Read the full stored bill text
House
File
355
-
Introduced
HOUSE
FILE
355
BY
ZABNER
A
BILL
FOR
An
Act
relating
to
the
establishment
of
an
easy
enrollment
1
health
care
coverage
program
utilizing
the
state
income
tax
2
form.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
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Section
1.
NEW
SECTION
.
422.12Q
Income
tax
form
——
easy
1
enrollment
health
care
coverage
program.
2
1.
The
department,
in
cooperation
with
the
department
of
3
health
and
human
services
and
the
insurance
division,
shall
4
establish
an
easy
enrollment
health
care
coverage
program
5
utilizing
the
state
income
tax
form
to
identify
residents
6
of
the
state
who
are
uninsured
but
may
qualify
for
benefits
7
under
a
health
care
coverage
program.
The
easy
enrollment
8
health
care
coverage
program
shall
be
designed
to
do
all
of
the
9
following:
10
a.
Facilitate
identification
of
taxpayers
and
members
of
11
taxpayers’
households
who
are
uninsured.
12
b.
Provide
taxpayers
with
a
method
to
authorize
the
13
department
to
share
insurance-relevant
information
with
the
14
Iowa
health
insurance
marketplace
and
the
department
of
health
15
and
human
services
for
the
purpose
of
assessing
eligibility
for
16
a
health
care
coverage
program.
17
c.
Provide
for
automatic
enrollment
or
provisionally
18
assessed
eligibility
of
the
taxpayer
or
a
member
of
the
19
taxpayer’s
household
in
the
Medicaid
program
or
other
health
20
care
coverage
program.
21
d.
Facilitate
enrollment
in
a
health
care
coverage
program.
22
2.
For
the
tax
year
beginning
January
1,
2025,
the
director
23
or
the
director’s
designee
shall
develop
the
income
tax
form
to
24
include
all
of
the
following
options
for
a
taxpayer
who
files
25
an
individual
or
joint
income
tax
return
with
the
department
26
under
section
422.13:
27
a.
A
check
box
indicting
that
the
taxpayer
filing
the
tax
28
return
either
has
or
does
not
have
health
care
coverage.
29
b.
A
check
box
indicating
that
the
spouse
of
the
taxpayer
30
filing
the
tax
return
either
has
or
does
not
have
health
care
31
coverage.
32
c.
A
check
box
indicating
each
dependent
of
the
taxpayer
who
33
does
not
have
health
care
coverage,
and
a
space
to
indicate
the
34
birth
date
of
each
such
dependent.
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d.
A
check
box
indicating
each
member
of
the
taxpayer’s
1
household
who
is
not
the
spouse
of
the
taxpayer
or
a
dependent
2
of
the
taxpayer,
the
individual’s
relationship
to
the
taxpayer,
3
the
individual’s
birth
date,
and
whether
the
individual
has
4
health
care
coverage.
5
e.
A
check
box
authorizing
the
department
to
share
6
insurance-relevant
information
with
the
Iowa
health
insurance
7
marketplace
and
the
department
of
health
and
human
services.
8
f.
A
check
box
authorizing
the
department
of
health
and
9
human
services
to
enroll
the
taxpayer
or
a
member
of
the
10
taxpayer’s
household
in
the
Medicaid
program
if
the
department
11
of
health
and
human
services
has
sufficient
insurance-relevant
12
information
to
complete
an
eligibility
determination
for
the
13
taxpayer
or
a
member
of
the
taxpayer’s
household,
but
only
if
14
the
taxpayer
or
the
member
of
the
taxpayer’s
household
will
not
15
be
subject
to
any
cost
including
deductibles
or
copayments
for
16
such
health
care
coverage.
17
g.
An
email
address,
telephone
number,
or
other
preferred
18
method
of
communicating
with
the
taxpayer
for
additional
19
contact
by
the
Iowa
health
insurance
marketplace
or
the
20
department
of
health
and
human
services.
21
3.
If
a
taxpayer
indicates
on
the
income
tax
form
that
22
the
taxpayer
or
anyone
in
the
taxpayer’s
household
does
23
not
have
health
care
coverage,
and
the
taxpayer
authorizes
24
the
department
to
share
the
taxpayer’s
insurance-relevant
25
information
with
the
Iowa
health
insurance
marketplace
and
26
the
department
of
health
and
human
services,
the
department
27
shall
forward
to
the
Iowa
health
insurance
marketplace
and
to
28
the
department
of
health
and
human
services
the
taxpayer’s
29
insurance-relevant
information
and
a
copy
of
the
taxpayer’s
30
authorization.
31
4.
a.
Upon
receiving
a
taxpayer’s
insurance-relevant
32
information
and
authorization
from
the
department
under
33
this
section,
the
Iowa
health
insurance
marketplace
and
the
34
department
of
health
and
human
services
shall
assess
the
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taxpayer’s
eligibility
or
the
eligibility
of
the
members
of
the
1
taxpayer’s
household
for
a
health
care
coverage
program.
2
b.
(1)
Following
the
assessment,
if
the
department
of
3
health
and
human
services
has
sufficient
insurance-relevant
4
information
to
determine
the
taxpayer
or
a
member
of
the
5
taxpayer’s
household
is
eligible
for
the
Medicaid
program,
the
6
department
shall
do
one
of
the
following:
7
(a)
If
the
taxpayer
authorized
such
enrollment,
enroll
8
the
eligible
taxpayer
or
eligible
member
of
the
taxpayer’s
9
household
in
the
Medicaid
program.
10
(b)
If
the
taxpayer
did
not
authorize
such
enrollment
in
the
11
Medicaid
program,
contact
the
taxpayer
and
provide
the
taxpayer
12
with
information
on
the
Medicaid
program.
13
(2)
Following
the
assessment,
if
the
department
of
14
health
and
human
services
has
sufficient
insurance-relevant
15
information
to
determine
the
taxpayer
or
a
member
of
the
16
taxpayer’s
household
is
not
eligible
for
the
Medicaid
program
17
but
may
be
eligible
for
other
health
care
coverage
programs
18
under
the
purview
of
the
department,
contact
the
taxpayer
to
19
provide
the
taxpayer
with
information
about
the
other
health
20
care
coverage
program
options
including
specific
benefits
21
and
cost-sharing
requirements,
enrollment
instructions,
and
22
enrollment
assistance.
23
(3)
Following
the
assessment,
if
the
department
of
health
24
and
human
services
does
not
have
sufficient
insurance-relevant
25
information
to
determine
if
the
taxpayer
or
a
member
of
the
26
taxpayer’s
household
is
eligible
for
the
Medicaid
program
27
or
other
health
care
coverage
programs
under
the
purview
of
28
the
department,
contact
the
taxpayer
to
obtain
sufficient
29
information
to
make
a
determination.
30
c.
Following
the
assessment,
if
the
Iowa
health
insurance
31
marketplace
determines
the
taxpayer
or
a
member
of
the
32
taxpayer’s
household
may
be
eligible
for
a
qualified
health
33
plan
or
financial
assistance
through
the
Iowa
health
insurance
34
marketplace,
the
Iowa
health
insurance
marketplace
shall
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contact
the
taxpayer
and
provide
the
taxpayer
with
information
1
on
all
of
the
following:
2
(1)
Qualified
health
plans
available
to
the
taxpayer
or
3
a
member
of
the
taxpayer’s
household
through
the
Iowa
health
4
insurance
marketplace.
5
(2)
Specific
enrollment
instructions
and
information
6
on
enrollment
assistance
for
each
of
the
qualified
health
7
plans
available
to
the
taxpayer
or
a
member
of
the
taxpayer’s
8
household.
9
(3)
Information
on
the
federal
premium
assistance
credit
10
provided
pursuant
to
26
U.S.C.
§36B.
11
5.
Notwithstanding
any
state
confidentiality
or
privacy
12
protection
or
other
provision
of
law
to
the
contrary,
the
13
department
may
share
confidential
tax
return
information
with
14
the
department
of
health
and
human
services
and
the
Iowa
health
15
insurance
marketplace
to
the
extent
the
confidential
tax
return
16
information
constitutes
insurance-relevant
information
and
the
17
department
has
received
the
taxpayer’s
consent
to
share
the
18
information.
19
6.
The
provision
of
information
by
a
taxpayer
under
this
20
section
is
voluntary
and
a
taxpayer
shall
not
be
subject
to
a
21
penalty
for
not
providing
the
information
specified
under
this
22
section.
23
7.
The
department,
the
department
of
health
and
human
24
services,
and
the
insurance
division
shall
collaboratively
do
25
all
of
the
following:
26
a.
Develop
the
instructions
for
completion
of
the
income
27
tax
return
form
and
compile
other
information
to
accompany
the
28
income
tax
form
provided
to
taxpayers
under
this
section.
29
b.
Define
terms
for
the
purposes
of
both
completion
of
the
30
income
tax
form
and
for
information
about
and
eligibility
for
31
health
care
coverage
programs
including
the
terms
“dependent”
32
and
“household”.
33
c.
Develop
outreach
educational
materials
and
programming
34
to
communicate
the
availability
and
the
purpose
of
the
easy
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enrollment
health
care
coverage
program
to
the
public.
The
1
materials
and
programming
shall
include
materials
developed
for
2
different
target
groups,
including
but
not
limited
to
in-person
3
and
online
tax
preparers,
consumer
assistance
organizations,
4
community
groups,
and
underserved
groups.
5
d.
Enter
into
any
data-sharing
agreements
necessary
to
6
facilitate
insurance-relevant
information
sharing
and
tracking,
7
eligibility
verification
procedures,
and
outreach
efforts.
8
e.
Consider
criteria
for
automatic
exclusions
such
as
9
taxpayers
who
do
not
reside
in
the
state.
10
f.
Notify
and
provide
training
for
both
in-person
tax
11
preparers
and
electronic
tax
preparation
programs
regarding
the
12
changes
to
the
tax
forms
to
facilitate
software
updates
and
13
compliance.
14
g.
Automate
the
tracking
and
response
mechanisms
to
the
15
greatest
extent
possible.
16
h.
Develop
and
utilize
any
other
processes
or
procedures
17
that
facilitate
the
easy
enrollment
health
care
coverage
18
program.
19
8.
Beginning
January
15,
2027,
and
annually
thereafter,
20
the
department,
the
department
of
health
and
human
services,
21
and
the
insurance
division
shall
collaboratively
report
to
22
the
governor
and
the
general
assembly
all
of
the
following
23
information
based
on
the
immediately
preceding
calendar
year’s
24
tax
return
data:
25
a.
The
number
of
taxpayers
who
indicated
on
their
tax
form
26
that
the
taxpayer,
the
taxpayer’s
spouse,
a
dependent
of
the
27
taxpayer,
or
another
household
member
of
the
taxpayer
did
not
28
have
health
care
coverage.
29
b.
The
number
of
taxpayers
who
authorized
the
sharing
of
30
insurance-relevant
information
for
the
purposes
of
assessing
31
eligibility
for
a
health
care
coverage
program.
32
c.
The
number
of
taxpayers
or
members
of
a
taxpayer’s
33
household
provisionally
assessed
as
eligible
for
a
health
care
34
coverage
program.
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d.
The
number
of
taxpayers
or
members
of
a
taxpayer’s
1
household
who
enrolled
in
a
health
care
coverage
program
as
the
2
result
of
the
easy
enrollment
health
care
coverage
program,
and
3
the
type
of
health
care
coverage
program
in
which
the
person
4
enrolled.
5
e.
Demographic
data
on
enrollment
in
specific
health
care
6
coverage
programs
resulting
from
the
easy
enrollment
health
7
care
coverage
program.
8
f.
Recommendations
to
improve
outreach
materials,
address
9
issues
related
to
information
required
for
establishing
10
eligibility
while
maintaining
confidentiality,
and
other
11
proposed
changes
to
improve
the
easy
enrollment
health
care
12
coverage
program.
13
9.
The
department,
the
department
of
health
and
human
14
services,
and
the
insurance
division
shall
each
adopt
rules
15
pursuant
to
chapter
17A
to
jointly
implement
and
administer
16
the
easy
enrollment
health
care
coverage
program
under
this
17
section.
18
10.
As
used
in
this
section:
19
a.
“Affordable
Care
Act”
means
the
federal
Patient
20
Protection
and
Affordable
Care
Act,
Pub.
L.
No.
111-148,
as
21
amended
by
the
federal
Health
Care
and
Education
Reconciliation
22
Act
of
2010,
Pub.
L.
No.
111-152,
and
any
amendments
thereto.
23
b.
“Health
care
coverage
program”
means
the
Medicaid
24
program,
the
healthy
and
well
kids
in
Iowa
program,
the
Iowa
25
health
and
wellness
plan,
or
a
qualified
health
plan
available
26
through
the
Iowa
health
insurance
marketplace.
27
c.
“Healthy
and
well
kids
in
Iowa
program”
or
“Hawki
program”
28
means
the
Hawki
program
as
defined
in
section
514I.2.
29
d.
“Household”
means
the
spouse,
any
dependent,
and
any
30
other
individual
who
resides
with
the
taxpayer
but
is
not
31
claimed
as
a
spouse
or
dependent
on
the
taxpayer’s
income
tax
32
return.
33
e.
“Insurance
division”
means
the
insurance
division
of
the
34
department
of
insurance
and
financial
services.
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f.
“Insurance-relevant
information”
means
information
1
pertaining
to
the
insurance
enrollment
status
of
a
taxpayer
2
or
members
of
a
taxpayer’s
household
and
that
is
derived
or
3
obtained
from
the
taxpayer’s
state
income
tax
return;
provided
4
that
information
is
limited
to
information
necessary
to
assess
5
the
eligibility
of
the
taxpayer
or
members
of
the
taxpayer’s
6
household
for
health
coverage
programs
and
includes:
7
(1)
Adjusted
gross
income
and
other
types
of
reported
income
8
used
to
assess
eligibility
for
a
health
coverage
program.
9
(2)
Household
size.
10
(3)
Claimed
dependents.
11
(4)
Contact
information
and
personally
identifying
12
information
necessary
to
assess
health
coverage
program
13
eligibility
and
used
to
match
against
relevant
third-party
data
14
sources.
15
(5)
Any
other
information
necessary
to
determine
16
eligibility
for
a
health
care
coverage
program
as
specified
by
17
rule
of
the
department,
in
consultation
with
the
department
of
18
health
and
human
services
and
the
insurance
division.
19
g.
“Iowa
health
and
wellness
plan”
means
the
Iowa
health
and
20
wellness
plan
established
in
chapter
249N.
21
h.
“Iowa
health
insurance
marketplace”
means
the
American
22
health
benefits
exchange
created
pursuant
to
the
Affordable
23
Care
Act.
24
i.
“Medicaid
program”
means
the
same
as
defined
in
section
25
249A.2.
26
j.
“Qualified
health
plan”
means
an
insurance
plan
that
is
27
certified
by
the
Iowa
health
insurance
marketplace,
provides
28
essential
health
benefits,
follows
established
limits
on
29
cost-sharing
including
for
deductibles,
copayments,
and
30
out-of-pocket
maximum
amounts,
and
meets
other
requirements
31
under
the
Affordable
Care
Act.
32
EXPLANATION
33
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
34
the
explanation’s
substance
by
the
members
of
the
general
assembly.
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This
bill
establishes
an
easy
enrollment
health
care
1
coverage
program.
The
bill
requires
the
department
of
revenue
2
(DOR)
in
cooperation
with
the
department
of
health
and
human
3
services
(HHS)
and
the
insurance
division
of
the
department
4
of
insurance
and
financial
services
(insurance
division)
to
5
establish
an
easy
enrollment
health
care
coverage
program
6
(program)
utilizing
the
state
income
tax
form
to
identify
7
residents
of
the
state
who
are
uninsured
but
may
qualify
for
8
benefits
under
a
health
care
coverage
program.
The
program
is
9
designed
to
facilitate
identification
of
taxpayers
and
members
10
of
taxpayers’
households
who
are
uninsured;
provide
taxpayers
11
with
a
method
to
authorize
the
sharing
of
insurance-relevant
12
information
for
the
purpose
of
assessing
eligibility
for
a
13
health
care
coverage
program;
provide
for
automatic
enrollment
14
or
provisionally
assessed
eligibility
of
the
taxpayer
or
a
15
member
of
the
taxpayer’s
household
in
the
Medicaid
program
or
16
other
health
care
coverage
program;
and
facilitate
enrollment
17
in
a
health
care
coverage
program.
18
For
the
tax
year
beginning
January
1,
2025,
the
director
of
19
revenue
(director),
or
the
director’s
designee
shall
develop
20
the
income
tax
form
to
include
specific
options
for
a
taxpayer
21
who
files
an
individual
or
joint
income
tax
return
to
indicate
22
certain
information,
including
that
the
taxpayer
either
does
23
or
does
not
have
health
care
coverage,
that
the
spouse
of
the
24
taxpayer
either
does
or
does
not
have
health
care
coverage,
25
each
of
the
dependents
of
the
taxpayer
who
do
not
have
health
26
care
coverage
and
their
birth
dates,
information
about
27
other
members
of
the
taxpayer’s
household
including
whether
28
the
individual
does
or
does
not
have
health
care
coverage,
29
authorization
for
DOR
to
share
insurance-relevant
information
30
with
the
Iowa
health
insurance
marketplace
(marketplace)
and
31
HHS;
authorization
for
HHS
to
enroll
the
taxpayer
or
a
member
32
of
the
taxpayer’s
household
in
the
Medicaid
program
if
HHS
33
has
sufficient
insurance-relevant
information
to
complete
34
an
eligibility
determination;
and
the
taxpayer’s
contact
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information
for
their
preferred
method
of
communication.
1
The
bill
provides
alternative
processes
that
the
marketplace
2
and
HHS
may
follow
depending
on
whether
the
taxpayer
indicates
3
the
taxpayer
or
anyone
in
the
taxpayer’s
household
does
not
4
have
health
care
coverage,
the
taxpayer
authorizes
the
sharing
5
of
the
taxpayer’s
insurance-relevant
information,
and
the
6
taxpayer’s
insurance-relevant
information
and
authorization
are
7
shared
with
the
marketplace
and
HHS.
Once
the
marketplace
and
8
HHS
receive
the
taxpayer’s
insurance-relevant
information,
the
9
marketplace
and
HHS
shall
assess
the
taxpayer’s
eligibility
10
or
the
eligibility
of
the
members
of
the
taxpayer’s
household
11
for
a
health
care
coverage
program.
Following
the
assessment,
12
if
HHS
has
sufficient
insurance-relevant
information
to
13
determine
the
taxpayer
or
a
member
of
the
taxpayer’s
household
14
is
eligible
for
the
Medicaid
program,
and
if
the
taxpayer
15
authorized
such
enrollment,
HHS
shall
enroll
the
eligible
16
taxpayer
or
eligible
member
of
the
taxpayer’s
household
in
17
the
Medicaid
program.
If
the
taxpayer
did
not
authorize
18
such
enrollment
in
the
Medicaid
program,
HHS
shall
contact
19
the
taxpayer
and
provide
the
taxpayer
with
information
on
20
the
Medicaid
program.
Following
the
assessment,
if
HHS
21
has
sufficient
insurance-relevant
information
to
determine
22
the
taxpayer
or
a
member
of
the
taxpayer’s
household
is
not
23
eligible
for
the
Medicaid
program
but
may
be
eligible
for
24
other
health
care
coverage
programs
under
the
purview
of
25
HHS,
HHS
shall
contact
the
taxpayer
to
provide
the
taxpayer
26
with
information
about
the
other
health
care
coverage
27
program
options,
including
specific
benefits
and
cost-sharing
28
requirements,
enrollment
instructions,
and
enrollment
29
assistance.
Following
the
assessment,
if
HHS
does
not
have
30
sufficient
information
to
determine
if
the
taxpayer
or
a
member
31
of
the
taxpayer’s
household
is
eligible
for
the
Medicaid
32
program
or
another
health
care
coverage
program
under
the
33
purview
of
the
department,
contact
the
taxpayer
to
obtain
34
sufficient
information
to
make
a
determination.
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Following
the
assessment,
if
the
marketplace
determines
1
the
taxpayer
or
a
member
of
the
taxpayer’s
household
may
be
2
eligible
for
a
qualified
health
plan
or
financial
assistance
3
through
the
marketplace,
the
marketplace
shall
contact
the
4
taxpayer
and
provide
the
taxpayer
with
specific
information
5
about
the
qualified
health
plans
available
through
the
6
marketplace.
7
The
bill
provides
that
notwithstanding
any
state
8
confidentiality
or
privacy
protection
or
other
provision
9
of
law
to
the
contrary,
DOR
may
share
confidential
tax
10
return
information
with
HHS
and
the
marketplace
to
the
11
extent
the
confidential
tax
return
information
constitutes
12
insurance-relevant
information
and
DOR
has
received
the
13
taxpayer’s
authorization
to
share
the
information.
14
The
provision
of
information
by
a
taxpayer
under
the
bill
is
15
voluntary
and
a
taxpayer
shall
not
be
subject
to
a
penalty
for
16
not
providing
the
information.
17
The
bill
requires
DOR,
HHS,
and
the
insurance
division
to
18
collaboratively
develop
the
tax
return
form
and
accompanying
19
information
to
be
provided
to
taxpayers;
develop
outreach
20
educational
materials
and
programming
to
communicate
the
21
availability
and
the
purpose
of
the
program
to
the
public;
22
enter
into
any
data-sharing
agreements
necessary
to
facilitate
23
insurance-relevant
information
sharing
and
tracking,
24
eligibility
verification
procedures,
and
outreach
efforts;
25
consider
criteria
for
automatic
exclusions
such
as
taxpayers
26
who
do
not
reside
in
the
state;
notify
and
provide
training
for
27
both
in-person
tax
preparers
and
electronic
tax
preparation
28
programs
regarding
the
changes
to
the
tax
forms
to
facilitate
29
software
updates
and
compliance;
automate
the
tracking
and
30
response
mechanisms
to
the
greatest
extent
possible;
and
31
develop
and
utilize
any
other
processes
or
procedures
that
32
facilitate
the
program.
33
Beginning
January
15,
2027,
and
annually
thereafter,
DOR,
34
HHS,
and
the
insurance
division
shall
collaboratively
report
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specified
information
and
recommendations
to
the
governor
1
and
the
general
assembly
based
on
the
immediately
preceding
2
calendar
year’s
tax
return
data.
3
DOR,
HHS,
and
the
insurance
division
shall
each
adopt
4
administrative
rules
to
jointly
implement
and
administer
the
5
program.
6
The
bill
provides
definitions
used
in
the
bill.
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