Sec. 3. Federal income tax returns used to facilitate enrollment into insurance affordability programs

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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— 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 have such household member enrolled into minimum essential coverage, provided that— such coverage is provided through a zero-net-premium plan, and the taxpayer does not— opt out of coverage through the zero-net-premium plan, or select a different plan.

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— identify any household member who is not covered under minimum essential coverage at the time of such filing; and with respect to each household member identified under subparagraph (A), elect whether to— 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 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— the member is eligible for such coverage through an insurance affordability program; and the member does not, by the end of the special enrollment period described in section 4(c)(1)(A)— select a different plan offering minimum essential coverage; or opt out of such coverage that is available with a zero net premium. 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. 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: State of residence. Date of birth. Employment and the availability of benefits under a group health plan at the time the return of tax is filed. Any changed circumstances described in section 1412(b)(2) of the Patient Protection and Affordable Care Act; ( 42 U.S.C. 18082(b)(2) ). 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. 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. Information about household composition that— may affect eligibility for an insurance affordability program, and is not otherwise included on the return of tax. 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. 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. 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. 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. 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. 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 ). 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. 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. 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. 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— the Secretary; or pursuant to such requirements and standards as are established by the Secretary (in consultation with the Secretary of Health and Human Services)— if the Secretary is not able to transfer such information to the applicable Exchange, the taxpayer; or the tax return preparer who prepared the return containing such information. As soon as is practicable after the filing of a return described in subsection

(a)in which the taxpayer has provided consent pursuant to subsection (b)(1)(B)(i), the Secretary shall provide for all relevant return information to be transferred to the applicable Exchange. Any transfer of relevant return information described in this subsection shall be conducted— pursuant to interagency agreements that ensure data security and maintain privacy in a manner that satisfies the requirements under section 1942(b) of the Social Security Act ( 42 U.S.C. 1396w–2(b) ); and in the case of any taxpayer filing their tax return electronically, in a manner that maximizes the opportunity for such taxpayer, as part of the process of filing such return, to immediately— obtain a determination with respect to the eligibility of any household member for any insurance affordability program; and enroll in minimum essential coverage. The Secretary of Health and Human Services, in consultation with the Secretary, shall establish procedures for addressing instances in which an error in relevant return information that was transferred to an Exchange under subsection

(d)may have resulted in a determination that an individual is eligible for more or less assistance under an insurance affordability program than the assistance for which the individual would otherwise have been eligible without the error. Such procedures shall include procedures for— the reporting of such error to the individual, the Secretary of Health and Human Services, and the applicable Exchange and insurance affordability program, regardless of whether such error was included in an amendment to the tax return; and correcting, as soon as practicable, the individual’s eligibility status for insurance affordability programs, subject to, in the case of reduced eligibility for assistance, any right of notice and appeal under laws governing the applicable insurance affordability program, including section 1411(f) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18081(f) ). Section 6103(l) of the Internal Revenue Code of 1986 is amended by adding at the end the following: In the case of any taxpayer who has consented to the disclosure and transfer of any relevant return information with respect to any household member pursuant to section 3(b) of the Easy Enrollment in Health Care Act , the Secretary shall disclose such information to the applicable Exchange. Return information disclosed under subparagraph

(A)may be— used by an Exchange only for the purposes of, and to the extent necessary in— determining eligibility for an insurance affordability program, or facilitating enrollment into minimum essential coverage, and further disclosed by an Exchange to any other person only for the purposes of, and to the extent necessary, to carry out subclauses

(I)and

(II)of clause (i). For purposes of this paragraph, the terms relevant return information , Exchange , insurance affordability program , and minimum essential coverage have the same meanings given such terms under section 2 of the Easy Enrollment in Health Care Act . . Section 6103(p)(4) of the Internal Revenue Code of 1986 is amended by inserting or any Exchange described in subsection (l)(23), after or any entity described in subsection (l)(21), each place it appears. Nothing in this Act shall be construed as requiring any individual, as a condition of applying for an insurance affordability program, to— file a return of tax for any taxable year for which filing a return of tax would not otherwise be required for such taxable year; or consent to disclosure of relevant return information under subsection (b)(1)(B)(i). Any agency administering an insurance affordability program shall implement methods and procedures, as prescribed by the Secretary of Health and Human Services, in consultation with the Secretary, through which, in the case of an individual applying for an insurance affordability program without filing a return of tax or consenting to disclosure of relevant return information under subsection (b)(1)(B)(i), the program determines household income and family size for— a calendar year described in section 1902(e)(14)(D)(vii)(I) of the Social Security Act ( 42 U.S.C. 1396a ), as added by section 5(a); and an applicable taxable year, as defined in section 36B(c)(5) of the Internal Revenue Code of 1986 (as added by section 5(b)). In this section, the term Secretary means the Secretary of the Treasury, or the Secretary’s delegate.

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U.S. Code

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42 USC 1396w–2(b)

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Sec. 3

Federal income tax returns used to facilitate enrollment into insurance affordability programs

Cite42 USC 1396w–2(b)

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