For consumers who chose to go without health insurance in 2014, income taxes this year came coupled with a new fee.
Starting Sunday, they'll have one last opportunity to sign up for coverage under the Affordable Care Act -- and avoid another, higher fee next year -- during a special enrollment period that will run through April 30.
The fee for failing to get insurance in 2014 was $95, or 1 percent of household income, whichever is greater. For those who don't obtain coverage by April 30 this year, the fee will rise: $325 or 2 percent of household income.
This is the first year consumers are being charged for not obtaining health insurance. It is also the first time those who signed up through the marketplace will be expected to fill out one or more of three new healthcare-related tax forms.
Andy Slavitt, principal deputy administrator at the Centers for Medicare and Medicaid Services, said CMS is focused on making the tax filing and fee process as seamless as possible in its first year.
"Right now this means raising awareness and making sure tax filers know they have to have insurance," Slavitt said.
He cited a McKinsey & Company study published this week, which reported that about 41 percent of the uninsured population was not aware that there was a penalty for forgoing coverage.
Slavitt said that's one reason the tax special enrollment period was opened. He said this is the only year it will be offered.
Kevin Counihan, CEO of the ACA marketplace, said consumers who have not enrolled in the 2015 marketplace for coverage will qualify for the special enrollment period if they owe a fee for 2014, did not know about the initial open enrollment period from Nov. 15 to Feb. 15, and were unaware of the individual mandate to get covered. Consumers will have to fulfill all three criteria to qualify.
Those who sign up in this special enrollment period will still have to pay the fee for 2014, Counihan added.
It's not the first special enrollment period this year. Glitches on the HealthCare.gov site during the last week of open enrollment spurred the creation of a week-long special enrollment period for consumers who experienced technical issues while trying to sign up.
In 2014, a similar period ran from the end of open enrollment on March 31 to April 19.
Milton Vazquez, a spokesman for nonprofit healthcare enrollment organization Get Covered America, said misinformation about penalties was common among consumers whom the organization helped enroll this year.
"Some folks assumed it [the fee] would only be $95," Vazquez said. "They weren't aware that it ramped up substantially this year."
The fee for going without coverage will continue to increase. In 2016, those who are uninsured and do not qualify for an exemption will have to pay $695 or 2.5 percent of their household income, whichever is greater.
Vazquez said reaching people when they file their income taxes will likely decrease the level of healthcare misinformation for next year's enrollment.
"I can't imagine a better way to reach out to as many people as possible," he said. "This way is probably going to have the highest impact of any single outreach method that has been tried thus far."