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CMS will re-open enrollment for Americans facing tax penalties

One-time 'special enrollment period' to run March 15 to April 30
Tools

The Centers for Medicare & Medicaid Services (CMS) will hold a special enrollment period on Healthcare.gov for Americans who learned after Feb. 15 that they face a penalty for not having insurance in 2014 and who want to enroll in 2015 in order to avoid that penalty.

This enrollment period begins March 15 and ends April 30. It will only be offered this year, and it applies only to the federal exchange. State exchanges are free to set their own policies, Andy Slavitt, Principal Deputy Administrator for CMS, said in a conference call with reporters Friday morning. Some states, such as Washington, have already done this.

In order to enroll, Slavitt said, consumers must be able to attest to the fact that they:

  • Are not currently enrolled in health insurance
  • Paid the tax penalty for not being insured in 2014
  • First became aware of the fee after open enrollment closed on Feb. 15, 2015

Those eligible to enroll can do so as other Healthcare.gov users have, Slavitt said--through the website, the call center, a local assister or broker, or directly with a health insurer.

The Department of the Treasury has estimated that as many as 6 million uninsured Americans face the prospect of paying the tax penalty in the 2014 tax season. Research released yesterday by the Urban Institute said that more than 40 percent of uninsured adults remained unaware of the tax penalty, the Healthcare.gov marketplace or the Feb. 15 enrollment deadline.

CMS has not set a goal for the special enrollment period, Slavitt said. The intention isn't to add to the Affordable Care Act's enrollment numbers for number's sake, he added, but to make sure that those potentially affected by the penalty aren't "disadvantaged."

In conjunction with the special enrollment period, CMS launched a tool on Healthcare.gov today to help consumers who did not have health insurance in 2014 determine if they qualify for an exemption from paying the tax penalty in 2015

Busy week for CMS

Today's announcement caps a whirlwind week for CMS and Healthcare.gov.

The Obama administration announced earlier this week that 11.4 million Americans signed up for insurance on the the ACA exchanges as Feb. 15. Of that amount, 8.6 used Healthcare.gov and 2.8 million used state exchanges.

That number stands to rise, as the enrollment deadlines for Healthcare.gov and many of the state insurance exchanges have been extended to accommodate those who began the application process on Feb. 15 but could not complete it.

Part of the motivation for the extension is that back-end issues remain on Healthcare.gov. Health insurers must still enter member information manually and submit it to the Department of Health and Human Services in a spreadsheet.

In addition, Slavitt announced on the call with reporters that CMS must mail new 1095A tax forms to those who received a premium tax credit after purchasing a plan on Healthcare.gov. The form incorrectly stated the benchmark used to calculate a taxpayer's final tax obligation. Slavitt said the error affects about 800,000 consumers, only about 50,000 of whom have already filed their 2014 taxes.

Looking at lessons learned

With the open enrollment period for 2015 winding down, Slavitt said CMS is turning its attention to lessons learned. Though the second open enrollment period went much more smoothly than the first, "We're not doing any victory laps," Healthcare.gov CEO Kevin Counihan said. "There's always opportunities to do better."

When traveling around the country during open enrollment, Counihan said he learned that consumers value individual assistance. They may ultimately purchase a plan on Healthcare.gov, but they also use the call center and in-person "assister" agents to learn about plans.

"We want to provide that support in the most substantive and simple way possible," Counihan said.

For more:
- read the Urban Institute report
- here's the HHS open enrollment announcement

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Despite hitting goal, Healthcare.gov continues to sing the blues
Healthcare.gov, state open enrollment deadlines extended
So far, so good for Healthcare.gov as enrollment deadline looms