Sponsors
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.
Last progress June 12, 2025 (8 months ago)
Introduced on June 12, 2025 by Ami Bera
Creates a program that uses federal income tax return data (with taxpayer consent) to find household members eligible for low-cost or free coverage and to automatically enroll them into zero-net-premium Medicaid, CHIP, or Marketplace plans. It authorizes Treasury and HHS to fund and build the data-exchange and enrollment systems, changes some eligibility and verification rules for Medicaid/CHIP and Exchanges, requires a study and advisory committee, and sets phased effective dates for key provisions.
The Secretary of Health and Human Services must conduct a study analyzing the impact of this Act and make recommendations based on the study.
Study and recommend State pilot projects to test improvements to this Act, including analyzing policies that automatically enroll eligible individuals into group health plans.
Study and recommend modifying open enrollment periods for Health Insurance Exchanges and plan years so that open enrollment coincides with the filing of Federal income tax returns.
Study and recommend other steps to improve outcomes achieved by this Act.
Not later than July 1, 2030, the Secretary must deliver a report on the study and recommendations to specified House and Senate committees.
Who is affected and how:
Individuals and families who file federal tax returns: Their return data can be used (with consent) to check eligibility and automatically enroll household members in zero-net-premium plans, potentially increasing coverage and reducing paperwork. People can opt out.
Children and families eligible for CHIP/Medicaid: May see faster determinations and higher enrollment rates because Exchanges and states can accept data matches and rely on TANF/SNAP findings.
Marketplace (Exchange) enrollees and applicants: Exchanges will get new tools and data to verify eligibility, default-enroll into zero-net-premium plans, and reduce requests for extra documents; this may speed enrollment but will require system changes.
State governments and state Medicaid/CHIP programs: Must adapt to new verification rules, data matches, and possible default-enrollment procedures; they may receive transferred funds but will face administrative and IT work.
Federal agencies (Treasury/IRS, HHS, Office of Child Support Enforcement): Will build, secure, and run data-exchange systems, set program rules, and oversee transfers and cost recovery; they assume major implementation responsibilities.
Privacy and consumer advocates: May raise concerns about using tax and wage data for enrollment; the bill includes privacy protections, data agreements, opt-out options, and error-correction processes intended to reduce risk.
Overall effects: The legislation aims to increase health coverage take-up and reduce administrative burden by automating parts of eligibility and enrollment, but it requires significant system builds, interagency data-sharing, state coordination, and careful privacy safeguards to avoid errors or unintended enrollments.
Updated 4 days ago
Last progress June 12, 2025 (8 months ago)