Covered California will start searching for consumers who have not filed past federal tax returns and start stripping away the Obamacare subsidies for non-tax filers.
Covered California will strip the health insurance subsidy from consumers who have not filed their federal taxes beginning on May 16, 2016. Word of the non-tax filer ineligibility for the Obamacare tax credits was released in a summary of updates to the Covered California online application software known as CalHEERS. The release notes for the CalHEERS 16.4 update state that enhancements to the application will include a way for consumers to attest that they have filed their taxes.
After the Covered California online application is updated with the programming changes on May 16th, the system will then begin comparing enrolled members with an IRS report filed tax returns.
16.4.3: Non-Tax Filer APTC eligibility
A consumer who applied for Covered California and received Advanced Premium Tax Credits (APTC) during the coverage year is required to file taxes. The IRS reports to CalHEERS when an individual did not file taxes for a year in which they received APTC. CalHEERS will use this information to both update APTC eligibility for existing consumers and determine APTC eligibility for new consumers.
- Beginning May 16, consumers renewing coverage and seeking premium assistance will receive an ineligible status if they did not file taxes for a previous coverage year.
- Existing APTC eligible consumers using the Report A Change function will receive an ineligible status if they did not file taxes for a previous coverage year.
- Existing APTC eligible consumers that did not file taxes for a previous coverage year are reminded that they must file taxes to continue eligibility for APTC.
o These consumers will have their eligibility automatically re-determined by CalHEERS.
o The redetermination may result in the discontinuance of APTC eligibility in the current year if the consumer did not file taxes for a previous coverage year.
- If the consumer is determined ineligible for APTC as a result of their Non-Tax Filer status, they may self-attest to having filed taxes in the online application.
o Renewing and currently enrolled consumers may access the Update Consent for Verification and Tax Filing Attestation Page in the online application.
o Consumers may attest under penalty of perjury to filing federal taxes for the year in which they received premium assistance and update their APTC eligibility.
- For more information on Tax Filing Attestation, review our Tax Attestation Job Aid.
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Lost or forgotten your password
Covered California will be adding a one-time passcode. The new function will allow a consumer or enroller to receive a one-time passcode by either text or email to access their account.
16.4.2: One Time Passcode for CalHEERS account access
Covered California consumers and Certified Enrollers have multiple ways to self-serve access to their online application when they are having difficulty logging in. Prior to Release 16.4, they are able to retrieve a username, answer security questions to reset a forgotten password, or reset their account PIN.
Release 16.4 allows consumers and Certified Enrollers the option to receive an email or text message for a One Time Passcode to access their account.
- Users must register for the One-Time Passcode verification method in their CalHEERS account to access these options. They may choose to register an email address, phone number or both.
- Consumers and Certified Enrollers will be displayed the One Time Passcode Registration Page upon first time logging in after Release 16.4. Users will also be given the option to opt out of the One Time Passcode option. However, if opting out, Certified Enrollers will not have the ability to register again until future CalHEERS releases.
- The Verification Method Page will now display for accounts registered for the One Time Passcode verification method along with the standard option of answering security questions.
- Once the One Time Passcode is sent, consumers will have the option to validate their passcode and reset their account password.
- For more details on the One Time passcode, review our One Time Passcode Job Aid.
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Undocumented children automatically eligible for Medi-Cal
The final change to the CalHEERS online program will be allowing children without documentation of legal residency to automatically become eligible for full-scope Medi-Cal benefits.
16.4.1: Full scope Medi-Cal access for children without eligible immigration status (SB-75)
Under a new California law to be implemented on May 1, 2016, children under 19 years of age in households up to 266% FPL (Income Guidelines) may be eligible for full-scope MAGI Medi-Cal benefits regardless of immigration and lawfully present status, as long as they meet all other eligibility requirements.
- Beginning May 16, CalHEERS will place applicants under 19 that have not indicated “Eligible Immigration Status” in the online application into full-scope MAGI Medi-Cal aid codes if their income and household size meet all other Medi-Cal eligibility requirements.
- Children found eligible for this program will no longer be asked to provide Proof of Citizenship, Lawful Presence or Proof of Immigration Status when applying for Covered California.
- Consumers seeking to apply for a child without eligible immigration status between May 1st and May 16th may be referred to the appropriate county office for assistance.
- Children under 19 with an existing restricted-scope Medi-Cal eligibility determination will be reviewed and re-determined by a County Eligibility Worker.
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