[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3947 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 3947
To streamline enrollment in health insurance affordability programs and
minimum essential coverage, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 12, 2025
Mr. Bera introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee on
Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To streamline enrollment in health insurance affordability programs and
minimum essential coverage, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Easy Enrollment in Health Care
Act''.
SEC. 2. DEFINITIONS.
In this Act:
(1) CHIP program.--The term ``CHIP program'' means a State
plan for child health assistance under title XXI of the Social
Security Act (42 U.S.C. 1397aa et seq.), including any waiver
of such a plan.
(2) Exchange.--The term ``Exchange'' means an American
Health Benefit Exchange established under subtitle D of title I
of the Patient Protection and Affordable Care Act (42 U.S.C.
18021 et seq.).
(3) Family size.--The term ``family size'' has the meaning
given such term in section 36B(d) of the Internal Revenue Code
of 1986.
(4) Group health plan.--The term ``group health plan'' has
the meaning given such term in section 5000(b)(1) of the
Internal Revenue Code of 1986.
(5) Household income.--The term ``household income'' has
the meaning given such term in section 36B(d) of the Internal
Revenue Code of 1986.
(6) Household member.--The term ``household member'' means
the taxpayer, the taxpayer's spouse, and any dependent of the
taxpayer.
(7) Insurance affordability program.--The term ``insurance
affordability program'' means any of the following:
(A) A Medicaid program.
(B) A CHIP program.
(C) The program under title I of the Patient
Protection and Affordable Care Act (42 U.S.C. 18001 et
seq.) for the enrollment in qualified health plans
offered through an Exchange, including the premium tax
credits under section 36B of the Internal Revenue Code
of 1986, cost-sharing reductions under section 1402 of
the Patient Protection and Affordable Care Act (42
U.S.C. 18071), and the advance payment of such credits
and reductions under section 1412(a)(3) of the Patient
Protection and Affordable Care Act (42 U.S.C.
18082(a)(3)).
(D) A State basic health program under section 1331
of the Patient Protection and Affordable Care Act (42
U.S.C. 18051).
(E) Any other Federal, State, or local program that
provides assistance for some or all of the cost of
minimum essential coverage and requires eligibility for
such program to be based in whole or in part on income,
including such a program carried out through a waiver
under section 1332 of the Patient Protection and
Affordable Care Act (42 U.S.C. 18052) or a State
program supplementing the advanced payment of tax
credits and cost-sharing reductions under section
1412(a)(3) of such Act (42 U.S.C. 18082(a)(3)).
(8) Medicaid program.--The term ``Medicaid program'' means
a State plan for medical assistance under title XIX of the
Social Security Act (42 U.S.C. 1396 et seq.), including any
waiver of such a plan.
(9) Minimum essential coverage.--The term ``minimum
essential coverage'' has the meaning given such term in section
5000A(f) of the Internal Revenue Code of 1986.
(10) Modified adjusted gross income.--The term ``modified
adjusted gross income'' has the meaning given such term in
section 36B(d)(2)(B) of the Internal Revenue Code of 1986.
(11) Net premium.--The term ``net premium'', with respect
to a health plan or other form of minimum essential coverage--
(A) except as provided in subparagraph (B), means
the payment from or on behalf of an individual required
to enroll in such plan or coverage, after application
of the premium tax credit under section 36B of the
Internal Revenue Code of 1986, the advance payment of
such credit under section 1412(a)(3) of the Patient
Protection and Affordable Care Act (42 U.S.C.
18082(a)(3)), and any other assistance provided by an
insurance affordability program; and
(B) does not include any amounts described in
section 36B(b)(3)(D) of the Internal Revenue Code of
1986 or section 1303(b)(2) of the Patient Protection
and Affordable Care Act (42 U.S.C. 18023(b)(2)).
(12) Poverty line.--The term ``poverty line'' has the
meaning given such term in section 36B(d)(3) of the Internal
Revenue Code of 1986.
(13) Qualified health plan.--The term ``qualified health
plan'' has the meaning given such term in section 1301(a) of
the Patient Protection and Affordable Care Act (42 U.S.C.
18021(a)).
(14) Relevant return information.--The term ``relevant
return information'' means, with respect to a taxpayer, any
return information, as defined in section 6103(b)(2) of the
Internal Revenue Code of 1986, which may be relevant, as
determined by the Secretary of the Treasury in consultation
with the Secretary of Health and Human Services, with respect
to--
(A) determining, or facilitating determination of,
the eligibility of any household member of the taxpayer
for any insurance affordability program, either
directly or through enabling access to additional
information potentially relevant to such eligibility;
or
(B) enrolling, or facilitating the enrollment of,
such individual in minimum essential coverage.
(15) Single, streamlined application.--The term ``single,
streamlined application'' means the form described in section
1413(b)(1)(A) of the Patient Protection and Affordable Care Act
(42 U.S.C. 18083(b)(1)(A)).
(16) Tax return preparer.--The term ``tax return preparer''
has the meaning given such term in section 7701(a)(36) of the
Internal Revenue Code of 1986.
(17) Zero net premium.--The term ``zero net premium'', with
respect to a health plan or other form of minimum essential
coverage, means a net premium of $0.00 for such plan or
coverage.
SEC. 3. FEDERAL INCOME TAX RETURNS USED TO FACILITATE ENROLLMENT INTO
INSURANCE AFFORDABILITY PROGRAMS.
(a) In General.--Not later than January 1, 2028, the Secretary
shall establish a program which allows any taxpayer who is not covered
under minimum essential coverage at the time their return of tax for
the taxable year is filed, as well as any other household member who is
not covered under such coverage, to, in conjunction with the filing of
their return of tax for any taxable year which begins after December
31, 2026, elect to--
(1) have a determination made as to whether the household
member who is not covered under such coverage is eligible for
an insurance affordability program; and
(2) have such household member enrolled into minimum
essential coverage, provided that--
(A) such coverage is provided through a zero-net-
premium plan, and
(B) the taxpayer does not--
(i) opt out of coverage through the zero-
net-premium plan, or
(ii) select a different plan.
(b) Taxpayer Requirements and Consent.--
(1) In general.--Pursuant to the program established under
subsection (a), the taxpayer may, in conjunction with the
filing of their return of tax for the taxable year--
(A) identify any household member who is not
covered under minimum essential coverage at the time of
such filing; and
(B) with respect to each household member
identified under subparagraph (A), elect whether to--
(i) in accordance with section 6103(l)(23)
of the Internal Revenue Code of 1986 (as added
by subsection (f)), consent to the disclosure
and transfer to the applicable Exchange of any
relevant return information for purposes of
determining whether such household member may
be eligible for any insurance affordability
program and facilitating enrollment into such
program and minimum essential coverage,
including any further disclosure and transfer
by the Exchange to any other entity as is
deemed necessary to accomplish such purposes;
and
(ii) in the case consent is provided under
clause (i) with respect to such household
member, enroll such household member in any
minimum essential coverage that is available
with a zero net premium, if--
(I) the member is eligible for such
coverage through an insurance
affordability program; and
(II) the member does not, by the
end of the special enrollment period
described in section 4(c)(1)(A)--
(aa) select a different
plan offering minimum essential
coverage; or
(bb) opt out of such
coverage that is available with
a zero net premium.
(2) Establishment of options for taxpayer consent and
election.--For purposes of paragraph (1)(B), the Secretary, in
consultation with the Secretary of Health and Human Services,
may provide the elections under such paragraph as a single
election or as 2 elections.
(3) Supplemental form.--
(A) In general.--In the case of a taxpayer who has
consented to disclosure and transfer of relevant return
information pursuant to paragraph (1)(B)(i), such
taxpayer shall be enrolled in the insurance
affordability program only if the taxpayer submits a
supplemental form which is designed to collect
additional information necessary (as determined by the
Secretary of Health and Human Services) to establish
eligibility for and enrollment in an insurance
affordability program, which may include (except as
provided in subparagraph (B)), with respect to each
individual described in paragraph (1)(A), the
following:
(i) State of residence.
(ii) Date of birth.
(iii) Employment and the availability of
benefits under a group health plan at the time
the return of tax is filed.
(iv) Any changed circumstances described in
section 1412(b)(2) of the Patient Protection
and Affordable Care Act; (42 U.S.C.
18082(b)(2)).
(v) Solely for the purpose of facilitating
automatic renewal of coverage and eligibility
redeterminations under section 1413(c)(3)(A) of
such Act (42 U.S.C. 18083(c)(3)(A)),
authorization for the Secretary to disclose
relevant return information for subsequent
taxable years to insurance affordability
programs.
(vi) Any methods preferred by the taxpayer
or household member for the purpose of being
contacted by the applicable Exchange or
insurance affordability program with respect to
any eligibility determination for, or
enrollment in, an insurance affordability
program or minimum essential coverage, such as
an email address or a phone number for calls or
text messages.
(vii) Information about household
composition that--
(I) may affect eligibility for an
insurance affordability program, and
(II) is not otherwise included on
the return of tax.
(viii) Such other information as the
Secretary, in consultation with the Secretary
of Health and Human Services, may require,
including information requested on the single,
streamlined application.
(B) Limitations.--The information obtained through
the form described in subparagraph (A) may not include
any request for information with respect to
citizenship, immigration status, or health status of
any household member.
(C) Additional information.--The form described in
subparagraph (A) and the accompanying tax instructions
may provide the taxpayer with additional information
about insurance affordability programs, including
information provided to applicants on the single,
streamlined application.
(D) Accessibility.--
(i) In general.--The Secretary shall ensure
that the form described in subparagraph (A) is
made available to all taxpayers without
discrimination based on language, disability,
literacy, or internet access.
(ii) Rule of construction.--Nothing in
clause (i) shall be construed as diminishing,
reducing, or otherwise limiting any other legal
obligation for the Secretary to avoid or to
prevent discrimination.
(4) Return language.--The Secretary, in consultation with
the Secretary of Health and Human Services, shall, with respect
to any items described in this subsection which are to be
included in a taxpayer's return of tax, develop language for
such items which is as simple and clear as possible (such as
referring to ``insurance affordability programs'' as ``free or
low-cost health insurance'').
(c) Tax Return Preparers.--
(1) In general.--With respect to any information submitted
in conjunction with a tax return solely for purposes of the
program described in subsection (a), any tax return preparer
involved in preparing the return containing such information
shall not be obligated to assess the accuracy of such
information as provided by the taxpayer.
(2) Submission of information.--As part of the program
described in subsection (a), the Secretary shall establish
methods to allow for the immediate transfer of any relevant
return information to the applicable Exchange and insurance
affordability programs in order to increase the potential for
immediate determinations of eligibility for and enrollment in
insurance affordability programs and minimum essential
coverage.
(d) Transfer of Information Through Secure Interface.--
(1) In general.--As part of the program established under
subsection (a), the Secretary shall develop a secure,
electronic interface allowing an exchange of relevant return
information with the applicable Exchange in a manner similar to
the interface described in section 1413(c)(1) of the Patient
Protection and Affordable Care Act (42 U.S.C. 18083(c)(1)).
Upon receipt of such information, the applicable Exchange may
convey such information to any other entity as needed to
facilitate determination of eligibility for an insurance
affordability program or enrollment into minimum essential
coverage.
(2) Transfer by treasury or tax preparers.--
(A) In general.--The interface described in
paragraph (1) shall allow, for any taxpayer who has
provided consent pursuant to subsection (b)(1)(B)(i),
for relevant return information, along with
confirmation that the Secretary has accepted the return
filing as meeting applicable processing criteria, to be
transferred to an applicable Exchange by--
(i) the Secretary; or
(ii) pursuant to such requirements and
standards as are established by the Secretary
(in consultation with the Secretary of Health
and Human Services)--
(I) if the Secretary is not able to
transfer such information to the
applicable Exchange, the taxpayer; or
(II) the tax return preparer who
prepared the return containing such