CMS Asks 310K Enrollees To Verify Immigration, Citizenship Status

On Tuesday, CMS sent letters to about 310,000 U.S. residents warning that if they do no submit documents to verify their citizenship or immigration statuses by Sept. 5, they could lose the coverage they purchased through the federal health insurance exchange, the New York Times reports (Goodnough, New York Times, 8/12).

Background

HHS earlier this month said it would contact hundreds of thousands of individuals who purchased subsidized coverage through the ACA's health insurance exchanges, asking them to verify their eligibilities, specifically their incomes and citizenship statuses. As of the end of May, 461,000 U.S. residents still had not yet verified their citizenship statuses and 505,000 still needed to prove their immigration statuses (California Healthline, 8/4).

Discrepancies Still Exist

The letters were sent only to those who still need to verify their immigration or citizenship statuses. Under the ACA, only those who are "lawfully present" in the U.S. can purchase health plans through the exchanges.

According to the Times, there are still about 450,000 unresolved discrepancies related to consumers' immigration or citizenship statuses. CMS Administrator Marilyn Tavenner said that of those inconsistencies, more than 200,000 are "in progress" of being resolved (New York Times, 8/12).

According to CMS spokesperson Aaron Albright, the 310,000 people receiving the letters already had been contacted on average five to seven times for the information but had not yet responded to the requests. He noted that many of those individuals had not uploaded or mailed the documents necessary to verify their eligibilities.

However, Albright said that an unknown number of those people had submitted the proper documents, but that contractors the federal government hired to resolve the discrepancies were not able to match the documents to individuals' applications. He added, "People will have to send in their info if we don't have a record of it" (Goldstein, Washington Post, 8/12).

Albright noted that no one has had coverage terminated because of citizenship or immigrations statuses so far (Howell, Washington Times, 8/12).

According to CMS, the discrepancies do not necessarily mean people are ineligible for coverage (Dickson, Modern Healthcare, 8/12). In order to prove their eligibility, the individuals receiving the letters must submit citizenship documents, green cards or other documentation proving their statuses (Washington Post, 8/12).

Letters Are Last-Ditch Effort

Tavenner said the letters are a last-ditch effort to contact the individuals to ensure that "as many consumers as possible" can remain enrolled in exchange coverage. She added, "[S]o we are giving these individuals a last chance to submit their documents before their coverage ... will end."

Tavenner noted that CMS also will try to contact the individuals via email and phone, as well as through local consumer assistance groups (New York Times, 8/12). She said, "Since this is an urgent matter, we are activating our networks on the ground to reach people directly in the communities where they live," adding, "Whether it is online, via our call center or with one of our local partners, consumers will have a number of ways to find the help they need to continue their coverage."

In addition, those who received the letters will also receive another notice before their coverage is terminated (Washington Times, 8/12).

According to the Wall Street Journal, about 93,800 of those receiving the letters reside in Florida, while 52,700 live in Texas (Radnofsky, Wall Street Journal, 8/12). The notices only apply to those residing in the states that are using the federal exchange (Washington Times, 8/12).

Advocates Urge CMS Not To Cancel Coverage

According to the Post, the letters come just two weeks after a group of 150 organizations representing low-income residents and immigrants urged HHS Secretary Sylvia Mathews Burwell to allow people to keep their coverage for now, regardless of whether their eligibilities have been determined.

In a letter sent to Burwell on July 31, the groups said the individuals whose statuses remain under dispute might still be legally present but could have had their paperwork caught in "system errors." In addition, the letter noted that some immigrants who still need to submit documents proving their eligibilities might not understand federal notices because they were sent only in English and Spanish (Washington Post, 8/12).

Meanwhile, Families USA Founding Executive Director Ron Pollack praised CMS for taking steps to correct the discrepancies, but he added, "You want to make sure that those people are not cut off just because of some paper problems that exist within the federal government." He said, "I would err on the side of caution in terms of cutting anyone off. People who have not responded so far probably think they've done everything they needed to do" (Wall Street Journal, 8/12).

According to a CMS release, the agency will later contact those who reported incomes that are inconsistent with federal records (New York Times, 8/12).