119-hr3947

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3947 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 3947

To streamline enrollment in health insurance affordability programs and 
 minimum essential coverage, and for other purposes.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 June 12, 2025

 Mr. Bera introduced the following bill; which was 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

_______________________________________________________________________

 A BILL

To streamline enrollment in health insurance affordability programs and 
 minimum essential coverage, and for other purposes.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Easy Enrollment in Health Care 
Act''.

SEC. 2. DEFINITIONS.

 In this Act:

    (1) CHIP program.--The term ``CHIP program'' means a State 
 plan for child health assistance under title XXI of the Social 
 Security Act (42 U.S.C. 1397aa et seq.), including any waiver 
 of such a plan.

    (2) Exchange.--The term ``Exchange'' means an American 
 Health Benefit Exchange established under subtitle D of title I 
 of the Patient Protection and Affordable Care Act (42 U.S.C. 
 18021 et seq.).

    (3) Family size.--The term ``family size'' has the meaning 
 given such term in 

section 36B
            (d) of the Internal Revenue Code 
 of 1986.

    (4) Group health plan.--The term ``group health plan'' has 
 the meaning given such term in 

section 5000

    (b)

    (1) of the 
 Internal Revenue Code of 1986.

    (5) Household income.--The term ``household income'' has 
 the meaning given such term in 

section 36B
            (d) of the Internal 
 Revenue Code of 1986.

    (6) Household member.--The term ``household member'' means 
 the taxpayer, the taxpayer's spouse, and any dependent of the 
 taxpayer.

    (7) Insurance affordability program.--The term ``insurance 
 affordability program'' means any of the following:
        (A) A Medicaid program.
        (B) A CHIP program.
            (C) The program under title I of the Patient 
 Protection and Affordable Care Act (42 U.S.C. 18001 et 
 seq.) for the enrollment in qualified health plans 
 offered through an Exchange, including the premium tax 
 credits under 

section 36B of the Internal Revenue Code 
 of 1986, cost-sharing reductions under 

section 1402 of 
 the Patient Protection and Affordable Care Act (42 
 U.S.C. 18071), and the advance payment of such credits 
 and reductions under 

section 1412

    (a)

    (3) of the Patient 
 Protection and Affordable Care Act (42 U.S.C. 
 18082

    (a)

    (3) ).
            (D) A State basic health program under 

section 1331 
 of the Patient Protection and Affordable Care Act (42 
 U.S.C. 18051).
        (E) Any other Federal, State, or local program that 
 provides assistance for some or all of the cost of 
 minimum essential coverage and requires eligibility for 
 such program to be based in whole or in part on income, 
 including such a program carried out through a waiver 
 under 

section 1332 of the Patient Protection and 
 Affordable Care Act (42 U.S.C. 18052) or a State 
 program supplementing the advanced payment of tax 
 credits and cost-sharing reductions under 

section 1412

    (a)

    (3) of such Act (42 U.S.C. 18082

    (a)

    (3) ).

    (8) Medicaid program.--The term ``Medicaid program'' means 
 a State plan for medical assistance under title XIX of the 
 Social Security Act (42 U.S.C. 1396 et seq.), including any 
 waiver of such a plan.

    (9) Minimum essential coverage.--The term ``minimum 
 essential coverage'' has the meaning given such term in 

section 5000A

    (f) of the Internal Revenue Code of 1986.

    (10) Modified adjusted gross income.--The term ``modified 
 adjusted gross income'' has the meaning given such term in 
 

section 36B
            (d) (2)
        (B) of the Internal Revenue Code of 1986.

    (11) Net premium.--The term ``net premium'', with respect 
 to a health plan or other form of minimum essential coverage--
        (A) except as provided in subparagraph
        (B) , means 
 the payment from or on behalf of an individual required 
 to enroll in such plan or coverage, after application 
 of the premium tax credit under 

section 36B of the 
 Internal Revenue Code of 1986, the advance payment of 
 such credit under 

section 1412

    (a)

    (3) of the Patient 
 Protection and Affordable Care Act (42 U.S.C. 
 18082

    (a)

    (3) ), and any other assistance provided by an 
 insurance affordability program; and
        (B) does not include any amounts described in 
 

section 36B

    (b)

    (3)
            (D) of the Internal Revenue Code of 
 1986 or 

section 1303

    (b)

    (2) of the Patient Protection 
 and Affordable Care Act (42 U.S.C. 18023

    (b)

    (2) ).

    (12) Poverty line.--The term ``poverty line'' has the 
 meaning given such term in 

section 36B
            (d) (3) of the Internal 
 Revenue Code of 1986.

    (13) Qualified health plan.--The term ``qualified health 
 plan'' has the meaning given such term in 

section 1301

    (a) of 
 the Patient Protection and Affordable Care Act (42 U.S.C. 
 18021

    (a) ).

    (14) Relevant return information.--The term ``relevant 
 return information'' means, with respect to a taxpayer, any 
 return information, as defined in 

section 6103

    (b)

    (2) of the 
 Internal Revenue Code of 1986, which may be relevant, as 
 determined by the Secretary of the Treasury in consultation 
 with the Secretary of Health and Human Services, with respect 
 to--
        (A) determining, or facilitating determination of, 
 the eligibility of any household member of the taxpayer 
 for any insurance affordability program, either 
 directly or through enabling access to additional 
 information potentially relevant to such eligibility; 
 or
        (B) enrolling, or facilitating the enrollment of, 
 such individual in minimum essential coverage.

    (15) Single, streamlined application.--The term ``single, 
 streamlined application'' means the form described in 

section 1413

    (b)

    (1)
        (A) of the Patient Protection and Affordable Care Act 
 (42 U.S.C. 18083

    (b)

    (1)
        (A) ).

    (16) Tax return preparer.--The term ``tax return preparer'' 
 has the meaning given such term in 

section 7701

    (a)

    (36) of the 
 Internal Revenue Code of 1986.

    (17) Zero net premium.--The term ``zero net premium'', with 
 respect to a health plan or other form of minimum essential 
 coverage, means a net premium of $0.00 for such plan or 
 coverage.

SEC. 3. FEDERAL INCOME TAX RETURNS USED TO FACILITATE ENROLLMENT INTO 
 INSURANCE AFFORDABILITY PROGRAMS.

    (a) In General.--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--

    (1) 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

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

    (b) Taxpayer Requirements and Consent.--

    (1) In general.--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--
        (A) identify any household member who is not 
 covered under minimum essential coverage at the time of 
 such filing; and
        (B) with respect to each household member 
 identified under subparagraph
        (A) , elect whether to--
            (i) 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
            (ii) 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--
            (I) the member is eligible for such 
 coverage through an insurance 
 affordability program; and
            (II) the member does not, by the 
 end of the special enrollment period 
 described in 

section 4
            (c) (1)
        (A) --

    (aa) select a different 
 plan offering minimum essential 
 coverage; or

    (bb) opt out of such 
 coverage that is available with 
 a zero net premium.

    (2) Establishment of options for taxpayer consent and 
 election.--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.

    (3) Supplemental form.--
        (A) In general.--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:
            (i) State of residence.
            (ii) Date of birth.
            (iii) Employment and the availability of 
 benefits under a group health plan at the time 
 the return of tax is filed.
            (iv) Any changed circumstances described in 
 

section 1412

    (b)

    (2) of the Patient Protection 
 and Affordable Care Act; (42 U.S.C. 
 18082

    (b)

    (2) ).
            (v) 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.
            (vi) 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.
            (vii) Information about household 
 composition that--
            (I) may affect eligibility for an 
 insurance affordability program, and
            (II) is not otherwise included on 
 the return of tax.
            (viii) 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.
        (B) Limitations.--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.
            (C) Additional information.--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.
            (D) Accessibility.--
            (i) In general.--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.
            (ii) Rule of construction.--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.

    (4) Return language.--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'').
            (c) Tax Return Preparers.--

    (1) In general.--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.

    (2) Submission of information.--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.
            (d) Transfer of Information Through Secure Interface.--

    (1) In general.--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.

    (2) Transfer by treasury or tax preparers.--
        (A) In general.--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--
            (i) the Secretary; or
            (ii) pursuant to such requirements and 
 standards as are established by the Secretary 
 (in consultation with the Secretary of Health 
 and Human Services)--
            (I) if the Secretary is not able to 
 transfer such information to the 
 applicable Exchange, the taxpayer; or
            (II) the tax return preparer who 
 prepared the return containing such 
 information.
        (B) Transfer requirements.--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.
            (C) Data security.--Any transfer of relevant return 
 information described in this subsection shall be 
 conducted--
            (i) 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
            (ii) 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--
            (I) obtain a determination with 
 respect to the eligibility of any 
 household member for any insurance 
 affordability program; and
            (II) enroll in minimum essential 
 coverage.

    (e) Errors That Affect Eligibility for Insurance Affordability 
Programs.--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--

    (1) 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

    (2) 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) ).

    (f) Disclosure of Return Information for Determining Eligibility 
for Insurance Affordability Programs and Enrollment Into Minimum 
Essential Health Coverage.--

    (1) In general.--

Section 6103
            (l) of the Internal Revenue 
 Code of 1986 is amended by adding at the end the following:
 ``

    (23) Disclosure of return information for determining 
 eligibility for insurance affordability programs and enrollment 
 into minimum essential health coverage.--
 ``
        (A) In general.--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.
 ``
        (B) Restriction on disclosure.--Return 
 information disclosed under subparagraph
        (A) may be--
 ``
            (i) used by an Exchange only for the 
 purposes of, and to the extent necessary in--
 ``
            (I) determining eligibility for 
 an insurance affordability program, or
 ``
            (II) facilitating enrollment into 
 minimum essential coverage, and
 ``
            (ii) 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) .
 ``
            (C) === Definitions. ===
-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.''.

    (2) Safeguards.--

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.

    (g) Applications for Insurance Affordability Programs Without 
Reliance on Federal Income Tax Returns.--

    (1) Rule of construction.--Nothing in this Act shall be 
 construed as requiring any individual, as a condition of 
 applying for an insurance affordability program, to--
        (A) 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
        (B) consent to disclosure of relevant return 
 information under subsection

    (b)

    (1)
        (B)
            (i) .

    (2) Methods and procedures.--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) 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
        (B) an applicable taxable year, as defined in 
 

section 36B
            (c) (5) of the Internal Revenue Code of 1986 
 (as added by 

section 5

    (b) ).

    (h) Secretary.--In this section, the term ``Secretary'' means the 
Secretary of the Treasury, or the Secretary's delegate.

SEC. 4. EXCHANGE USE OF RELEVANT RETURN INFORMATION.

    (a) In General.--An Exchange that receives relevant return 
information under 

section 3
            (d) with respect to a taxpayer who has 
provided consent under 

section 3

    (b)

    (1)
        (B) shall--

    (1) minimize additional information (if any) that is 
 required to be provided by such taxpayer for a household member 
 to qualify for any insurance affordability program by, whenever 
 feasible, qualifying such household member for such program 
 based on--
        (A) relevant information provided on the tax return 
 filed by the taxpayer, including information on the 
 supplemental form described in 

section 3

    (b)

    (3) ; and
        (B) information from other reliable third-party 
 data sources that is relevant to eligibility for such 
 program but not available from the return, including 
 information obtained through data matching based on 
 social security numbers, other identifying information, 
 and other items obtained from such return;

    (2) determine the eligibility of any household member for 
 the CHIP program and, where eligibility is determined based on 
 modified adjusted gross income, the Medicaid program, as 
 required under 

section 1413 of the Patient Protection and 
 Affordable Care Act (42 U.S.C. 18083) and 

section 1943 of the 
 Social Security Act (42 U.S.C. 1396w-3), subject to any right 
 of notice and appeal under laws governing such programs, 
 including 

section 1411

    (f) of the Patient Protection and 
 Affordable Care Act (42 U.S.C. 18081

    (f) );

    (3) to the extent that any additional information is 
 necessary for determining the eligibility of any household 
 member for an insurance affordability program, obtain such 
 information in the manner that--
        (A) imposes the lowest feasible procedural burden 
 to the taxpayer, including--
            (i) in the case of a taxpayer filing their 
 tax return electronically, online collection of 
 such information at or near the time of such 
 filing; and
            (ii) prior to a denial of eligibility or 
 enrollment due to failure to provide such 
 information, attempting to contact the taxpayer 
 multiple times using the preferred contact 
 methods described in 

section 3

    (b)

    (3)
        (A)
            (vi) ; 
 and
        (B) provides the individual with all procedural 
 protections that would otherwise be available in 
 applying for such program, including the reasonable 
 opportunity period described in 

section 1137
            (d) (4)
        (A) of the Social Security Act (42 U.S.C. 1320b-
 7
            (d) (4)
        (A) ); and

    (4) when an individual is found eligible for an insurance 
 affordability program other than the Medicaid program--
        (A) enable such individual, through procedures 
 prescribed by the Secretary of Health and Human 
 Services, to seek coverage under the Medicaid program 
 or CHIP program by providing additional information 
 demonstrating potential eligibility for such program, 
 with any resulting determination subject to rights of 
 notice and appeal under laws governing insurance 
 affordability programs, including 

section 1411

    (f) of 
 the Patient Protection and Affordable Care Act (42 
 U.S.C. 18081

    (f) ); and
        (B) provide such individual with notice of such 
 procedures.

    (b) Medicaid and CHIP.--

    (1) State options.--
        (A) In general.--In a State for which the Secretary 
 of Health and Human Services is determining eligibility 
 for individuals who apply for insurance affordability 
 programs at the Exchange serving residents of the 
 individual's State, the Secretary of Health and Human 
 Services shall present the State with not less than 3 
 sets of options for verification procedures and 
 business rules that the Exchange serving residents of 
 such State shall use in determining eligibility for the 
 State Medicaid program and CHIP program with respect to 
 individuals who are household members described in 
 

section 3

    (b)

    (1)
        (B) . Notwithstanding any other provision 
 of law, the Secretary of Health and Human Services may 
 present each State with the same 3 sets of options, 
 provided that each set can be customized to reflect 
 each State's decisions about optional eligibility 
 categories and criteria for the Medicaid program and 
 CHIP program.
        (B) Business rules.--The business rules described 
 in subparagraph
        (A) shall specify detailed eligibility 
 determination rules and procedures for processing 
 initial applications and renewals, including--
            (i) the Secretary's use of data from State 
 agencies and other sources described in 
 subsection
            (c) (3)
        (A)
            (ii) of 

section 1413 of the 
 Patient Protection and Affordable Care Act (42 
 U.S.C. 18083); and
            (ii) the circumstances for administrative 
 renewal of eligibility for the Medicaid program 
 and the CHIP program, based on data showing 
 probable continued eligibility.
            (C) Default.--In the case of a State described in 
 subparagraph
        (A) that does not select an option from 
 the set presented under such subparagraph within a 
 timeframe specified by the Secretary of Health and 
 Human Services, the Secretary of Health and Human 
 Services shall determine the option that the Exchange 
 shall use for such State for the purposes described in 
 such subparagraph.
            (D) Rule of construction.--Nothing in this 
 paragraph shall be construed as requiring a State to 
 provide benefits under title XIX or XXI of the Social 
 Security Act (42 U.S.C. 1396 et seq., 1397aa et seq.) 
 to a category of individuals, or to set an income 
 eligibility threshold for benefits under such titles at 
 a certain level, if the State is not otherwise required 
 to do so under such titles.

    (2) Enrollment.--
        (A) In general.--If the Exchange in a State 
 determines that an individual described in paragraph

    (1)
        (A) is eligible for benefits under the State 
 Medicaid program or CHIP program, the Exchange shall 
 send the relevant information about the individual to 
 the State and, if consent has been given under 

section 3

    (b)

    (1)
        (B) to enrollment in a health plan or other form 
 of minimum essential coverage with a zero net premium, 
 the State shall enroll such individual in the State 
 Medicaid program or CHIP program (as applicable) as 
 soon as practicable, except as provided in 
 subparagraphs
        (B) and
            (D) .
        (B) Exception.--A State shall not enroll an 
 individual in coverage under the State Medicaid program 
 or CHIP program without the affirmative consent of the 
 individual if the individual would be required to pay a 
 premium for such coverage.
            (C) Managed care.--If the State Medicaid program or 
 CHIP program requires an individual enrolled under 
 subparagraph
        (A) to receive coverage through a managed 
 care organization or entity, the State shall use a 
 procedure for assigning the individual to such an 
 organization or entity (including auto-assignment 
 procedures) that is commonly used in the State when an 
 individual who is found eligible for such program does 
 not affirmatively select a particular organization or 
 entity.
            (D) Opt-out procedures.--Notwithstanding 
 subparagraph
        (A) , an individual described in such 
 subparagraph shall be given one or more opportunities 
 to opt out of coverage under a State Medicaid program 
 or CHIP program, using procedures prescribed by the 
 Secretary of Health and Human Services.
            (c) Advance Premium Tax Credits for Qualified Health Plans.--

    (1) In general.--In the case where a taxpayer has filed 
 their return of tax for a taxable year on or before the date 
 specified under 

section 6072

    (a) of the Internal Revenue Code of 
 1986 with respect to such year and has provided consent 
 described in 

section 3

    (b)

    (1)
        (B)
            (i) , if the Exchange has 
 determined that an applicable household member has not 
 qualified for the Medicaid program or the CHIP program, such 
 Exchange shall--
        (A) in addition to any such period that may 
 otherwise be available, provide a special enrollment 
 period that begins on the date the taxpayer has 
 provided such consent; and
        (B) determine--
            (i) whether the taxpayer would, pursuant to 
 

section 1412 of the Patient Protection and 
 Affordable Care Act (42 U.S.C. 18082), be 
 eligible for advance payment of the premium 
 assistance tax credit under 

section 36B of the 
 Internal Revenue Code of 1986 if such household 
 member of the taxpayer were enrolled in a 
 qualified health plan; and
            (ii) if the taxpayer has made the election 
 described in 

section 3

    (b)

    (1)
        (B)
            (ii) , whether 
 such household member has one or more options 
 to enroll in a qualified health plan with a 
 zero net premium.

    (2) Enrollment in a qualified health plan with a zero net 
 premium.--
        (A) In general.--In the case that a household 
 member described in paragraph

    (1) has one or more 
 options to enroll in a qualified health plan with a 
 zero net premium, and consent has been given under 
 

section 3

    (b)

    (1)
        (B) for enrollment of such household 
 member in a qualified health plan with a zero net 
 premium--
            (i) the Exchange shall identify a set of 
 options (as described in subparagraph
        (B) ) for 
 qualified health plans offering a zero net 
 premium; and
            (ii) from such set, select a qualified 
 health plan as the default enrollment choice 
 for the household member in accordance with 
 subparagraph
            (C) .
        (B) Option sets.--
            (i) In general.--In the case that multiple 
 qualified health plans with a zero net premium 
 are available with more than 1 actuarial value, 
 the Exchange shall limit the set of options 
 under subparagraph
        (A)
            (i) to such qualified 
 health plans with the highest available 
 actuarial value.
            (ii) Further restrictions.--In the case 
 described in clause
            (i) , the Exchange may 
 further limit the set of options under 
 subparagraph
        (A)
            (i) , among the qualified health 
 plans that have the highest available actuarial 
 value as described in clause
            (i) , based on the 
 generosity of such plans' coverage of services 
 not subject to a deductible.
            (iii) Definition of highest actuarial 
 value.--For purposes of this subparagraph, the 
 term ``highest actuarial value'' means the 
 highest actuarial value among--
            (I) the levels of coverage 
 described in paragraph

    (1) of 

section 1302
            (d) of the Patient Protection and 
 Affordable Care Act (42 U.S.C. 
 18022
            (d) ), without regard to allowable 
 variance under paragraph

    (3) of such 
 section; and
            (II) as applicable, the levels of 
 coverage that result from the 
 application of cost-sharing reductions 
 under 

section 1402 of such Act (42 
 U.S.C. 18071).
            (C) Selecting a default option.--The Secretary of 
 Health and Human Services shall establish procedures 
 that Exchanges may use in selecting, from the set of 
 options described in subparagraph
        (B) , the default 
 enrollment choice under subparagraph
        (A)
            (ii) . Such 
 procedures shall include--
            (i) State options for randomization among 
 health insurance issuers; and
            (ii) factors that may be used to weight 
 such randomization.
            (D) Notification of default enrollment.--As soon as 
 possible after an Exchange has identified a default 
 enrollment choice for an individual under subparagraph
        (A)
            (ii) , the Exchange shall provide the individual with 
 notice of such selection. The notice shall include--
            (i) a description of coverage provided by 
 the selected qualified health plan;
            (ii) encouragement to learn about all 
 available qualified health plan options before 
 the end of the special enrollment period under 
 paragraph

    (1)
        (A) and to select a plan that best 
 meets the needs of the individual and the 
 individual's family;
            (iii) an explanation that, if the 
 individual does not select a qualified health 
 plan by the end of such special enrollment 
 period or opt out of default enrollment in 
 accordance with the process described in clause
            (iv) , the Exchange will enroll the individual 
 in such selected qualified health plan in 
 accordance with subparagraph
        (E) ;
            (iv) an explanation of the opt-out process 
 preceding implementation of default enrollment, 
 which shall meet standards prescribed by the 
 Secretary of Health and Human Services; and
            (v) information on options for assistance 
 with enrollment and plan choice, including 
 publicly funded navigators and private brokers 
 and agents approved by the Exchange.
        (E) Default enrollment.--
            (i) In general.--Subject to subparagraph
        (F) , an Exchange shall enroll in a default 
 enrollment choice any individual who--
            (I) is sent a notice under 
 subparagraph
            (D) ; and
            (II) fails to select a different 
 qualified health plan, or opt out of 
 default enrollment under this 
 paragraph, by the end of the special 
 enrollment period described in 
 paragraph

    (1)
        (A) .
            (ii) Updated notice.--At the time of the 
 default enrollment described in clause
            (i) , the 
 Exchange shall send a notice to the individual 
 explaining that default enrollment has 
 occurred, describing the plan into which the 
 individual has been enrolled, and explaining 
 the reconsideration procedures described in 
 subparagraph
        (F) .
        (F) Reconsideration.--
            (i) In general.--Not later than 30 days 
 after receiving a notice under subparagraph
        (E)
            (ii) , the individual receiving such notice 
 may use a method provided by the Exchange to 
 indicate--
            (I) the individual's decision to 
 disenroll from the qualified health 
 plan selected under subparagraph
        (A)
            (ii) ; or
            (II) in the case of a household 
 member for whom the selected qualified 
 health plan under such subparagraph is 
 a high cost-sharing qualified health 
 plan, the individual's decision to 
 enroll in a specified lower cost-
 sharing qualified health plan, 
 identified by the Exchange, that is 
 offered by the same health insurance 
 issuer that sponsors the qualified 
 health plan that was selected under 
 such subparagraph.
            (ii) === Definitions. ===
-For purposes of this 
 subparagraph:
            (I) High cost-sharing qualified 
 health plan.--The term ``high cost-
 sharing qualified health plan'' means--

    (aa) in the case of a 
 household member with a 
 household income at or below 
 200 percent of the poverty 
 line, a qualified health plan 
 that is not at the silver 
 level; or

    (bb) in the case of a 
 household member with a 
 household income above 200 
 percent of the poverty line, a 
 qualified health plan that is 
 not at the gold or platinum 
 level.
            (II) Specified lower cost-sharing 
 qualified health plan.--The term 
 ``specified lower cost-sharing 
 qualified health plan'' means--

    (aa) in the case of a 
 household member with a 
 household income at or below 
 200 percent of the poverty 
 line, the lowest-premium 
 qualified health plan offered 
 by the health insurance issuer 
 that is at the silver level; or

    (bb) in the case of a 
 household member with a 
 household income above 200 
 percent of the poverty line, 
 the lowest-premium qualified 
 health plan offered by the 
 health insurance issuer that is 
 at the gold level.

SEC. 5. MODERNIZING ELIGIBILITY CRITERIA FOR INSURANCE AFFORDABILITY 
 PROGRAMS.

    (a) Income Eligibility Determinations for Medicaid and CHIP.--

    (1) In general.--

Section 1902

    (e)

    (14)
            (D) of the Social 
 Security Act (42 U.S.C. 1396a

    (e)

    (14)
            (D) ) is amended by adding 
 at the end the following new clauses:
 ``
            (vi) SNAP and tanf eligibility 
 

=== findings ===
-
 ``
            (I) In general.--Subject to 
 subclause
            (III) , a State shall provide 
 that an individual for whom a finding 
 has been made as described in clause
            (II) shall meet applicable eligibility 
 for assistance under the State plan or 
 a waiver of the plan involving 
 financial eligibility, citizenship or 
 satisfactory immigration status, and 
 State residence. A State shall rely on 
 such a finding both for the initial 
 determination of eligibility for 
 medical assistance under the plan or 
 waiver and any subsequent 
 redetermination of eligibility.
 ``
            (II) Findings described.--A 
 finding described in this subclause is 
 a determination made within a 
 reasonable period (as determined by the 
 Secretary) by a State agency 
 responsible for administering the 
 Temporary Assistance for Needy Families 
 program under part A of title IV or the 
 Supplemental Nutrition Assistance 
 Program established under the Food and 
 Nutrition Act of 2008 that an 
 individual is eligible for benefits 
 under such program.
 ``
            (III) Limitation.--A State shall 
 be required to rely on the findings of 
 the State agency responsible for 
 administering the supplemental 
 nutrition assistance program 
 established under the Food and 
 Nutrition Act of 2008 only in the case 
 of--
 ``

    (aa) an individual who is 
 under 19 years of age; or
 ``

    (bb) an individual who is 
 described in subsection

    (a)

    (10)
        (A)
            (i) 
            (VIII) .
 ``
            (IV) State option.--A State may 
 rely on the findings of the State 
 agency responsible for administering 
 the supplemental nutrition assistance 
 program established under the Food and 
 Nutrition Act of 2008 in the case of an 
 individual not described in subclause
            (III) .
 ``
            (vii) Recent annual income establishing 
 eligibility.--
 ``
            (I) In general.--For purposes of 
 determining the income eligibility for 
 medical assistance of an individual 
 whose eligibility is determined based 
 on the application of modified adjusted 
 gross income under subparagraph
        (A) , a 
 State shall provide that an individual 
 whose eligibility date occurs in 
 January, February, March, or April of a 
 calendar year shall be financially 
 eligible if the individual's modified 
 adjusted gross income for the preceding 
 calendar year satisfies the income 
 eligibility requirement applicable to 
 the individual.
 ``
            (II) === Definition. ===
-For purposes of 
 this clause, an `eligibility date' 
 means--
 ``

    (aa) in the case of an 
 individual who is not receiving 
 medical assistance when the 
 individual applies for an 
 insurance affordability program 
 (as defined in 

section 2 of the 
 Easy Enrollment in Health Care 
 Act), whether such application 
 takes place through 

section 3

    (b) of such Act or otherwise, 
 the date on which such 
 individual applies for such 
 program; and
 ``

    (bb) in the case of an 
 individual who is receiving 
 medical assistance and whose 
 continued eligibility for such 
 assistance is being 
 redetermined, the date on which 
 the individual is determined to 
 satisfy all eligibility 
 requirements applicable to the 
 individual other than income 
 eligibility.
 ``
            (III) Rules of construction.--
 ``

    (aa) Eligibility 
 determinations during may 
 through december.--Nothing in 
 subclause
            (I) shall be 
 construed as diminishing, 
 reducing, or otherwise limiting 
 the State's obligation to grant 
 eligibility, under 
 circumstances other than those 
 described in such subclause, 
 based on data that include 
 income shown on an individual's 
 tax return, including the 
 obligation under 

section 1413
            (c) (3)
        (A) of the Patient 
 Protection and Affordable Care 
 Act (42 U.S.C. 18083
            (c) (3)
        (A) ).
 ``

    (bb) Alternative grounds 
 for eligibility.--Nothing in 
 subclause
            (I) shall be 
 construed as diminishing, 
 reducing, or otherwise limiting 
 grounds for eligibility other 
 than those described in such 
 subclause, including 
 eligibility based on income as 
 of the point in time at which 
 an application for medical 
 assistance under the State plan 
 or a waiver of the plan is 
 processed.
 ``
            (cc) Qualifying for 
 additional assistance.--
 Notwithstanding subclause
            (I) , 
 a State shall use an 
 individual's modified adjusted 
 gross income as determined as 
 of the point in time at which 
 the individual's application 
 for medical assistance is 
 processed or, in the case of 
 redetermination of eligibility, 
 projected annual income, to 
 determine the individual's 
 eligibility for medical 
 assistance if using the 
 individual's modified adjusted 
 gross income, as so determined, 
 would result in the individual 
 being eligible for greater 
 benefits under the State plan 
 (or a waiver of such plan) or 
 in the imposition of lower 
 premiums or cost-sharing on the 
 individual under the plan (or 
 waiver) than if the 
 individual's eligibility was 
 determined using the modified 
 adjusted gross income of the 
 individual as shown on the 
 individual's tax return for the 
 preceding calendar year.''.

    (2) Conforming amendment.--

Section 1902

    (e)

    (14)
        (H)
            (i) of the 
 Social Security Act (42 U.S.C. 1396a

    (e)

    (14)
        (H)
            (i) ) is amended 
 by inserting ``except as provided in subparagraph
            (D) 
            (vii) 
            (I) ,'' before ``the requirement''.

    (3) Effective date.--The amendments made by this subsection 
 shall take effect on January 1, 2027.

    (b) Improving the Stability and Predictability of Exchange 
Coverage.--

    (1) Internal revenue code of 1986.--

Section 36B of the 
 Internal Revenue Code of 1986 is amended--
        (A) in subsection

    (b) --
            (i) in paragraph

    (2)
        (B)
            (ii) , by striking 
 ``taxable year'' and inserting ``applicable tax 
 year'', and
            (ii) in paragraph

    (3) --
            (I) in subparagraph
        (A) --

    (aa) in clause
            (i) , by 
 striking ``taxable year'' and 
 inserting ``applicable taxable 
 year'', and

    (bb) in clause
            (ii) 
            (I) , by 
 inserting ``(or, in the case of 
 applicable taxable years 
 beginning in any calendar year 
 after 2027)'' after ``2014'', 
 and
            (II) in subparagraph
        (B) --

    (aa) in clause
            (ii) 
            (I) (aa) , 
 by striking ``the taxable 
 year'' each place it appears 
 and inserting ``the applicable 
 taxable year'', and

    (bb) in the flush matter at 
 the end--

    (AA) striking 
 ``files a joint return 
 and no credit is 
 allowed'' and inserting 
 ``filed a joint return 
 during the applicable 
 taxable year and no 
 credit was allowed'', 
 and

    (BB) striking 
 ``unless a deduction is 
 allowed under 

section 151 for the taxable 
 year'' and inserting 
 ``unless a deduction 
 was allowed under 
 

section 151 for the 
 applicable taxable 
 year'',
        (B) in subsection
            (c) --
            (i) in paragraph

    (1) --
            (I) in subparagraphs
        (A) and
            (C) , 
 by striking ``taxable year'' each place 
 it appears and inserting ``applicable 
 taxable year'', and
            (II) in subparagraph
            (D) , by 
 striking ``is allowable'' and all that 
 follows through the period and 
 inserting ``was allowable to another 
 taxpayer for the applicable taxable 
 year.'',
            (ii) in paragraph

    (2)
            (C) , by adding at the 
 end the following:
 ``
            (v) Time period.--
 ``
            (I) In general.--Except as 
 provided under subclause
            (II) , 
 eligibility for minimum essential 
 coverage under this subparagraph shall 
 be based on the individual's 
 eligibility for employer-sponsored 
 minimum essential coverage during the 
 open enrollment period (or during a 
 special enrollment period for an 
 individual who enrolls or who changes 
 their qualified health plan during a 
 special enrollment period), as 
 determined by the applicable Exchange.
 ``
            (II) Exception.--An individual 
 shall be considered eligible for 
 minimum essential coverage under clause
            (iii) for a month for which such 
 Exchange has determined, subject to 
 rights 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) )), that the individual 
 is covered by an eligible employer-
 sponsored plan.'', and
            (iii) by adding at the end the following:
 ``

    (5) Applicable taxable year.--The term `applicable 
 taxable year' means--
 ``
        (A) with respect to a coverage month that is 
 January, February, March, April, or May, the most 
 recent taxable year that ended at least 12 months 
 before January 1 of the plan year, and
 ``
        (B) with respect to any coverage month not 
 described in subparagraph
        (A) , the most recent taxable 
 year that ended before January 1 of the plan year.
 ``

    (6) Exchange.--The term `Exchange' means an American 
 Health Benefit Exchange established under subtitle D of title I 
 of the Patient Protection and Affordable Care Act (42 U.S.C. 
 18021 et seq.).
 ``

    (7) Open enrollment period.--The term `open enrollment 
 period' means an open enrollment period described in subsection
            (c) (6)
        (B) of 

section 1311 of the Patient Protection and 
 Affordable Care Act (42 U.S.C. 18031).'',
            (C) in subsection
            (d) --
            (i) in paragraph

    (1) --
            (I) by striking ``is allowed'' and 
 inserting ``was allowed'', and
            (II) by inserting ``applicable'' 
 before ``taxable year'', and
            (ii) in paragraph

    (3)
        (B) , by inserting 
 ``applicable'' before ``taxable year'',
            (D) in subsection

    (e)

    (1) --
            (i) by striking ``is allowed'' and 
 inserting ``was allowed'', and
            (ii) by inserting ``applicable'' before 
 ``taxable year'', and
        (E) in subsection

    (f)

    (2) --
            (i) in subparagraph
        (A) , by striking ``If'' 
 and inserting ``Except as provided in 
 subparagraphs
        (B) and
            (C) , if'', and
            (ii) by inserting at the end the following:
 ``
            (C) Safe harbor.--
 ``
            (i) Income and family size.--No increase 
 under subparagraph
        (A) shall be imposed if the 
 advance payments do not exceed amounts that are 
 consistent with income and family size, 
 either--
 ``
            (I) as shown on the return of tax 
 for the applicable plan year, provided 
 such return was accepted by the 
 Secretary as meeting applicable 
 processing criteria, or
 ``
            (II) as determined by the 
 applicable Exchange under subsection

    (b)

    (4) of 

section 1412 of the Patient 
 Protection and Affordable Care Act (42 
 U.S.C. 18082).
 ``
            (ii) Employer-sponsored minimum essential 
 coverage.--No increase under subparagraph
        (A) shall be imposed based on eligibility for 
 minimum essential coverage under subsection
            (c) (2)
            (C) if the applicable Exchange--
 ``
            (I) determined, under clause
            (v) 
            (I) of such subsection, that the 
 individual was ineligible for employer-
 sponsored minimum essential coverage, 
 and
 ``
            (II) did not determine, under 
 clause
            (v) 
            (II) of such subsection, that 
 the individual was covered through 
 employer-sponsored minimum essential 
 coverage.
 ``
            (iii) Exception.--Clauses
            (i) and
            (ii) shall not apply to the extent that any 
 determination described in such clauses was 
 based on a false statement by the taxpayer 
 which--
 ``
            (I) was intentional or grossly 
 negligent, and
 ``
            (II) was--
 ``

    (aa) made on a return of 
 tax, or
 ``

    (bb) provided or caused 
 to be provided to an Exchange 
 by the taxpayer.''.

    (2) Patient protection and affordable care act.--

Section 1412

    (b) of the Patient Protection and Affordable Care Act (42 
 U.S.C. 18082

    (b) ) is amended--
        (A) in paragraph

    (1)
        (B) , by striking ``the most 
 recent'' and all that follows through the period at the 
 end and inserting ``the applicable taxable year, as 
 defined in 

section 36B
            (c) (5) of the Internal Revenue 
 Code of 1986.'';
        (B) in paragraph

    (2)
        (B) , by striking ``second 
 preceding taxable year'' and inserting ``applicable 
 taxable year, as defined in such 

section 36B
            (c) (5) ''; 
 and
            (C) by adding at the end the following:
 ``

    (3) Change form.--If, after the submission of an 
 individual's application form, the individual experiences 
 changes in circumstances as described in paragraph

    (2) , the 
 individual may, by submitting a change form as prescribed by 
 the Secretary, apply for an increased amount of advance 
 payments of the premium tax credit under 

section 36B of the 
 Internal Revenue Code of 1986, increased cost-sharing 
 reductions under 

section 1402, increased assistance under the 
 basic health program under 

section 1331, and coverage through a 
 State Medicaid program or CHIP program.
 ``

    (4) Eligibility for additional assistance.--
 ``
        (A) In general.--The Secretary, in consultation 
 with the Secretary of the Treasury, shall establish a 
 process through which--
 ``
            (i) an Exchange determines, through data 
 sources and procedures described in sections 
 1411 and 1413 (42 U.S.C. 18081; 42 U.S.C. 
 18083), whether each individual who has 
 submitted a change form under paragraph

    (3) has 
 experienced substantial changes in 
 circumstances that warrant additional 
 assistance through an insurance affordability 
 program, as defined in 

section 2 of the Easy 
 Enrollment in Health Care Act;
 ``
            (ii) in the case the Exchange determines 
 an individual has experienced substantial 
 changes in circumstances as described in clause
            (i) , the Exchange conveys such determination to 
 the Secretary of the Treasury under 

section 36B

    (f) of the Internal Revenue Code of 1986 and 
 to the administrator of an insurance 
 affordability program for which the individual 
 may qualify under that determination; and
 ``
            (iii) in the case the Exchange determines 
 an individual has experienced substantial 
 changes in circumstances described in clause
            (i) , the individual may qualify without delay 
 for additional advance premium tax credits 
 under 

section 36B of the Internal Revenue Code 
 of 1986, increased cost-sharing reductions 
 under 

section 1402, additional basic health 
 program assistance under 

section 1331, or 
 coverage through a State Medicaid program or 
 CHIP program.
 ``
        (B) Rights to notice and appeal.--A determination 
 made by an Exchange under this paragraph shall be 
 subject to any applicable rights of notice and appeal, 
 including such rights under 

section 1411

    (f) .''.

    (3) Effective dates.--The amendments made by this 
 subsection shall take effect on January 1, 2028, and continue 
 in effect through December 31, 2034.

SEC. 6. STRENGTHENING DATA INFRASTRUCTURE FOR ELIGIBILITY FOR INSURANCE 
 AFFORDABILITY PROGRAMS.

    (a) Insurance Affordability Program Access to National Directory of 
New Hires.--

Section 453
            (i) of the Social Security Act (42 U.S.C. 
653
            (i) ) is amended by adding at the end the following new paragraph:
 ``

    (5) Administration of insurance affordability programs.--
 ``
        (A) In general.--The Secretary shall provide 
 access to insurance affordability programs (as such 
 term is defined in 

section 2 of the Easy Enrollment in 
 Health Care Act) to information in the National 
 Directory of New Hires that involves--
 ``
            (i) identity, employer, quarterly wages, 
 and unemployment compensation, to the extent 
 such information is potentially relevant to 
 determining the eligibility or scope of 
 coverage of an individual for benefits provided 
 by such a program; and
 ``
            (ii) new hires, to the extent such 
 information is potentially relevant to 
 determining whether an individual is offered 
 minimum essential coverage through a group 
 health plan, as defined in 

section 5000

    (b)

    (1) of the Internal Revenue Code of 1986.
 ``
        (B) Reimbursement of hhs costs.--Insurance 
 affordability programs shall reimburse the Secretary, 
 in accordance with subsection

    (k)

    (3) , for the 
 additional costs incurred by the Secretary in 
 furnishing information under this paragraph.''.

    (b) Use of Information From the National Directory of New Hires.--
Notwithstanding any other provision of law--

    (1) in determining an individual's eligibility for advance 
 payment of premium tax credits under 

section 1412

    (a)

    (3) of the 
 Patient Protection and Affordable Care Act (42 U.S.C. 
 18082

    (a)

    (3) ), and cost-sharing reductions under 

section 1402 of 
 the Patient Protection and Affordable Care Act (42 U.S.C. 
 18071), and a basic health program under 

section 1331 of the 
 Patient Protection and Affordable Care Act (42 U.S.C. 18051), 
 an Exchange may use information about identity, employer, 
 quarterly wages, and unemployment compensation in the National 
 Directory of New Hires, and information about new hires to 
 determine whether an individual is offered minimum essential 
 coverage through a group health plan, as defined in 

section 5000

    (b)

    (1) of the Internal Revenue Code of 1986, subject to 
 notice and appeal rights for any resulting eligibility 
 determination, including the rights described in 

section 1411

    (f) of the Patient Protection and Affordable Care Act (42 
 U.S.C. 18081

    (f) ); and

    (2) Medicaid programs and CHIP programs may use information 
 in the National Directory of New Hires about identity, 
 employer, quarterly wages, and unemployment compensation to 
 determine eligibility and to implement third-party liability 
 procedures or premium assistance programs otherwise permitted 
 or mandated under Federal law, and use information about new 
 hires to implement such procedures and policies, subject to 
 notice and appeal rights for any resulting determination, 
 including those available under title XIX or title XXI of the 
 Social Security Act or under 

section 1411

    (f) of the Patient 
 Protection and Affordable Care Act (42 U.S.C. 18081

    (f) ).
            (c) Use of Information About Eligibility for or Receipt of Group 
Health Coverage.--Notwithstanding any other provision of Federal or 
State law:

    (1) In general.--Subject to the requirements described in 
 paragraph

    (2) , for purposes of determining eligibility and, in 
 the case of a Medicaid program, for purposes of determining the 
 applicability of third-party liability procedures or premium 
 assistance policies otherwise permitted or mandated under 
 Federal law, an insurance affordability program shall have 
 access to any source of information, maintained by or 
 accessible to a public entity, about receipt or offers of 
 coverage through a group health plan. Such sources shall 
 include--
        (A) information maintained by or accessible to the 
 Secretary of Health and Human Services for purposes of 
 implementing 

section 1862

    (b) of the Social Security Act 
 (42 U.S.C. 1395y

    (b) );
        (B) information maintained by or accessible to a 
 State Medicaid program for purposes of implementing 
 subsection

    (a)

    (25) or

    (a)

    (60) of 

section 1902 of the 
 Social Security Act (42 U.S.C. 1396a); and
            (C) information reported under sections 6055 and 
 6056 of the Internal Revenue Code of 1986.

    (2) Requirements.--An insurance affordability program shall 
 obtain the information described in paragraph

    (1) pursuant to 
 an interagency or other agreement, consistent with standards 
 prescribed by the Secretary of Health and Human Services, in 
 consultation with the Secretary, that prevents the unauthorized 
 use, disclosure, or modification of such information and 
 otherwise protects privacy and data security.
            (d) Authorization To Receive Relevant Information.--

    (1) In general.--Notwithstanding any other provision of 
 law, a Federal or State agency or private entity in possession 
 of the sources of data potentially relevant to eligibility for 
 an insurance affordability program is authorized to convey such 
 data or information to the insurance affordability program, and 
 such program is authorized to receive the data or information 
 and to use it in determining eligibility.

    (2) Application of requirements and penalties.--A 
 conveyance of data to an insurance affordability program under 
 this subsection shall be subject to the same requirements that 
 apply to a conveyance of data to a State Medicaid plan under 
 title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) 
 under 

section 1942 of such Act (42 U.S.C. 1396w-2), and the 
 penalties that apply to a violation of such requirements, 
 including penalties that apply to a private entity making a 
 conveyance.

    (e) Electronic Transmission of Information.--In determining an 
individual's eligibility for an insurance affordability program, the 
program shall--

    (1) with respect to verifying an element of eligibility 
 that is based on information from an Express Lane Agency (as 
 defined in 

section 1902

    (e)

    (13)
        (F) of the Social Security Act 
 (42 U.S.C. 1396a

    (e)

    (13)
        (F) )), from another public agency, or 
 from another reliable source of relevant data, waive any 
 otherwise applicable requirement that the individual must 
 verify such information, provide an attestation as to the 
 subject of such information, or provide a signature for 
 attestations that include that subject, before the individual 
 is enrolled into minimum essential coverage; and

    (2) satisfy any otherwise applicable signature requirement 
 with respect to an individual's enrollment in an insurance 
 affordability program through an electronic signature (as 
 defined in 

section 1710

    (1) of the Government Paperwork 
 Elimination Act (44 U.S.C. 3504 note)).

    (f) Rule of Construction.--Nothing in this section shall be 
construed as diminishing, reducing, or otherwise limiting the legal 
authority for an insurance affordability program to grant eligibility, 
in whole or in part, based on an attestation alone, without requiring 
verification through data matches or other sources.

SEC. 7. FUNDING FOR INFORMATION TECHNOLOGY DEVELOPMENT AND OPERATIONS.

    (a) In General.--Out of amounts in the Treasury not otherwise 
appropriated, there are appropriated to the Secretary of Health and 
Human Services such sums as may be necessary to establish information 
exchange and processing infrastructure and operate all information 
exchange and processing procedures described in this Act, including for 
the costs of staff and contractors.

    (b) Agencies Receiving Funding.--The Secretary of Health and Human 
Services may, as necessary and in accordance with the procedures 
described in subsection
            (c) , transfer amounts appropriated under 
subsection

    (a) to entities that include the following for the purposes 
described in such subsection:

    (1) The Secretary of the Treasury, including the Internal 
 Revenue Service.

    (2) The Office of Child Support Enforcement of the 
 Department of Health and Human Services.

    (3) A State-administered insurance affordability program, 
 including a Medicaid or CHIP program and a State basic health 
 program under 

section 1331 of the Patient Protection and 
 Affordable Care Act (42 U.S.C. 18051).

    (4) An entity operating an Exchange.

    (5) A third-party data source, which may be a public or 
 private entity.
            (c) Procedures.--The Secretary of Health and Human Services, in 
consultation with the Secretary of the Treasury, shall establish 
procedures for the entities described in subsection

    (b) to request a 
transfer of funding from the amounts appropriated under subsection

    (a) , 
including procedures for reviewing such requests, modifying and 
approving such requests, appealing decisions about transfers, and 
auditing such transfers.

SEC. 8. CONFORMING STATUTORY CHANGES.

    (a) State Income and Eligibility Verification Systems.--

Section 1137 of the Social Security Act (42 U.S.C. 1320b-7) is amended--

    (1) in subsection

    (a)

    (1) , by inserting ``(in the case of an 
 individual who has consented to the disclosure and transfer of 
 relevant return information that includes the individual's 
 social security account number pursuant to 

section 3

    (b)

    (1)
        (B) of the Easy Enrollment in Health Care Act, the State shall deem 
 such individual to have satisfied the requirement to furnish 
 such account number to the State under this paragraph)'' before 
 the semicolon; and

    (2) in subsection
            (d) --
        (A) in paragraph

    (1)
        (A) , by striking ``The State 
 shall require'' and inserting ``Subject to paragraph

    (6) , the State shall require''; and
        (B) by adding at the end the following new 
 paragraph:
 ``

    (6) Satisfaction of requirement through reliable data 
 matches.--In the case of an individual applying for the program 
 described in subsection

    (b) or the Children's Health Insurance 
 Program under title XXI of this Act, the program shall not 
 require an individual to make the declaration described in 
 paragraph

    (1)
        (A) if the procedures established pursuant to 
 

section 3

    (a)

    (1) of the Easy Enrollment in Health Care Act or 
 

section 1413
            (c) (2)
        (B)
            (ii) 
            (II) of the Patient Protection and 
 Affordable Care Act (42 U.S.C. 18083
            (c) (2)
        (B)
            (ii) 
            (II) ) were 
 used to verify the individual's citizenship, based on the 
 individual's social security number as well as other 
 identifying information, which may include such facts as name 
 and date of birth, that increases the accuracy of matches with 
 applicable sources of citizenship data.''.

    (b) Eligibility Determinations Under PPACA.--

Section 1411

    (b) of the 
Patient Protection and Affordable Care Act (42 U.S.C. 18081

    (b) ) is 
amended--

    (1) in paragraph

    (3) , by striking subparagraph
        (A) and 
 inserting the following:
 ``
        (A) Information regarding income and family 
 size.--The information described in paragraphs

    (21) and

    (23) of 

section 6103
            (l) of the Internal Revenue Code of 
 1986 for the applicable taxable year, as defined in 
 

section 36B
            (c) (5) of such Code.''; and

    (2) by adding at the end the following:
 ``

    (6) Receipt of information.--The requirements for 
 providing information under this subsection may be satisfied 
 through data submitted to the Exchange through reliable data 
 matches, rather than by the applicant providing information. In 
 the case described in paragraph

    (2)
        (A) , data matches shall not 
 be used for this purpose unless they meet the requirements 
 described in 

section 1137
            (d) (6) of the Social Security Act (42 
 U.S.C. 1320b-7
            (d) (6) ).''.

SEC. 9. ADVISORY COMMITTEE.

    (a) In General.--The Secretary of the Treasury, in conjunction with 
the Secretary of Health and Human Services, shall establish an advisory 
committee to provide guidance to both Secretaries in carrying out this 
Act. The members of the committee shall include--

    (1) national experts in behavioral economics, other 
 behavioral science, insurance affordability programs, 
 enrollment and retention in health programs and other benefit 
 programs, public benefits for immigrants, public benefits for 
 other historically marginalized or disadvantaged communities, 
 and Federal income tax policy and operations; and

    (2) representatives of all relevant stakeholders, 
 including--
        (A) consumers;
        (B) health insurance issuers;
            (C) health care providers; and
            (D) tax return preparers.

    (b) Purview.--The advisory committee established under subsection

    (a) shall be solicited for advice on any topic chosen by the Secretary 
of the Treasury or the Secretary of Health and Human Services, 
including (at a minimum) all matters as to which a provision in this 
Act, other than subsection

    (a) , requires a consultation between the 
Secretary of the Treasury and the Secretary of Health and Human 
Services.

SEC. 10. STUDY.

    (a) In General.--The Secretary of Health and Human Services shall 
conduct a study analyzing the impact of this Act and making 
recommendations for--

    (1) State pilot projects to test improvements to this Act, 
 including an analysis of policies that automatically enroll 
 eligible individuals into group health plans;

    (2) modifying open enrollment periods for Exchanges and 
 plan years so that open enrollment coincides with filing of 
 Federal income tax returns; and

    (3) other steps to improve outcomes achieved by this Act.

    (b) Report.--Not later than July 1, 2030, the Secretary of Health 
and Human Services shall deliver a report on the study and 
recommendations under subsection

    (a) to the Committee on Ways and 
Means, the Committee on Education and the Workforce, and the Committee 
on Energy and Commerce of the House of Representatives and to the 
Committee on Finance and the Committee on Health, Education, Labor, and 
Pensions of the Senate.

SEC. 11. APPROPRIATIONS.

 Out of amounts in the Treasury not otherwise appropriated, there 
are appropriated, in addition to the amounts described in 

section 7 and 
any amounts otherwise made available, to carry out the purposes of this 
Act, such sums as may be necessary to the Secretary of the Treasury, 
and such sums as may be necessary to the Secretary of Health and Human 
Services, to remain available until expended.
 <all>