Republicans Seek Details on Medicaid Backlog, Exchange Subsidies

Three Republicans this week in a letter to CMS Administrator Marilyn Tavenner expressed concern that the federal government would penalize states for having a backlog of Medicaid applications stemming from the problematic roll out of HealthCare.gov last fall, The Hill reports.

The letter sent Wednesday, by Rep. Fred Upton (R-Mich.) and Sens. Lamar Alexander (R-Tenn.) and Orrin Hatch (R-Utah), was in response to comments by HHS Secretary Kathleen Sebelius at a recent hearing. Sebelius said the government was considering "administrative reductions in payments" if states did not process the pending applications more quickly.

The three lawmakers wrote that they "believe it would be inappropriate for CMS to reduce payments to states that may be experiencing a backlog of applications due to troubles with HealthCare.gov" as "[s]uch an approach would violate the very nature of a federal-state partnership."

They asked Tavenner to clarify if CMS plans to decrease payments because of such backlogs, and if the agency does, they asked that Tavenner submit details about the plan. In addition, they asked CMS to indicate which states would be affected by backlog penalties and when the agency would have the full set of data on individuals who are eligible for Medicaid coverage under the ACA (Al-Faruque, The Hill, 5/22).

GOP Lawmakers Seek Answers About Subsidy Eligibility

Separately, Sens. Mike Johanns (R-Neb.) and Jerry Moran (R-Kan.) on Thursday sent a letter to Sebelius accusing her department for failing to effectively ensure that it is verifying an individual's income before paying out subsidies, the Washington Times reports.

The senators' letter was in response to a recent media report that hundreds of thousands of new enrollees in the ACA's insurance exchanges might have received incorrect amounts of subsidies. The report also stated that the federal government was not equipped to check enrollees' incomes and reconcile discrepancies.

In addition, the two senators said Sebelius misled them by claiming that the income verification system would be in place.

According to the Times, the senators' concerns were similar to those outlined in a letter sent Wednesday to Treasury Secretary Jacob Lew. The Treasury oversees the subsidies and tax penalties related to the ACA. That letter was sent by Republicans on the House Ways and Means Committee (Howell, Washington Times, 5/22).