Maryland: "Easy Enrollment" Special Enrollment Period kicking off to help up to 120,000 more #GetCovered

Last March, I wrote about a clever and absurdly simple (on the surface) bill being passed through the Maryland state legislature which could result in the state lowering their uninsured rate up to as many as an estimated 120,000 people:

In early 2018, Maryland state legislators introduced a bill which included a twist on the coverage mandate penalty--those who failed to sign up had another option: They could either pay the penalty or they could choose to have the penalty amount be used to automatically enroll them in the lowest-cost insurance policy available. If they qualified for ACA subsidies, those would even be baked into the equation as well. This was a clever way of softening the blow, while also increasing enrollment and helping out the ACA risk pool.

...Stan Dorn is a Senior Fellow at Families USA, and apparently he's been hard at work on helping push through a revised version of the "Down Payment" bill, which seems to have a much better chance of making it through the process and becoming law:

Maryland would use state tax forms to identify uninsured residents and refer them to options for no-cost or low-cost health care under a bill moving forward in the General Assembly.

The bill, if approved, would add a question on state tax returns asking taxpayers if they have health insurance. Those who answer that they don’t have health insurance would be referred to the state's Medicaid program or the health exchange, where individuals can buy health insurance plans.

...Dorn explained to me that the way it would work is much more than that: The state tax returns would include a new line where uninsured filers would be required to check off one of two boxes:

Box 1: "Have the exchange determine my eligibility for free or low-cost insurance"

Box 2: "I prefer to remain uninsured."

When the tax form goes to the state treasury department, if they checked Box 1, their data is forwarded to the Maryland Health Benefit Exchange, which now has permission to check their status. If they qualify for Medicaid, they're auto-enrolled. If they qualify for a subsidized exchange plan, the exchange will then contact them and let them know what sort of plans they're eligible for.

This may not sound like that big of a deal, but it could be:

The program is expected to identify about 50,000 people eligible for Medicaid, the government health insurance program for those with low incomes, according to the Maryland Citizens’ Health Initiative.

An additional 70,000 Marylanders could buy insurance at little to no cost through the state’s health exchange with the help of government subsidies, according to the organization.

The bill was signed into law by Republican Governor Larry Hogan last May, and now that we're actually into 2020 and tax filing season has kicked off, so too has the new "Easy Enrollment" program.

Medicaid expansion enrollment is available year-round (which makes sense...the only reason to have limited enrollment periods is to prevent attempts at gaming the system, but Medicaid is essentially free at the point of service for the enrollee in most states, so there's little to be gained by limiting the time period to sign up), so that's not an issue. As for those earning more than 138% of the Federal Poverty Line, they'd normally have to wait until November to enroll for ACA exchange coverage starting the following year, but the new law clarifies that those who are found to be eligible for subsidized exchange coverage by the state tax dept. will also be eligible for a new Special Enrollment Period (SEP).

Here's a story in the Baltimore Sun about the new law and new program:

Need health insurance? Marylanders can now check a box on their income taxes to begin enrollment

Tax-filing season is here. It’s not usually a time to celebrate, but this year, there’s a new feature that thousands of state taxpayers may find beneficial.

This tax season marks the beginning of the Maryland Easy Enrollment Health Insurance Program, thanks to legislation passed by the General Assembly last year. This innovative new program lets people without health insurance simply check a box on their state income tax return to start the process of enrolling in a health plan.

Once a tax filer checks that box, the Maryland Health Benefit Exchange will determine their eligibility for Medicaid and for free or low-cost private insurance. This year, people will get a letter saying whether they qualify for insurance, with instructions about how to complete their enrollment. Starting next year, a more streamlined and automatic process will apply.

This new program will make it easy for uninsured Marylanders to learn whether they qualify for affordable insurance and then to enroll. This should reach people throughout Maryland who don’t yet know how much help they can get under the Affordable Care Act. Before long, thousands will have coverage — and the peace of mind that comes with more affordable health care.

No other state has tried this approach, and we’re proud that Maryland is once again leading the way in health care innovation.

Here's the official website info:

Maryland Easy Enrollment Health Insurance Program

This tax season, Marylanders will be able to sign up for health coverage through an innovative new pilot program.

Beginning in 2020, you can indicate on your tax return if you would like the Maryland Health Benefit Exchange, the state agency that runs Maryland Health Connection, to estimate your eligibility for coverage. This selection launches an easy process that will help you enroll.

How it works:

  • On your 2020 Tax Forms 502 and 502B, you must indicate whether you, your spouse, and/or your dependents have health insurance coverage.
  • If you are uninsured, then select to authorize the Comptroller to share information from your tax return with the Maryland Health Benefit Exchange (MHBE) to determine pre-eligibility for free or low-cost health care coverage.
  • After filing your taxes, MHBE will send you a letter indicating whether you are preliminarily eligible for coverage through Maryland Health Connection (Maryland’s health insurance marketplace) and asking you to take further steps to confirm eligibility and enroll.
  • To complete enrollment, you can visit, call 855.642.8572, or receive free in-person assistance from trained experts throughout the state.

For what it's worth, the Maryland ACA exchange enrolled around 159,000 people during Open Enrollment this year, so if they were to manage to get all 70,000 subsidy-eligible Marylanders to sign up via the EZ Enrollment SEP, they'd theoretically increase their exchange enrollment by a whopping 44%. I'd be surprised if they manage to add more than perhaps 10,000 or so the first year, but that'd still be huge, and it should ramp up in future years. I'd expect them to have an even better batting average with the Medicaid-eligible population, since it would effectively cost them nothing to do so, so I could see the program covering a total of as many as 40,000 or so more Marylanders out of the gate.