Maryland program linking insurance enrollment to tax filing shows promise

In 2019, Maryland launched an initiative to use income tax filing as an on-ramp to health coverage. How's it going?

States have begun to explore and initiate facilitated enrollment strategies to directly connect uninsured consumers to marketplace coverage opportunities and simplify the enrollment process. (Photo: Shutterstock)

Despite advances made under the Affordable Care Act and state Medicaid expansion, nearly 33 million non-elderly Americans still lacked health insurance in 2019.

In recent years, encouraging those who are eligible for subsidies to enroll in Marketplace coverage has become a major focus for many states. Reducing the number of uninsured improves the well-being of state residents and brings federal dollars into the state. States have begun to explore and initiate facilitated enrollment strategies to directly connect uninsured consumers to marketplace coverage opportunities and simplify the enrollment process.

Related: How ‘hassle cost’ affects decision-making among health plan members: Study

In May 2019, Maryland created the state’s new Easy Enrollment Health Insurance Program (MEEHP), a facilitated tax-time enrollment pathway providing assisted enrollment into Medicaid and Qualified Health Plans with a special enrollment period. This program, a partnership between the Maryland Health Benefit Exchange and the Office of the Maryland Comptroller, represents the country’s first attempt to use income tax filing as an on-ramp to health coverage. The new tax-based enrollment system took effect in January 2020.

“MEEHP’s leveraging of tax filing provides both a remarkable opportunity to identify the uninsured and could help overcome one of the most serious obstacles to coverage; namely, a lack of information about available assistance,” according to a white paper by the health insurance broker GetInsured. “Nationwide, there are a lot of misconceptions about the availability and affordability of health coverage, and Maryland expects that their new program will help to move past these misconceptions.”

The white paper identified three key best practices for other states to implement similar programs:

“Early results from Maryland are promising, and the fact that several states are following Maryland’s example points to the enormous potential this type of program offers to reduce uninsured rates,” the white paper concluded. “States with income tax and uninsured rates over a certain threshold should consider implementing this innovative program.”

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