whose enrollment under such coverage or such plan was 
terminated during such month.’’. 
(B) MEDICAID.—Section 1902 of the So-
cial Security Act (42 U.S.C. 1396a) is amended 
by adding at the end the following new sub-
section: 
‘‘(nn) REPORTING
ON DISENROLLMENT
OF MED-
ICAID ENROLLEES.—For each month beginning on or 
after January 1, 2021, a State shall submit to the Sec-
retary a report, at such time, in such manner, and con-
taining such information as the Secretary may require, on 
each individual who was disenrolled from the State plan 
(or a waiver of such plan) during such month.’’. 
(C) CHIP.—Section 2107(e)(1) of the So-
cial Security Act (42 U.S.C. 1397gg(e)(1)) is 
amended— 
(i) by redesignating subparagraphs 
(L) through (S) as subparagraphs (M) 
through (T), respectively; and 
(ii) by inserting after subparagraph 
(K) the following new subparagraph: 
‘‘(L) Section 1902(nn) (relating to report-
ing on disenrollment of enrollees).’’. 
(e) REPORT.—Not later than 6 months after the date 
of enactment of this Act, the Secretary of Health and 
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Human Services, in coordination with the Commissioner 
of the Internal Revenue Service, shall submit to Congress 
a report with best practice recommendations on how a 
State may establish an auto-enrollment system (as defined 
in subsection (f)). Such report shall include the following: 
(1) Identification of any statutory barriers to 
establishing such a system, including data-sharing, 
administrative, and technological barriers. 
(2) How such a system would interact with en-
rollment periods for qualified health plans (as de-
fined in section 1301 of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18021)) and income 
eligibility determinations for premium assistance tax 
credits under section 36B of the Internal Revenue 
Code, the impact of such system on enrollment in 
health insurance coverage in a State establishing 
such system, and the effects of changing the enroll-
ment periods for such system to align with the filing 
of individual Federal tax returns. 
(3) An evaluation of prior outreach efforts tar-
geted to individuals without health insurance cov-
erage eligible for such tax credits. 
(f) DEFINITIONS.—For purposes of this Act: 
(1) AUTO-ENROLLMENT
SYSTEM.—The term 
‘‘auto-enrollment system’’ means a system designed 
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and operated by a State that provides for an eligible 
individual residing in such State to be automatically 
enrolled in a qualified health plan offered through 
an Exchange in the State, or, if eligible, in the State 
plan under title XIX of the Social Security Act (or 
under a waiver of such plan), provided that the sys-
tem exempts such individual from paying any pre-
mium imposed by the State under such plan (or 
waiver). Such automatic enrollment shall be void if 
within 60 days after first being notified of the auto-
matic enrollment the eligible individual declines such 
coverage. 
(2) ELIGIBLE INDIVIDUAL.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B), the term ‘‘eligible individual’’ means, 
with respect to a taxable year, an individual 
who is not eligible for minimum essential cov-
erage, other than minimum essential coverage 
described in subparagraph (A)(ii) or (C) of sec-
tion 5000A(f)(1) of the Internal Revenue Code 
of 1986, for such year. 
(B) LIMITATION.—An individual who is 
only eligible for minimum essential coverage de-
scribed in section 5000A(f)(1)(C) of the Inter-
nal Revenue Code of 1986 may only be treated 
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as an eligible individual for purposes of this sec-
tion if the amount that would be calculated 
under section 36B(b)(2)(B) of such Code for 
such individual for a coverage month is not less 
than the monthly premium for the least expen-
sive plan offered on the Exchange for which 
such individual is eligible. This subclause shall 
be calculated on the basis of the individual’s 
household income for the most recent taxable 
year for which the Secretary determines infor-
mation is available. 
(3) STATE.—The term ‘‘State’’ means each of 
the several States, the District of Columbia, and 
each territory or possession of the United States. 
Æ 
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