HHS Asks Insurance Exchange Enrollees To Verify Subsidy Eligibility
HHS is contacting hundreds of thousands of U.S. residents who purchased subsidized coverage through the Affordable Care Act's health insurance exchanges, asking them to verify their eligibilities, specifically their income and citizenship status, the Raleigh News & Observer reports.
Those who are found ineligible could end up paying higher premiums, and some might need to repay some or all of their subsidies, according to health care analysts.
HHS spokesperson Tasha Bradley said the department is conducting the verification process "to make sure individuals and families get the tax credits and coverage they deserve and that no one receives a benefit they shouldn't."
Under the ACA, most consumers with discrepancies have 90 days to resolve the issue with documents -- such as tax filings and Social Security data -- that support eligibility.
However, HHS Secretary Sylvia Mathews Burwell has extended that period. According to the News & Observer, the extension could be attributed to the sizeable backlog of inconsistent information. Specifically, as of the end of May:
- 1.2 million consumers had inconsistencies with their reported incomes;
- 461,000 had to verify their citizenship statuses; and
- 505,000 needed to prove their immigration statuses.
In addition, two Office of Inspector General reports found that the federal exchange had difficulty identifying the actual number of consumers with misinformation. However, CMS Administrator Marilyn Tavenner -- who said "it is not surprising" that there are inconsistencies during the system's first year -- said the system is now capable of determining the number of cases with at least one inconsistency. As of mid-July, 650,000 cases had been processed (Chang/Madigan, Raleigh News & Observer, 8/3).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.