Dive Brief:
- The Obama administration has announced that more than 300,000 individuals enrolled in ACA plans could lose their coverage by the end of September if they don't provide documentation proving that they are legal residents of the U.S.
- The cases in question involve individuals whose original applications include inconsistent information from when they were enrolled in the healthcare plans.
- CMS says that it has already closed about 450,000 of these cases, and is working on 210,000 cases, but that some consumers have not responded. If consumers don't provide the necessary documentation by September 5, coverage will end on September 30.
Dive Insight:
The White House hasn't suggested that the 300,000-odd persons whose coverage is in danger are legal residents, but rather, that the information they provided doesn't match up with data the HealthCare.gov site uses to verify applications. Either way, consumers must take steps to satisfy CMS if they hope to keep their coverage.
Critics have noted for some time that HealthCare.gov doesn't do a good job of verifying applicants for eligibility. In fact, a June report from the Office of the Inspector General for HHS found "deficiencies" in controls intended to prevent fraudulent or incorrect information from being submitted by applicants to the federal ACA marketplace. To address the current eligibility question, CMS has been attempting to reach affected individuals via email, phone calls and letters in English and Spanish for several months, but it seems those efforts are falling short.
Given the politically charged nature of such applications, the Obama administration could face another PR debacle over the technology behind HealthCare.gov if 300,000+ consumers are booted out of their insurance plans. Let's see if CMS is up to the challenge of wringing a response out of those it has targeted as potentially fraudulent applicants.
Want to read more? You may enjoy this story about how fake applicants obtained ACA coverage in an undercover GAO investigation.