success both in our state and nationwide. I’ll be looking for every opportunity to pass this common-sense proposal to ensure more Americans are able to access the quality health care plans they are already eligible to participate in,” said Senator Van Hollen.

“As a doctor and former Chief Medical Officer for Sacramento County, I know that health care is extremely personal and oftentimes very stressful to navigate,” said Representative Ami Bera, M.D. “That why it’s critical that we cut burdensome red-tape to make it easier for Americans to sign-up for health care coverage. I am proud to join Senator Van Hollen in introducing the Easy Enrollment in Health Care Act, legislation that would help millions of uninsured Americans automatically enroll in affordable health insurance at the same time they file their federal tax returns."

Text of the legislation is available here.


Nearly 2 in 3 uninsured Americans are eligible for programs like Medicaid, CHIP, and Advanced Premium Tax Credits but still aren’t covered, totaling in over 18 million people – including 13 million who are eligible for free insurance at this very moment. This “enrollment gap” disproportionately harms families of color. In 2019, adults of color were 41% more likely than whites to qualify for health programs but not be enrolled, and nearly 2 in 3 uninsured children who qualify for Medicaid or CHIP are African-American, Latino, Indigenous, or other children of color. However, 4 in 5 uninsured citizens and lawfully present immigrants filed federal income tax returns, including 64% of those with incomes below 150% of the FPL. 

Under this bill, Americans would be able to check a box on their federal income tax returns that would connect them with available health care programs in their state. By checking the box, the IRS would be authorized to share the data they already have on file with the individual’s state health care marketplace exchange. A menu of options would then be sent back to the individual in a formal letter – at which point that person could either chose to opt-in to a specific program or remain uninsured if they choose. Individuals would have a 60 day special enrollment window to make your choice, and those who are eligible for a zero-premium plan who neither select a program nor opt out would be paired automatically with the program that provides the highest coverage with no premiums. 

This type of tax filing system could reach the millions of uninsured Americans who know little about health programs or their eligibility to receive free health care. In 2017, after ample public education and 4 open enrollment periods, 40% of uninsured Americans were still unaware of health insurance marketplaces. By checking the box, these same families could see whether they qualify for free or low-cost health care and then enroll. This legislation brings health care information directly to people who need it most – and makes it easier than ever to sign up for a plan with zero premiums.

The bill is supported by a large and diverse group of organizations, including: Families USA, Protect Our Care, Third Way, Blue Cross Blue Shield Association, First Focus, Alliance of Community Health Plans, American Academy of Pediatrics, American Cancer Society Action Network, American Heart Association, and Centene.

"Senator Van Hollen's game-changing legislation takes the best ideas from states like Maryland and health policy experts across the political spectrum to finally tackle America's enrollment gap in a significant manner. The enrollment gap is a huge, persistent problem that contributes to inequity in health care. Tens of millions of people – disproportionately from working-class families and communities of color – qualify for health coverage but still remain uninsured. Under his proposal, uninsured taxpayers who are unaware even that health insurance marketplaces exist would learn about their eligibility for assistance and be enrolled in coverage automatically – simply by checking a consent box on their tax return. Families USA looks forward to working with the Senator and his colleagues in Congress to make this critical bill a reality so families can get the best health and health care they need and deserve,” said Frederick Isasi, Executive Director, Families USA. 

“First Focus is pleased to support the introduction of the Easy Enrollment in Health Care Act because it will help uninsured, working parents quickly and easily determine if they and their children qualify for coverage under their state’s health insurance exchange.  This common sense approach which ties tax filing and health coverage determinations together has shown to be effective in the state of Maryland so we support expanding it to uninsured, working poor families across the country,” said Bruce Lesley, President of First Focus.

"Ensuring access to affordable, quality health care, regardless of race, gender, age or ethnicity, is essential to prevent and treat cardiovascular diseases. The American Heart Association is pleased to support the Easy Enrollment in Health Care Act and appreciates Sen. Van Hollen's efforts to ease the process of enrollment for the uninsured,” said Mark Schoeberl, Executive Vice President, Advocacy, American Heart Association.

“The Affordable Care Act is more popular than ever, but millions of people still don’t know they are eligible for quality, affordable coverage under the law. Senator Van Hollen is bringing a commonsense approach to streamline health care enrollment for uninsured families that had overwhelming success in Maryland to the rest of the country. We must work to close the enrollment gap to build on the ACA and ensure every American has access to health care,” said Anne Shoup, Communications Director, Protect our Care. 

“The Maryland Health Care For All! Coalition thanks Senator Chris Van Hollen for once again being a great public health leader by introducing national easy enrollment legislation,” said Vincent DeMarco, President of the Maryland Health Care For All! Coalition. “Senator Van Hollen’s new proposal will help Maryland’s landmark easy enrollment law work better and help millions of people across America get the health care coverage they need.”