Senate Commerce Committee Statement to Senate, No. 3238 — State of New Jersey (January 21, 2021)

Summary

A Senate Commerce Committee statement to the Senate on Senate Bill No. 3238, State of New Jersey, dated January 21, 2021, reporting the bill favorably with committee amendments. As amended, the bill requires the Department of Banking and Insurance to establish the New Jersey Easy Enrollment Health Insurance Program, using State income tax returns to identify uninsured residents interested in minimum essential coverage and determine eligibility for insurance affordability assistance. The State Treasurer must add a checkoff box to the income tax return for uninsured status and waive the State shared responsibility tax for taxpayers who opt in. A special enrollment period of not shorter than 14 days begins on the filing date, and the bill applies to taxable years beginning after December 31, 2020, unless the Treasurer delays it.

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SENATE COMMERCE COMMITTEE

STATEMENT TO

SENATE, No.
3238

with
committee amendments

STATE
OF NEW JERSEY

DATED: JANUARY
21, 2021

The
Senate Commerce Committee reports favorably and with committee amendments
Senate Bill No. 3238.

As amended, this bill requires the Department of
Banking and Insurance to establish and operate the New Jersey Easy Enrollment
Health Insurance Program (the program). The department is required to integrate
the program with the State-based health insurance exchange, and may enter into
an agreement with a third-party for operation of the program. The purpose of
the program is to:

(1) establish a State-based reporting system to
provide information about the health insurance status of State residents
through the use of State income tax returns to identify individuals and
determine whether an individual is interested in obtaining minimum essential
coverage;

(2) determine whether an individual who is interested
in obtaining minimum essential coverage qualifies for insurance affordability
assistance;

(3) proactively contact an individual who is
interested in obtaining minimum essential coverage to assist in enrolling the
individual in insurance affordability assistance and minimum essential
coverage; and

(4) maximize enrollment of eligible individuals in
insurance affordability assistance and minimum essential coverage to improve
access to care and reduce insurance costs for all residents of the State.

The bill requires the Commissioner
of Banking and Insurance, the Commissioner of Human Services, and the State
Treasurer to develop and implement systems, policies, and practices that
encourage, facilitate, and streamline determination of eligibility for insurance
affordability assistance and enrollment in minimum essential coverage to
achieve the purposes of the program.

The bill requires the Commissioner of Banking and
Insurance to establish a New Jersey Easy Enrollment Health Insurance Program
Advisory Workgroup to provide ongoing advice regarding the implementation of
the program, which is to include representation from various organizations.
The workgroup is required to meet at least once every six months.

The program is required to determine eligibility for
insurance affordability assistance as soon as possible after an individual
files a State income tax return on which the individual indicates that the
individual is seeking health benefits coverage.

To the extent practicable, the program must verify an
individual's eligibility for insurance affordability assistance with
information on a State income tax return and other data from third-party data
sources, without requesting additional information from the individual.

The bill provides that if additional documentation
from an individual is required to establish eligibility for insurance
affordability assistance, the program must take certain steps to limit the
burden on the individual.

Before determining eligibility of an individual for
insurance affordability assistance, the program is required to attempt to
verify the citizenship status of the individual and each household member
listed on the State income tax return, based on the information available from
the return and reliable third-party sources of citizenship data. If this
process does not confirm that the individual and each household member listed
on the State income tax return is a United States citizen, the program may not
seek additional verification or take other steps to determine eligibility for
or enroll the individual in insurance affordability assistance until the
individual provides affirmative consent using forms and procedures approved by
the program.

If citizenship is not verified and affirmative consent
is not provided in accordance with the bill, the program may not take any
further steps to determine an individual's eligibility for or enroll an
individual in insurance affordability assistance.

The bill requires the program to make a determination
of eligibility for the State Medicaid program or the NJ FamilyCare Program
before determining eligibility for any other insurance affordability
assistance. If an individual is determined to be eligible for the State
Medicaid program or the NJ FamilyCare Program, the procedures described in the
bill and the guidelines established by the program to implement the bill apply.

If an individual fails to select a managed care
organization plan within a period of time established by the program, the
program may assign the individual to and promptly enroll the individual in a
managed care organization plan.

Before an individual is assigned to a managed care
organization plan, the individual is required to receive advance notice, an
opportunity to select another managed care organization plan, and an
opportunity to opt out of coverage.

If an individual is determined to not be eligible for
the State Medicaid program or the NJ FamilyCare Program, the program is
required to determine whether the individual is eligible for premium tax
credits or cost-sharing reductions.

The bill provides that a special enrollment period for
the New Jersey Individual Health Coverage Program will begin on the date an
income tax return is filed by or on behalf of an individual that indicates the
individual is seeking insurance coverage. The enrollment period is to last for
a period of time, to be determined by the program before the start of the
calendar year, that may not be shorter than 14 days.

Information about the enrollment period described in
the bill must be communicated to the public and affected individuals through
measures that may include language in the instructions for the State individual
income tax return, if inclusion of the language is approved by the State
Treasurer.

The bill requires the Department of Banking and
Insurance to develop data privacy and data security safeguards to govern the
conveyance, storage, and utilization of data under the program.

The bill requires the State Treasurer to include on
the individual income tax return form a checkoff box for indicating whether the
individual, or each spouse in the case of a joint return, and any individual
claimed as a dependent on the tax return is uninsured at the time the tax
return is filed.

The bill requires the State Treasurer to include with
the income tax return form a separate form that is required only for
individuals who file a tax return indicating that an individual is uninsured at
the time the tax return is filed.

The form is required to include two checkoff boxes.
One checkoff box shall give an individual who files a tax return the choice to
have the program determine the individual's eligibility for insurance
affordability assistance, and obtain additional data that may be relevant to
determine the individual's eligibility for insurance affordability assistance.
The other checkoff box shall allow an individual who files a tax return the
choice to not have the program make that determination.

The bill requires the State Treasurer to waive the
State shared responsibility tax for any taxpayer who chooses the checkoff box indicating
the taxpayer wishes the program to determine the individual’s eligibility for
insurance affordability assistance. If the taxpayer fails to enroll in health
benefits coverage and maintain that coverage in each month following the
enrollment period, the taxpayer is liable for any payments to which the
taxpayer would have otherwise been subject.

The bill takes effect immediately and applies to tax
returns filed for taxable years beginning after December 31, 2020, unless the
State Treasurer determines, after consultation with the Department of Banking
and Insurance, that the implementation of the bill is not

administratively feasible for taxable years beginning after
December 31, 2020, in which case the Treasurer may delay implementation to
taxable years beginning after December 31, 2021.

COMMITTEE AMENDMENTS:

The committee amended the bill to make a technical
change.

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