Letter points to success of state-led “Easy Enrollment” programs that allow Americans to sign up for health insurance when filing their taxes

Washington (June 1, 2023) – Senator Edward J. Markey (D-Mass.) joined 15 senators, led by Senator Chris Van Hollen (D-Md.), in a letter urging the Biden administration to support state-level “Easy Enrollment” initiatives, which enable uninsured low-income families to sign up for health insurance when filing their state income tax returns. Nearly 30 million Americans do not have health insurance and, as of this year, about 18 million are eligible for programs like Medicaid, CHIP, and Advanced Premium Tax Credits – but still aren’t covered. State-based Easy Enrollment programs aim to close this gap, and the efforts have yielded proven success. In their letter to U.S. Health and Human Services Secretary (HHS) Xavier Becerra and Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure, the senators called on the agencies to address administrative barriers that reduce the efficiency of states’ Easy Enrollment programs, in order to make it easier for low-income families to access health care.

“Easy Enrollment efforts ultimately aim to let uninsured tax filers request automatic enrollment in Medicaid, CHIP, or zero-premium Marketplace coverage, but these initiatives are facing unnecessary bureaucratic obstacles. To reach as many eligible uninsured as possible, these states seek to limit the need for people who have already filed their tax returns to complete further paperwork before obtaining health care coverage,” they wrote.

To help states streamline their Easy Enrollment initiatives, the senators urge the Administration to allow states to verify filers’ financial eligibility for programs like Medicaid or the Children’s Health Insurance Program (CHIP), confirm their citizenship status using existing electronic records, and waive tax reconciliation penalties for consumers who choose to automatically enroll in zero-premium Marketplace plans after they have enrolled in health care coverage. The senators note, “With these three flexibilities, States could strengthen Easy Enrollment programs so that numerous uninsured people who are already known to be U.S. citizens could choose to be enrolled automatically into Medicaid, CHIP, and Marketplace plans, based on qualifying income shown on their state income tax returns.”

“Given the large and growing number of states pursuing Easy Enrollment initiatives, we recommend that CMS develop one or more templates making it easy for states to obtain federal approvals needed to maximize coverage gains from this promising approach. In the meantime, we urge the Administration to work proactively with states and to quickly approve state proposals to take the above steps. Easy Enrollment requires coordinating policy and operations between state health and tax agencies, so planning for 2024 Easy Enrollment has already begun. Clear and early guidance showing federal support for automating enrollment, as outlined in this letter, would give our states and others the confidence to innovate boldly and effectively in closing America’s large, persistent, and inequitable enrollment gap,” the senators concluded.

Senators Markey and Van Hollen were joined in sending this letter by Senators Martin Heinrich (D-N.M.), Ben Ray Luján (D-N.M.), Angus King (I-Maine), Mark Warner (D-Va.), Tim Kaine (D-Va.), Cory Booker (D-N.J.), Ben Cardin (D-Md.), Bob Casey (D-Pa.), Elizabeth Warren (D-Mass.), Michael Bennet (D-Colo.), Alex Padilla (D-Calif.), John Hickenlooper (D-Colo.), John Fetterman (D-Pa.), and Bob Menendez (D-N.J.).

The senators’ full letter can be viewed HERE.

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