To streamline enrollment in health insurance affordability programs and minimum essential coverage, and for other purposes.
Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.
Summary
What This Bill Does
This bill creates an opt-in system allowing taxpayers to check a box on their federal income tax return to authorize automatic enrollment in health insurance programs they qualify for. Starting in 2028, when filing taxes, uninsured taxpayers can consent to have their income and household information shared with health insurance exchanges to determine eligibility for Medicaid, CHIP, ACA marketplace plans with subsidies, or state basic health programs. Eligible individuals would be automatically enrolled in zero-premium plans unless they opt out.
Who Benefits and How
Uninsured Americans gain a simplified path to health coverage without navigating separate enrollment systems - their tax return data automatically determines eligibility. State Medicaid and CHIP programs benefit from streamlined enrollment using existing SNAP and TANF eligibility findings, reducing administrative duplication. Health insurance exchanges gain access to IRS tax data and the National Directory of New Hires for more accurate eligibility determinations. Low-income families especially benefit as children and adults can be enrolled in coverage with minimal additional paperwork.
Who Bears the Burden and How
The IRS and Treasury Department must build new IT infrastructure to share tax return data with health exchanges by 2028, funded by open-ended appropriations. HHS must coordinate across multiple agencies including CMS, state Medicaid programs, and the Office of Child Support Enforcement. Insurance affordability programs must reimburse HHS for data access. States must modify their Medicaid eligibility systems to accept cross-program findings from SNAP and TANF.
Key Provisions
- Creates opt-in tax return checkbox for automatic health coverage enrollment starting 2028
- Authorizes disclosure of tax return information to health exchanges for eligibility determination
- Requires states to accept SNAP and TANF eligibility findings for Medicaid
- Grants exchanges access to National Directory of New Hires for employment and wage verification
- Establishes advisory committee on behavioral economics and enrollment optimization
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers.
At a Glance
What This Bill Does
Streamlines enrollment in health insurance affordability programs by allowing taxpayers to opt-in to automatic eligibility determination and enrollment in Medicaid, CHIP, or ACA marketplace plans through the federal income tax filing process
Key Policy Areas
Healthcare, Taxation, Social Services, Data Privacy
Primary Purpose
Streamlines enrollment in health insurance affordability programs by allowing taxpayers to opt-in to automatic eligibility determination and enrollment in Medicaid, CHIP, or ACA marketplace plans through the federal income tax filing process
Policy Domains
Easy Enrollment in Health Care Act
Identified Gains
Contextual inference, no direct clause citation- Uninsured Americans eligible for subsidized coverage
- State Medicaid and CHIP programs
- Health insurance exchanges
- Children eligible for CHIP
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- IRS and Treasury Department
- HHS and CMS
- State Medicaid agencies
Contextual inference, no direct clause citation
Sponsors
Legislative Progress
IntroducedMr. Bera introduced the following bill; which was referred to …
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
HHS, HHS Office of Information Technology, Office of Child Support Enforcement
Health insurance exchanges, Health insurance industry stakeholders, Health insurers offering zero-premium plans
Health insurance exchanges faces effects in multiple directions
Taxpayers, Uninsured individuals eligible for coverage, Uninsured taxpayers eligible for subsidies
Positive-direction: Uninsured individuals eligible for coverage, Uninsured taxpayers eligible for subsidies
Negative-direction: Taxpayers
IT contractors serving federal health agencies, Tax preparation software companies
Positive-direction: IT contractors serving federal health agencies
Negative-direction: Tax preparation software companies
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "exchange"
- → American Health Benefit Exchange (ACA marketplace)
- "the_secretary"
- → Secretary of the Treasury (unless otherwise specified)
- "the_secretary_hhs"
- → Secretary of Health and Human Services
Key Definitions
Terms defined in this bill
A State plan for child health assistance under title XXI of the Social Security Act
An American Health Benefit Exchange established under the Patient Protection and Affordable Care Act
The taxpayer, the taxpayer's spouse, and any dependent of the taxpayer
Medicaid, CHIP, ACA exchange plans with premium tax credits, state basic health programs, and other programs providing assistance for minimum essential coverage
Coverage as defined in section 5000A(f) of the Internal Revenue Code (qualifying health insurance)
A plan with no premiums after accounting for advance premium tax credits
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology