Sponsors (5)
Introduced June 12, 2025 by Christopher Van Hollen · Last progress June 12, 2025
The bill aims to expand and accelerate health coverage for eligible people by leveraging tax and administrative data and funding system upgrades, trading off meaningful increases in enrollment and administrative efficiency against substantial privacy risks, state implementation costs, potential wrongful eligibility decisions, and open-ended federal spending.
Uninsured and low-income households: the bill uses tax, employer, and federal data plus automatic enrollment/renewal to identify and enroll more eligible people into Medicaid, CHIP, and zero-net-premium marketplace plans, increasing coverage and continuity of care.
Applicants and state agencies: broader use of electronic data matching (IRS, NDNH, employer wage data, SSNs) and streamlined verification reduces paperwork, speeds eligibility determinations and renewals, and can lower administrative burden for applicants and state Exchanges.
Taxpayers and enrollees: clearer, uniform statutory definitions (e.g., 'net premium', timing rules) and coordinated IRS/Exchange rules make premium tax credit calculations and eligibility determinations more consistent, reducing confusion and errors when reconciling on tax returns.
Taxpayers, applicants, and beneficiaries: the bill greatly expands cross-agency and third-party sharing of tax, SSN, employer, and wage data, raising material privacy, surveillance, and data-security risks if data are mishandled or breached.
Taxpayers and federal oversight: the Act authorizes open-ended 'such sums as may be necessary' appropriations and multi-year available funds, which can increase federal outlays and reduce precise Congressional control and fiscal predictability.
Applicants and beneficiaries: reliance on automated data matches and bulk data transfers risks incorrect or outdated matches that can produce erroneous eligibility determinations, wrongful denials or terminations, and administrative appeals.
Based on analysis of 11 sections of legislative text.
Permits taxpayers to consent to share tax-return data with Exchanges so household members can be screened and auto-enrolled into zero-net-premium coverage using administrative data matches.
Creates a program that lets taxpayers opt in to share certain tax-return data with health insurance Exchanges so household members without minimum essential coverage can be screened for and, if eligible, automatically enrolled in zero-net-premium coverage unless they opt out. It requires Exchanges, HHS, and Treasury to use reliable data matches (including new use of National Directory of New Hires data and other sources) to minimize paperwork, funds IT and data-sharing infrastructure, changes timing rules for eligibility, and establishes an advisory committee and a study with a report due by July 1, 2030.