Maryland and Massachusetts, soon to be followed by other states, now allow taxpayers to begin the sign-up for health care coverage on their tax returns, aiming to draw many residents into low- or no-cost plans they may not know they qualify for.
The effort is intended to gather in many of the last Americans — more than 28 million of them — still without health insurance, despite the gains achieved by the 2010 Affordable Care Act.
A quarter of those people are eligible for Medicaid, the public health plan for low-income Americans, according to an analysis of the uninsured by the Kaiser Family Foundation. And more than a third could get federal tax subsidies to help them pay for at least part of the premiums for private plans.
“As surprising as it may seem, there are many people out there who don’t know there are insurance options for them,” said Michele Eberle, executive director of the Maryland Health Benefit Exchange, a state agency that helps enroll residents. “People are just surviving out there. They don’t know what’s available to them.”
Republican Gov. Larry Hogan signed Maryland’s first-of-its-kind measure into law in 2019. For the past two years, Maryland income tax forms have included a box that taxpayers can check to indicate they do not have health insurance. With the taxpayer’s permission, the state comptroller submits the household’s income and family size data to the state’s health insurance exchange for possible enrollment in Medicaid or subsidized private insurance.
The Massachusetts legislature adopted a similar measure this year, which will be implemented next year.
Other states are following suit.
Colorado and New Jersey have passed legislation, both with strong bipartisan support, to implement their own easy enrollment plans via tax returns. Colorado Democratic Gov. Jared Polis signed the bill into law. In New Jersey, Democratic Gov. Phil Murphy has said he strongly supports the measure, but asked for some small technical changes, which the legislature is likely to adopt next month.
The idea also is gaining steam, either legislatively or administratively, in New Mexico, Pennsylvania and Virginia.
Meanwhile, in Congress, U.S. Sen. Chris Van Hollen, a Democrat from Maryland, introduced a bill last month that would put a similar check-off box on federal tax returns.