An Act To Maximize Health Care Coverage for the Uninsured through Easy Enrollment in the MaineCare Program or in a Qualified Health Plan in the Marketplace
Maine Legislature, Session 130, LD 1390
Committee: Health Coverage, Insurance and Financial Services
Sponsors: EVANS, CLAXTON, BROOKS, COLLINGS, HYMANSON, ZAGER
Amends: 22 MRSA §5412, 22 MRSA §5413, 36 MRSA §191, 36 MRSA §5293

Legislative Document
No. 1390
H.P. 1024
House of Representatives, April 7, 2021
An Act To Maximize Health Care Coverage for the Uninsured 
through Easy Enrollment in the MaineCare Program or in a 
Qualified Health Plan in the Marketplace
Received by the Clerk of the House on April 5, 2021.  Referred to the Committee on Health 
Coverage, Insurance and Financial Services pursuant to Joint Rule 308.2 and ordered printed 
pursuant to Joint Rule 401.
ROBERT B. HUNT
Clerk
Presented by Representative EVANS of Dover-Foxcroft.
Cosponsored by Senator CLAXTON of Androscoggin and
Representatives: BROOKS of Lewiston, COLLINGS of Portland, HYMANSON of York, 
ZAGER of Portland.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §5412 is enacted to read:
§5412.  Easy enrollment program
The easy enrollment program is established under this chapter to identify residents of 
this State who are uninsured but qualify for benefits under the MaineCare program or a 
qualified health plan in the marketplace.
1.  Tax checkoff.  A person filing a tax return in this State pursuant to Title 36, chapter 
who has marked the relevant check-off boxes on the State income tax form as described 
in Title 36, section 5293 is identified as a person who may be determined eligible for 
benefits under the MaineCare program or to enroll in a qualified health plan in the 
marketplace.  The superintendent, in conjunction with the Department of Administrative 
and Financial Services, Bureau of Revenue Services, shall determine by rule the 
information necessary to be shared with the marketplace to determine eligibility and the 
schedule regarding the frequency of transferring the information.
2.  Eligibility determination.  The marketplace shall determine whether the person 
filing the tax return under subsection 1 has an address in the State and whether the persons 
in the household indicated as uninsured are already enrolled in the MaineCare program or 
a qualified health plan in the marketplace.  The marketplace shall mail a notice to 
households with an address in the State and with persons in the household who are 
uninsured.  The notice must notify the person filing the tax return that the person or other 
uninsured members of the household may be eligible for health care coverage and provide 
information about the special enrollment period available on the marketplace pursuant to 
subsection 3 and that MaineCare enrollment is available at any time.  If the person filing 
the tax return has included an e-mail address, the marketplace shall also send an e-mail 
notice.
3.  Special enrollment period; assistance; coverage begins.  A person filing a tax 
return under subsection 1 who is determined eligible to enroll in a qualified health plan in 
the marketplace has a special enrollment period that begins on the date of the tax filing and 
ends 35 days from the date of the notice mailed by the marketplace to the person pursuant 
to subsection 2.  Once a person begins the application to enroll in a qualified health plan in 
the marketplace, the marketplace shall provide assistance through follow-up e-mails or 
other communications until the person is successfully enrolled or the marketplace 
determines that the person does not wish to enroll.  Coverage in the marketplace is effective 
on the first day of the month after the date a plan is selected by the person.
4.  Medicaid coverage; coverage begins.  If the marketplace determines that any 
member of the household is eligible for benefits under the MaineCare program under this 
section, the marketplace shall notify the department and the person who filed the tax return 
of the potential eligibility.  The department shall contact the person who filed the tax return 
and provide assistance with the MaineCare application unless the marketplace determines 
that the person does not wish to enroll.  For a person enrolled in the MaineCare program 
under this section, coverage begins on the first day of the month in which the person applied 
to enroll.
5.  Outreach efforts.  The marketplace, superintendent and department shall jointly 
develop educational materials and programming to communicate the purpose of the income 
tax checkoff under Title 36, section 5293 and the benefits of enrolling in the MaineCare 
program or a qualified health plan in the marketplace to the public.  The materials and 
programming must include materials developed for different target groups in the public, 
including, but not limited to, tax preparers, consumer assistance organizations, community 
groups and underserved groups.  The materials must be made available in English and in 
languages appropriate for communities in the State whose primary languages are not 
English.
Sec. 2.  22 MRSA §5413 is enacted to read:
§5413.  Easy enrollment advisory group; data collection
1.  Advisory group.  An advisory group is established to advise the superintendent on 
state income tax changes including the format of check-off boxes on income tax forms 
pursuant to Title 36, section 5293, effectiveness of the easy enrollment program under 
section 5412, feasibility of automatic enrollment in health care plans, improvements to 
outreach materials, issues related to necessary information required for establishing 
eligibility while maintaining confidentiality and proposed changes to improve the program.  
The superintendent is the chair and convenes the advisory group.  The chair shall appoint 
members to the advisory group, and members must include the stakeholders described in 
section 5404, subsection 2, paragraph B and representatives of the Department of 
Administrative and Financial Services, Bureau of Revenue Services and professional tax 
preparers.  The advisory group shall meet at least 3 times a year and as often as necessary 
to carry out its advisory duties.
2.  Data collection.  The superintendent shall provide an annual report on the easy 
enrollment program under section 5412 to the joint standing committee of the Legislature 
having jurisdiction over health insurance matters and the joint standing committee of the 
Legislature having jurisdiction over MaineCare matters.  The report must include the 
number of persons who marked the check-off boxes on tax returns as described in section 
5412, subsection 1, the number determined eligible by the marketplace for benefits under 
the MaineCare program or a qualified health plan in the marketplace, the number who 
enrolled in the MaineCare program, the number who enrolled in qualified health plans in 
the marketplace, how many enrolled in a qualified health plan in the marketplace who were 
eligible for financial assistance and demographic data on enrollment.  The report must be 
submitted by November 15th of each year beginning in 2022 and contain data based on the 
previous calendar year's tax return data.
Sec. 3.  36 MRSA §191, sub-§2, ¶MMM is enacted to read:
MMM.  The disclosure of information to the Maine Health Insurance Marketplace and 
the Superintendent of Insurance to administer the easy enrollment health insurance 
program pursuant to Title 22, section 5412 and the health insurance check-off box 
pursuant to section 5293.
Sec. 4.  36 MRSA §5293 is enacted to read:
§5293.  Easy enrollment health insurance program; voluntary checkoff
1.  Health insurance check-off box.  For tax years beginning on or after January 1, 
2021, the State Tax Assessor shall provide on the income tax form a space for an easy 
enrollment health insurance check-off box that includes the following:
A. A check box indicating that the taxpayer filing the tax return does not have health 
care coverage;
B.  A check box indicating that the spouse of the taxpayer filing the tax return does not 
have health care coverage; 
C.  A check box indicating whether any dependents of the taxpayer do not have health 
care coverage;
D.  A check box authorizing the bureau to share information from the income tax return 
with the marketplace established in Title 22, chapter 1479; and
E.  An e-mail address, if available, for additional contact by the marketplace under 
Title 22, chapter 1479.
2.  Information sharing.  The bureau shall forward to the marketplace established in 
Title 22, chapter 1479 the information of a taxpayer who marked any check box in 
paragraph A, B or C and marked the check box in paragraph D.  The information transferred 
to the marketplace, and the frequency of that transfer, is established by rule according to 
Title 22, section 5412, subsection 1.
3.  Rulemaking.  The bureau shall adopt rules to implement this section.  Rules adopted 
pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, 
subchapter 2-A.
SUMMARY
This bill establishes a process to identify individuals and families who are uninsured 
but potentially eligible for benefits under the MaineCare program or enrollment in a 
qualified health plan in the Maine Health Insurance Marketplace through the state income 
tax filing system.  It requires the Department of Administrative and Financial Services, 
Bureau of Revenue Services to add check-off boxes to the state income tax form that allow 
an individual who is filing a state income tax return to identify that the individual or the 
individual's spouse or dependents are uninsured and authorize the bureau to share that 
information with the marketplace.  The marketplace must determine eligibility and follow 
up with the individual filing the tax return.  A special enrollment period on the exchange is 
available to the uninsured individuals.  The marketplace must offer assistance with the 
enrollment process for a qualified health plan and the Department of Health and Human 
Services must offer assistance with MaineCare enrollment.  Outreach materials and 
programming for educational purposes are developed by the Superintendent of Insurance 
within the Department of Professional and Financial Regulation, the marketplace and the 
Department of Health and Human Services.  An advisory group is created to assist the 
superintendent with improving the effectiveness of the program.  The superintendent must 
submit an annual report with related data to the joint standing committees of the Legislature 
having jurisdiction over health insurance matters and MaineCare matters.