1) It is the goal of STATE to ensure that all eligible [STATE] residents have efficient access to affordable health insurance coverage.

2) EXPRESS LANE ELIGIBILITY PROGRAM ESTABLISHED

a) On or before [DATE], subject to the state budget, and as permitted by federal law, [DEPARTMENT] shall establish an express lane eligibility (ELE) program to determine eligibility and enrollment of STATE residents eligible for Medicaid and the children’s health insurance program (CHIP), based on eligibility findings from public programs, including the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

b) If before implementing this section, [DEPARTMENT] determines a waiver or authorization from a federal agency is necessary for implementation of this section, such as by submitting a state plan amendment to the Centers for Medicare and Medicaid Services (CMS) for or related to express lane eligibility (ELE), the agency shall request the waiver or authorization.

c) [DEPARTMENT] shall make all reasonable efforts to expedite enrollment of eligible individuals in the ELE program, provided that the DEPT may propose or implement the use of ELE for renewals before proposing or implementing the use of ELE for initial enrollment.

3) EASY ENROLLMENT PROGRAM ESTABLISHED

a) The [STATE] “Easy Enrollment Program,” hereby referred to as “the Program,” is established for the purpose of leveraging the individual income tax filing process to maximize the enrollment of eligible uninsured individuals and uninsured members of their households by:

i) Facilitating identification of taxpayers and members of the taxpayers’ households who are uninsured and interested in health insurance coverage;

ii) Providing taxpayers with a method to consent to the [DEPARTMENT OF REVENUE/TAX] provision of insurance-relevant information to the DEPT and the [State Health Benefits Exchange, if a STATE HEALTH BENEFITS EXCHANGE is operational], for the purpose of assessing eligibility for health coverage programs;

iii) Determining or assessing, as feasible, whether an individual who is interested in obtaining health coverage programs qualifies for insurance affordability assistance;

iv) Providing for notification to taxpayers regarding their eligibility or eligibility of their household members for health coverage programs and insurance affordability assistance; and

v) Facilitating enrollment in health coverage programs and insurance affordability assistance.

b) ELIGIBILITY IDENTIFICATION PROCESS

i) For taxable years beginning on or after [DATE], the [DEPT] shall include a checkbox or a similar mechanism in the state income tax form for a taxpayer to:

(1) Indicate on their individual income tax return their interest in health care coverage and insurance affordability assistance;

(2) Identify whether the taxpayer or members of the taxpayer’s household are uninsured;

(3) Authorize the [DEPT] to share the taxpayer’s income information with the [STATE HEALTH BENEFITS EXCHANGE] for that purpose, [if a STATE HEALTH BENEFITS EXCHANGE is operational].

(4) Provide the taxpayer’s consent to provide to the [DEPT] and the exchange, [if a STATE HEALTH BENEFITS EXCHANGE is operational]:

(a) The taxpayer’s insurance-relevant information;

(b) Any additional information necessary to determine the taxpayer’s eligibility for health insurance benefits and insurance affordability assistance; and

(c) Information on any consent provided by the taxpayer pursuant to this subsection.

(5) Provide the taxpayer’s consent to enroll:

(a) The taxpayer in Medicaid or CHIP; or

(b) Members of the taxpayer’s household in Medicaid or CHIP if:

(i) Coverage by Medicaid or CHIP is available to those household members; and

(ii) The taxpayer has legal authority to consent to enroll those household members; and

(iii) Provide information on any consent provided by the taxpayer pursuant to this subsection.

c) The [DEPT OF PUBLIC HEALTH], [DEPT OF REVENUE/TAX], [OTHER RELEVANT STATE AGENCIES] shall develop and implement systems, policies, and practices that encourage, facilitate, and streamline determination of eligibility for insurance affordability programs and enrollment in State health insurance coverage to achieve the purposes of the easy enrollment program.

4) CONTINUOUS COVERAGE FOR CHILDREN

a) On or before [DATE], subject to federal financial participation, and subject to subdivision 4(c), an eligible child shall remain continuously enrolled for the STATE Medicaid or health care coverage available through the federal children’s health insurance program (CHIP) program up to six years of age. The DEPT shall seek any federal approvals that may be necessary to implement this subdivision. Implementation of this section is contingent on all of the following conditions:

i) All necessary federal approvals have been obtained by the department pursuant to subdivision 4(c).

ii) The Legislature has appropriated funding to implement this section after a determination that ongoing General Fund resources are available to support the ongoing implementation of this section in the [DATE] fiscal year and subsequent fiscal years.

iii) The DEPT has determined that systems have been programmed to implement this section.

b) If at any time the [DIRECTOR OF THE DEPT] determines that the eligibility criteria established under this section for the program may jeopardize the state’s ability to receive federal financial participation under the federal Patient Protection and Affordable Care Act (Public Law 111-148), any amendment or extension of that act, or any similar federal legislation affecting federal financial participation, the director may alter the eligibility criteria to the extent necessary for the state to receive that federal financial participation.

c) This section shall be implemented only to the extent that any necessary federal approvals are obtained, and federal financial participation is available and not otherwise jeopardized.

5) DEFINITIONS

a) “Exchange” means the State health insurance exchange;

b) “Health coverage program” means Medicaid, health care coverage available through the federal children’s health insurance program (CHIP), a qualified health plan available through the exchange pursuant to the [STATE] healthcare exchange or a health plan available through the [STATE] medical insurance pool;

c) “Insurance-relevant information” means information pertaining to the insurance enrollment status of a taxpayer or members of a taxpayer’s household and that is derived or obtained from the taxpayer’s state income tax return; provided that information is limited to that information necessary to assess the eligibility of the taxpayer or members of the taxpayer’s household for health coverage programs and includes:

i) Adjusted gross income and other types of reported income used to assess eligibility for health coverage programs;

ii) Household size;

iii) Claimed dependents; and

iv) Contact information and identifying information necessary to assess health coverage program eligibility and used to match against relevant third-party data sources.