WASHINGTON – Today U.S. Sen. Mark R. Warner (D-VA) sent a letter to Internal Revenue Service (IRS) Commissioner Charles Rettig and Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma urging them to ensure that families aren’t denied critical financial assistance needed in order to purchase quality health insurance through the Affordable Care Act (ACA). The letter comes after Sen. Warner’s office heard from Virginia families, including the Burger family, who discovered that they were wrongfully denied tax credits due to delays in processing 2019 tax filings that are required to purchase affordable health insurance through the ACA marketplace exchanges. The deadline to enroll for the ACA is December 15. 

“I am writing to draw your attention to an issue that could cause a significant number of individuals to be denied affordable health insurance on the Affordable Care Act (ACA) Marketplace. It is my understanding that due to delayed processing of 2019 tax returns, numerous Americans have been deemed in violation of the Marketplace’s ‘failure to file and reconcile’ requirement (FTR), and will be ineligible for advanced premium tax credits (APTCs) to ensure affordable health coverage starting January 1, 2021,” wrote Sen. Warner to IRSCommissioner Rettig and Administrator Verma.

The Affordable Care Act (ACA) established advanced premium tax credits (APTC) to help working families purchase affordable health insurance through the exchanges. In order to receive the tax credit during this year’s enrollment period, individuals have to complete their 2019 tax return. However, because of the COVID-19 pandemic, the IRS has not been able to process these returns in a timely manner due to reduced staff hours at the agency. As a result, individuals who would normally be eligible for the credit cannot receive it because the IRS has not yet processed their returns. 

“Put simply, a number of Americans will be denied an APTC in the Marketplace through no fault of their own, because their tax returns were delayed. I have already heard from several Virginians who – as a direct result of delayed tax returns – have been unable to or confused about their ability to enroll in health care coverage during this years’ open enrollment period,” continued Sen. Warner. “Financial assistance is essential to millions of working class Americans and their families to ensure affordable health coverage on the Marketplace. I am concerned that individuals will be wrongfully denied coverage and that a failure to address this issue could result in these families going without health care coverage during the peak of an unprecedented global pandemic.”

In his letter, Sen. Warner also pressed the Administration to suspend termination of the 2021 APTC, inform affected enrollees of this change, and extend the deadline to apply for 2021 ACA coverage through a special open enrollment period for individuals and families wrongfully denied financial assistance.  

Text of the letter is available here or below.

Dear Commissioner Rettig and Administrator Verma:

I am writing to draw your attention to an issue that could cause a significant number of individuals to be denied affordable health insurance on the Affordable Care Act (ACA) Marketplace. It is my understanding that due to delayed processing of 2019 tax returns, numerous Americans have been deemed in violation of the Marketplace’s “failure to file and reconcile” requirement (FTR), and will be ineligible for advanced premium tax credits (APTCs) to ensure affordable health coverage starting January 1, 2021. 

Under existing Marketplace regulations, an enrollee becomes ineligible for an APTC if they did not file an income tax return for a prior year during which an APTC was received. However, in response to the COVID-19 pandemic, Treasury delayed the tax filing deadline for all Americans from April 15, 2020 to July 15, 2020. In addition, the Internal Revenue Service (IRS) has cut staff hours as result of the COVID-19 pandemic and continues to experience significant tax return processing delays. 

Put simply, a number of Americans will be denied an APTC in the Marketplace through no fault of their own, because their tax returns were delayed. I have already heard from several Virginians who – as a direct result of delayed tax returns – have been unable to or confused about their ability to enroll in health care coverage during this years’ open enrollment period. 

Financial assistance is essential to millions of working class Americans and their families to ensure affordable health coverage on the Marketplace. I am concerned that individuals will be wrongfully denied coverage and that a failure to address this issue could result in these families going without health care coverage during the peak of an unprecedented global pandemic.

I urge you to address this problem by suspending the termination of 2021 APTC. In addition, I ask that you inform affected enrollees of this change and extend the deadline to apply for 2021 coverage through a special open enrollment period for individuals who were deterred from enrolling due to the previous notices they received threatening to end their financial assistance.

Thank you for your attention to this important matter, and I look forward to hearing back from you.

Sincerely,

Mark R. Warner

U.S. Senator

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