The Obama administration said Friday it will allow a special health law enrollment period from March 15 to April 30 for consumers who realize while filling out their taxes that they owe a fee for not signing up for coverage last year.

The special enrollment period applies to people in the 37 states covered by the federal marketplace, though some state-run exchanges are also expected to follow suit.

People will have to attest that they first became aware of the tax penalty for lack of coverage when they filled out their taxes. They will still have to pay the fine, which for last year was $95 or 1 percent of their income, whichever was greater. By signing up during the special enrollment period for 2015 they can avoid paying most of the tax penalty for this year.

The Affordable Care Act requires most Americans to have health insurance or pay a financial penalty. But some people may not realize they face a penalty for not having coverage until they file their tax returns ahead of the April 15 tax deadline.

The administration also said Friday it sent out the wrong information to 800,000 people to help them calculate whether they received too much of a subsidy for health coverage last year or too little. Those affected are being notified today by email or telephone – and are being asked to wait to file their taxes until after new 1095-A forms are sent in early March.

For the 5 percent of those affected who have already filed returns for 2014, more instructions are to come from the Treasury Department, officials said.  The 800,000 represents about 20 percent of the total number of people who were sent 1095-A tax forms.  Officials declined to say how the mistake occurred.

The administration would not estimate how many people it expects to take advantage of the new enrollment period. Millions of Americans who did not enroll in a plan are exempt from the requirement to buy coverage because their income is too little or they qualify for other exemptions. Officials said this special enrollment would be just for this year to account for people who did not hear or heed messages about the individual insurance mandate that was included in the health law approved by Congress in 2010.

So far, 11.4 million Americans have enrolled in private health insurance through Obamacare during the open enrollment period that ended on Sunday.

Separately, administration officials have said they will allow people who had trouble completing their enrollment by Feb. 15 to finish by Sunday Feb. 22. Officials estimated it would help fewer than 150,000 people.

Julie Appleby contributed to this story.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

A “teachable moment” is one way to describe the  consternation that many uninsured people may feel when they file their taxes this spring and realize they owe a penalty for not having health insurance.

According to a new survey, the number of people who may need to be schooled is substantial: Forty-four percent of uninsured people who may be subject to the penalty say they know nothing or only a little about the penalty they may face.

The Urban Institute analysis was based on its December 2014 Health Reform Monitoring Survey of uninsured adults with incomes above the poverty level, a group that might be expected to owe a penalty for not having coverage.

For 2014, the penalty is the greater of $95 or 1 percent of annual income. In 2015, the penalty increases to 2 percent or $325, whichever is greater.

People who don’t become aware of the penalty until they file their 2014 taxes in March or April could end up owing penalties for both years. The open enrollment period to sign up for 2015 health insurance ended Feb. 15.

Consumer advocates have been strongly encouraging the Obama administration to create a special enrollment period for uninsured people who only realize the financial hit they’re facing after open enrollment has ended. While they probably can’t avoid a penalty for being uninsured last year, they could avoid getting dinged again in 2015 if they enrolled this spring.

“These results suggest that a special enrollment period could help a significant percentage of the uninsured get coverage,” says Stephen Zuckerman, co-director of the Urban Institute’s Health Policy Center and a co-author of the analysis.

In addition to being generally unaware of the penalties for not having insurance, 30 percent of those surveyed said they had not heard of the state health insurance marketplaces, while 29 percent said they knew about the marketplaces but didn’t know about the Feb. 15 enrollment deadline.

“There’s a general gap in knowledge,” Zuckerman says. “Looking across the years, there’s a surprising persistence of people who are not aware of the various provisions of the health law.”

Please contact Kaiser Health News to send comments or ideas for future topics for the Insuring Your Health column.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

The bacterial outbreak at a Los Angeles hospital highlights shortcomings in the federal government’s efforts to avert the most lethal hospital infections, which are becoming increasingly impervious to treatment.

Government efforts are hobbled, infection control experts say, by gaps in monitoring the prevalence of these germs both within hospitals and beyond. The continued overuse of antibiotics — due to over-prescription by doctors, patients’ insistence and the widespread use in animals and crops — has helped these bacteria evolve into more dangerous forms and flourish.

In the outbreak at UCLA’s Ronald Reagan Medical Center, two patients have died and more than 100 may have been exposed to CRE, an antibiotic-resistant bacteria commonly found in the digestive tract. When this germ reaches the bloodstream, fatality rates are 40 percent. The government estimates about 9,000 infections leading to 600 deaths, are caused each year by CRE, which stands for carbapenem-resistant Enterobacteriaceae.

UCLA Health says the infections probably were passed around by inadequately sterilized scopes used to peer inside a body.

Previous CRE outbreaks have occurred elsewhere in the country, including hospitals in Illinois and Seattle.

The immediate public health response has focused on the safety of the scopes and tracking down people who may have been exposed. The U.S. Food and Drug Administration Thursday issued a warning about the devices. But the California outbreak comes amid the government’s broader struggle to spot and battle the swelling ranks of bacteria that are impervious to most, if not all, antibiotics.

CRE is one of three infectious agents that the Centers for Disease Control and Prevention categorized as the drug-resistant threats that require the most urgent monitoring and prevention. CRE is resistant to almost all antibiotics, including carbapenems, which doctors often deploy as a last resort. The remaining treatments are often toxic. A CDC report found that in the first six months of 2012, nearly 5 percent of hospitals reported at least one CRE infection.

Unlike another urgent threat, Clostridium difficile, known as C. diff, the federal government does not publicly report CRE infection rates at each hospital.

The federal government also does not monitor the prevalence of any of these antibiotic-resistant bacteria beyond health care facilities, although California, Georgia, Minnesota and seven other states do.

“That is an example of a world-class infections system, but it’s only in 10 states,” said Dr. Trish Perl, a senior epidemiologist at the Johns Hopkins Health System in Baltimore, Md.

“We have very targeted sources of information as opposed to an integrated and holistic system,” she said. “It’s like air control towers if you only had data from Chicago and Atlanta.”

People can often carry CRE in their gut without injury, but it can spread outside the gut quickly in people who are taking antibiotics for other ailments or in a weakened state. Lisa McGiffert, director of the Safe Patient Project at Consumers Union, said that the CDC recommends hospitals screen all new patients for CRE but “I find it highly unlikely that many hospitals are doing that.” She noted that UCLA this week notified patients who underwent procedures as long ago as October that they may have been infected.

The federal government has been trying for years to get doctors and hospitals to shrink their use of antibiotics, since their proliferation has helped create these new resistant bacteria strains. The CDC has encouraged hospitals to create antibiotic stewardship programs, where experts systemically try to insure that the bacteria-fighting drugs are the best resource and that there is evidence that they actually work on the specific infection the patient has.

For instance, stewardship programs can discourage doctors from bombarding patients with lots of different antibiotics. Instead, doctors can take an “antibiotic time out” until they get get lab results and reconsider their approach. (UCLA Health has a stewardship program in place.)

California last year mandated hospitals create stewardship programs, but the federal government considers them voluntary. Even the Infectious Diseases Society of America was unable to determine how many hospitals have such a program,  said John Billington, the society’s director of health policy.

The U.S. Centers for Medicare & Medicaid Services has been taking a tougher tactic against hospital infections. Since October, more than 700 hospitals have been receiving lower payments from Medicare if they have higher rates of infections and other injuries. However, that program only tracks two kinds of catheter-related infections, not CRE. It will be another two years before the penalties incorporate rates from two antibiotic-resistant germs that have been around for longer than CRE: C. diff, and methicillin-resistant Staphylococcus aureus, known as MRSA.

“A lot of patients are walking around with CRE and don’t know about it,” said Dr. Anthony Harris, president of the Society for Healthcare Epidemiology of America. “At this point CRE is still a fairly rare event, but this is the time to intervene so you don’t have the magnitude of the problem we have with MRSA.”

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

HHS invests in enhancing domestic preparedness efforts for Ebola