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Health insurance

Feds grant another ACA deadline extension

Jayne O'Donnell, and Laura Ungar
USA Today
Affordable Care Act health insurance marketplace navigator Leticia Chaw, right, helps Jennifer Sanchez with information on how to re-enroll in a  health insurance plan on Nov. 14, 2014, in Houston.

Millions of consumers who haven't filed their 2014 taxes and owe a penalty for not having health insurance will now be able to sign up from March 15 to April 30, the Centers for Medicare and Medicaid Services said Friday.

This "special enrollment period," which will include most of the estimated 6 million people who will owe a penalty, is available to those who attest they first learned of the tax penalty after open enrollment when they were preparing their taxes, said Andy Slavitt, CMS' principal deputy administrator.

About 800,000 consumers who have health insurance will also be contacted starting today because a tax form sent by CMS contained a mistake in the benchmark plan used to calculate how much tax they owe, CMS said.

CMS urged people to hold off on filing their taxes until they get new corrected forms and estimated that less than 10% of the 800,000 had likely already filed.

This year's tax season is the first time people will be asked to provide information about their health coverage on tax returns.

People with incomes above the federal poverty level must enroll in coverage or face a penalty. Under the Affordable Care Act, the fee for not having coverage in 2014 is $95 a person or 1% of annual household income, whichever is greater. The fee for not having coverage in 2015 is $325 per person or 2% of household income, whichever is greater.

The new special enrollment period will be a "helpful, teachable moment and will enable many people to obtain health coverage and avoid future penalties," said Ron Pollack, executive director of the non-profit advocacy group Families USA.

The insurance industry, which learned to grapple with multiple deadline changes during last year's glitch-ridden federal enrollment, says it will be able to adjust to this one.

"Given that this is a new process for consumers, this targeted special enrollment period is a sensible approach for those who qualify," said Clare Krusing, a spokeswoman for the trade group America's Health Insurance Plans.

HealthCare.gov and CuidadodeSalud.gov, the sites used by the 37 states that didn't set up their own health insurance exchanges, also had a new tool starting Friday to help people determine whether they are eligible for a hardship exemption from the requirement to have insurance. These exemptions include not being able to afford coverage, based on the government definition of affordability.

Those taking advantage of the new enrollment period will still owe a fee for the months they were uninsured and didn't receive an exemption in 2014 and 2015. This special enrollment period is designed to allow these people the chance to get covered for the rest of the year and avoid additional fees for 2015, CMS said.

On Thursday, Vermont joined Washington state and Minnesota in offering a special tax season enrollment period for those who realize they will face a penalty. Several other states are considering similar special enrollment periods, including California and Kentucky.

Peter Lee, executive director of Covered California, said earlier this week that the prospect of penalties drove many to sign up in the final days of the regular enrollment period. He said some residents signed up for Obamacare plans immediately after seeing tax professionals and realizing they would face a fee.

"This is the first time in our history health care and taxes are totally intertwined," he said.

An estimated 44% of uninsured people who are likely to be penalized for not having coverage have heard nothing, or only a little, about the tax penalties, according to research out Thursday by the Urban Institute and the Robert Wood Johnson Foundation. It also showed 65% of those likely to pay the penalty had either not heard about the health care exchanges, didn't know the date of the open enrollment deadline or thought it was in March.

Federal officials on Monday had announced a separate special enrollment period that ends this Sunday for those using Healthcare.gov who don't already have coverage, haven't been terminated from a plan purchased through HealthCare.gov this year and who say they tried to enroll by the deadline but ran into a technical issue or endured a long call center wait on Feb. 13, 14 or 15.

Officials said people can verbally "attest" they had issues with the call center, and if they are applying online will see a statement of requirements, then text that says "by continuing, you attest ..."

Senate Finance Committee Chairman Orrin Hatch, R-Utah, released a statement Friday saying taxpayers are suffering as the administration "struggles with how to enforce the individual mandate" requiring Americans to have health insurance.

"Whether it's providing taxpayers with incorrect subsidy information or having to create special enrollment periods so that taxpayers can avoid costly penalties, Obamacare continues to frustrate and confuse Americans," Hatch said. "The Administration's latest attempt to unilaterally tweak their own law to avoid political fallout once again underscores the failed policies rooted in Obamacare's DNA."

Beyond all the tax-related news and in keeping with the Obama administration's theme this open enrollment season, Slavitt said CMS is now "getting ready to jump to a lessons-learned exercise."

HHS said earlier this week that as of the original Feb. 15 deadline,11.4 million Americans had newly enrolled or re-enrolled in private health coverage through the ACA.

The agency is taking a hard look at enrollment outreach to see why some efforts were so much more successful than others. For example, Healthcare.gov CEO Kevin Counihan said one enrollment store was only open from 11 a.m to 3 p.m. – when it was able to find the staffing needed – but that was also when most consumers looking for help were working too.

"We're not doing any victory laps," Counihan said. "We're confident next year will be even more successful and better for consumers."

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