February 14, 2023

Van Hollen Reintroduces Bill to Make it Easier to Sign Up for Health Coverage, Close Massive Enrollment Gap

Today, U.S. Senator Chris Van Hollen (D-Md.) reintroduced his Easy Enrollment in Health Care Act, legislation to simplify the process of enrolling in a health insurance plan. The Senator’s bill, modeled off a program already successfully in place in Maryland, would enable Americans to receive health care plan information and enroll in coverage through their federal income tax returns.

“More Americans than ever can access free or low-cost health insurance through the Affordable Care Act, yet millions are still uninsured because of barriers they face in enrollment. Getting covered doesn’t need to be this complicated – and that’s why I’m introducing this bill to help Americans more easily find the health plans that work best for them by simply checking a box on their federal tax returns. Easy Enrollment is a simple, yet powerful approach that has already been proven in Maryland to boost participation in affordable health care plans, and it’s time we make it available nationwide,” said Senator Van Hollen.

Congressman Ami Bera, M.D. (D-Calif.) plans to reintroduce the companion legislation in the U.S. House later this week. 

“As a doctor who has cared for our nation’s patients, I have seen first-hand how stressful and overwhelming it can be to sign up for health care coverage,” said Representative Ami Bera, M.D, who previously served as Chief Medical Officer for Sacramento County. “That’s why I’m introducing the Easy Enrollment in Health Care Act with Senator Van Hollen to help millions of uninsured Americans automatically enroll in affordable health insurance at the same time they file their federal tax returns. It’s critical that we cut burdensome red tape to make it easier for Americans to get insured.” 

On Friday, Senator Van Hollen announced the bill’s reintroduction as he joined Maryland Comptroller Brooke Lierman, Maryland Healthcare for All! Coalition President Vinny DeMarco, Maryland Health Benefit Exchange Executive Director Michele Eberle, and other state and local leaders and advocates. During that press conference, the leaders encouraged the state’s uninsured residents to “check the box” on their state tax returns to start the process of getting covered. They also highlighted the success of Maryland’s Easy Enrollment Program, which was created in 2019 and has since helped more than 10,000 Marylanders enroll in affordable health insurance.

“I am grateful to Senator Van Hollen for championing the Easy Enrollment in Health Care Act, paving the way for the rest of the country to be afforded the same access to healthcare information Maryland residents can obtain when they file their annual state tax returns,” says Maryland Comptroller Brooke Lierman. “These types of tax reforms modernize our system and present a unique opportunity to help millions of uninsured Americans, many of whom may not be aware they are eligible for free coverage or have the time to navigate a complex enrollment system.” 

“The Maryland Health Care For All! Coalition commends Senator Chris Van Hollen for introducing national Easy Enrollment legislation. Our first in the nation East Enrollment program in Maryland has worked very well to expand health care coverage to try thousands of previously uninsured Marylanders. Senator Van Hollen’s bill will help millions of Americans get the health care coverage they need,” said Vinny DeMarco, President, Maryland Health Care for All! Coalition.

Text of the legislation is available here.

Nearly 30 million Americans are uninsured and, as of this year, about 7.3 million uninsured Americans are eligible for programs like Medicaid, CHIP, and Advanced Premium Tax Credits – but still aren’t covered. This “enrollment gap” disproportionately harms families of color. More than 60 percent of uninsured children who qualify for Medicaid or CHIP are African American, Latino, Indigenous, or other children of color.  

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 their 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. 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: Protect Our Care, Third Way, First Focus, Families USA, the American Academy of Pediatrics, the American Heart Association, and the Maryland Health Care for All! Coalition.

“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.

“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. 

“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 of Advocacy, American Heart Association.

“First Focus Campaign for Children is pleased to support the reintroduction 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 Campaign for Children.