California Healthline Daily Edition

Summaries of health policy coverage from major news organizations

Feds Seek To Resolve Discrepancies in ACA Exchange Applications

The Obama administration has begun notifying hundreds of thousands of people who acquired subsidized health coverage through the Affordable Care Act's insurance exchanges to verify their eligibility or risk having to pay back some of those funds next year or lose their coverage altogether, the New York Times reports (Pear, New York Times, 6/15).

The notices come less than a month after CMS reported that coverage applications from about one in four enrollees, or slightly more than two million people, had discrepancies with federal records. Those applications included roughly 1.2 million people who filed applications with inconsistent information about their annual income (California Healthline, 6/11).

In order to reconcile the inconsistencies, enrollees have been asked to submit copies of certain documents, such as:

  • Birth certificates;
  • Driver's licenses;
  • High school diplomas;
  • Pay stubs; and
  • Social Security and voter registration cards.

Officials at Serco -- a federal contractor tasked with resolving the discrepancies between exchange applications and government records -- said that technical issues with and a lack of a system to seamlessly transfer documents and information to the government meant that the firm had to manually resolve any conflicts until late May, leading to a high number unresolved cases.

Additionally, some enrollees have reported that they already sent the requested documents or have had issues uploading documents to, according to the Times (New York Times, 6/15).

More Insurers Joining Exchanges

Meanwhile, 27 new insurers in 10 states have pledged to offer private plans in the ACA's exchanges next year after declining to do so this year, while no insurers have plans to leave the marketplaces, The Hill reports.

According to Avalere Health President and CEO Dan Mendelson, the trend among insurers to participate in the exchanges serves as a "very positive sign." Such increased competition could result in lower prices and reduce subsidy costs, according to The Hill.

The number of insurers joining varies by state, ranging from five additional companies in Michigan and at least one new insurer in Kentucky and Connecticut. No new insurers in Oregon are joining the exchange as insurers signed two-year contracts with the state last year (Viebeck, The Hill, 6/15).

This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.