(Story updated at 1 p.m. ET.)
A special enrollment period will begin March 15 and end April 30 to help consumers avoid tax penalties for not obtaining health insurance coverage this year, Andrew Slavitt, principal deputy administrator at the CMS, said during a news briefing Friday.
The CMS also announced that as many as 800,000 enrollees received incorrect subsidy information on the 1095-A tax forms sent by the federal exchange, HealthCare.gov. As a result, some may have incorrectly calculated that they received too large a subsidy, while others incorrectly deduced their subsidy was too small.
To qualify for the special enrollment period, people will need to self-attest that they had to pay a penalty for not having coverage in 2014, they cannot be currently enrolled in a plan on HealthCare.gov, and claim that they only found out they were going to have to pay a tax penalty when they filed their income tax forms. The CMS had no estimates on how many people fall into this group.
Up to 6 million Americans are expected to pay a penalty for not having coverage in 2014, according to recent Obama administration projections. Most of the uninsured won't actually face the penalty because they'll qualify for an exemption, either related to their inability to afford coverage or some other hardship.
For 2015, the penalty is $325 per uninsured person or 2% of household income, depending on which is higher, over the tax filing threshold. That's up from 2014, when it was $95 per uninsured person or 1% of household income, depending on which is higher, over the tax filing threshold.
Advocates were thrilled with the announcement. “There remain millions of people who are unaware of the premium subsidies that make insurance affordable and who didn't know about the tax penalty for failing to buy insurance,” Ron Pollack, executive director of Families USA, said in a statement. “This special enrollment period will therefore be a helpful, teachable moment and will enable many people to obtain health coverage and avoid future penalties.”
HHS has already announced a special enrollment period ending Feb. 22 for people who had an in-process application on Feb. 15. This group includes the just under 150,000 people who used the call center Feb. 15 and were unable to complete the application process before the deadline. That number does not include those who had technical issues and were unable to complete their enrollment. HHS has no estimates on the number of people in this second group. HHS will be releasing how many additional people gained coverage from this special enrollment period by Feb. 25, Slavitt said.
As of midnight Feb. 15, 11.4 million consumers selected or were automatically re-enrolled in plans. That includes 8.6 million with plans on HealthCare.gov and about 2.8 million people who obtained coverage from a state-based marketplace, HHS announced.
HHS' goal for the second re-enrollment period is to have an effectuated enrollment, people who have selected plans and paid for them, of 9.1 million. It may not be until the next open-enrollment period begins next fall that the agency will know if it has reached that goal.
The CMS is investigating how a faulty formula made its way onto some 1095 forms. It has begun to aggressively reach out to the 800,000 individuals who received the forms to not file their taxes until they receive corrected forms. To date, however, 50,000 have already filed their taxes. The U.S. Treasury Department will be reaching out to them with follow-up instructions, Slavitt said.
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