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Obamacare Data Mismatch Could Leave Thousands Uninsured
Failure to submit the proper paperwork to the U.S. health care agency could result in nearly 500,000 people losing health insurance or the tax breaks that help pay for it.
These issues are some of the most recent hiccups with sign-ups for health insurance that threaten to push Obamacare back into the spotlight as voters head to the polls in November. Meanwhile, the government's health care agency is letting consumers know that it is trying to recoup both correct information and taxpayer dollars in carrying out the details of the health law.
[READ: Immigrants Must Show Legal Status to Keep Health Insurance]
This week officials from the Centers for Medicare and Medicaid Services, the agency that is tasked with implementing the Affordable Care Act, are notifying consumers who have the wrong information on file about their income. The agency also will notify people who have not submitted documentation showing proof of legal citizenship or immigration status that they have passed the Sept. 5 deadline and will lose their health insurance coverage by the end of the month.
The deadlines apply specifically to people in 36 states who have signed up for insurance through Healthcare.gov, the site built by the federal government that faced numerous technological glitches during its rollout last fall. They do not apply to people who have signed up through their state's exchanges or through private brokers, for which no information about mismatched data is currently available. Just under 9 percent of those who submitted information under the marketplaces face losing coverage under these deadlines.
Currently, income information for 360,000 people does not match the agency's records, and those people have until the end of the month to submit additional documentation. Anyone who fails to do so will lose tax subsidies that help pay for insurance. The subsidies, provided to more than eight in 10 people who enrolled through the federal insurance marketplaces, are in place to help families whose income isn't low enough to qualify for Medicaid, but is still lower than $94,200 a year.
Under this plan, most families who have qualified for tax subsidies are paying less than $100 a month for premiums, said CMS administrator Marilyn Tavenner in a statement. The average monthly subsidy for health insurance is $264 a month.
If consumers submit the required documents by the end of the month, the health agency will help them sign up for a health plan through a special enrollment period, Andy Slavitt, principal deputy administrator at CMS, told reporters in a phone briefing held Monday.
"If they don’t [get back to the health agency], they will either face an adjustment to their premiums to reflect the income we have on record, or they face the liability or the reconciliation process when they file their taxes,” Slavitt said. If people accidentally submitted income information that was higher than what they were actually making, those who have been overpaying for health insurance may be able to recoup some of the money, a CMS spokesman said.
Slavitt denied that the mismatched information was a result of Healthcare.gov's technical issues. Instead, he said, it was part of the process of enrolling people in coverage when they might have had life changes, such as getting married, losing a job or changing jobs. The information people provided may not be incorrect, the health agency said in a statement. It does mean, however, additional documentation to demonstrate proof of income must be provided.
[REPORT: Obamacare, Boomers, Recession Slowing Medicare Costs]
The health care agency closed missing information from 467,000 households since May and is working to resolve another 430,000. About 279,000 households, or 363,000 individuals, still need to provide the correct paperwork for their income to the agency.
A separate deadline for people who have to demonstrate legal residency or immigration status may leave an additional 115,000 people in jeopardy. Under Obamacare, immigrants who are in the country illegally are not eligible to receive health insurance through federal online marketplaces. Those remaining have failed to properly demonstrate their legal citizenship or immigration status and will lose health insurance coverage by the end of the month.
The agency may be lenient to some who submit information that confirms their eligibility after the deadline, officials said, offering a special enrollment period to get coverage.
As with income information, those at risk of losing health care coverage from the Affordable Care Act are not necessarily undocumented or ineligible: There typically has been data inconsistency that needs to be resolved.
In some cases, a reported Social Security or Permanent Resident Card number doesn't match the information the government has on file, according to CMS.
The agency already has whittled down the total number of people with citizenship or immigration errors from 966,000 people in May. As of Sept. 4, the health care agency reported that no one who had filed additional information about their status has lost health insurance.
Critics have blamed the gap of information on issues with the website or for failing to help consumers who speak a language besides Spanish or English to understand what documents they are missing.
http://www.usnews.com/news/articles/2014/09/16/obamacare-data-mismatch-could-leave-thousands-uninsured-at-election-time
These issues are some of the most recent hiccups with sign-ups for health insurance that threaten to push Obamacare back into the spotlight as voters head to the polls in November. Meanwhile, the government's health care agency is letting consumers know that it is trying to recoup both correct information and taxpayer dollars in carrying out the details of the health law.
[READ: Immigrants Must Show Legal Status to Keep Health Insurance]
This week officials from the Centers for Medicare and Medicaid Services, the agency that is tasked with implementing the Affordable Care Act, are notifying consumers who have the wrong information on file about their income. The agency also will notify people who have not submitted documentation showing proof of legal citizenship or immigration status that they have passed the Sept. 5 deadline and will lose their health insurance coverage by the end of the month.
The deadlines apply specifically to people in 36 states who have signed up for insurance through Healthcare.gov, the site built by the federal government that faced numerous technological glitches during its rollout last fall. They do not apply to people who have signed up through their state's exchanges or through private brokers, for which no information about mismatched data is currently available. Just under 9 percent of those who submitted information under the marketplaces face losing coverage under these deadlines.
Currently, income information for 360,000 people does not match the agency's records, and those people have until the end of the month to submit additional documentation. Anyone who fails to do so will lose tax subsidies that help pay for insurance. The subsidies, provided to more than eight in 10 people who enrolled through the federal insurance marketplaces, are in place to help families whose income isn't low enough to qualify for Medicaid, but is still lower than $94,200 a year.
Under this plan, most families who have qualified for tax subsidies are paying less than $100 a month for premiums, said CMS administrator Marilyn Tavenner in a statement. The average monthly subsidy for health insurance is $264 a month.
If consumers submit the required documents by the end of the month, the health agency will help them sign up for a health plan through a special enrollment period, Andy Slavitt, principal deputy administrator at CMS, told reporters in a phone briefing held Monday.
"If they don’t [get back to the health agency], they will either face an adjustment to their premiums to reflect the income we have on record, or they face the liability or the reconciliation process when they file their taxes,” Slavitt said. If people accidentally submitted income information that was higher than what they were actually making, those who have been overpaying for health insurance may be able to recoup some of the money, a CMS spokesman said.
Slavitt denied that the mismatched information was a result of Healthcare.gov's technical issues. Instead, he said, it was part of the process of enrolling people in coverage when they might have had life changes, such as getting married, losing a job or changing jobs. The information people provided may not be incorrect, the health agency said in a statement. It does mean, however, additional documentation to demonstrate proof of income must be provided.
[REPORT: Obamacare, Boomers, Recession Slowing Medicare Costs]
The health care agency closed missing information from 467,000 households since May and is working to resolve another 430,000. About 279,000 households, or 363,000 individuals, still need to provide the correct paperwork for their income to the agency.
A separate deadline for people who have to demonstrate legal residency or immigration status may leave an additional 115,000 people in jeopardy. Under Obamacare, immigrants who are in the country illegally are not eligible to receive health insurance through federal online marketplaces. Those remaining have failed to properly demonstrate their legal citizenship or immigration status and will lose health insurance coverage by the end of the month.
The agency may be lenient to some who submit information that confirms their eligibility after the deadline, officials said, offering a special enrollment period to get coverage.
As with income information, those at risk of losing health care coverage from the Affordable Care Act are not necessarily undocumented or ineligible: There typically has been data inconsistency that needs to be resolved.
In some cases, a reported Social Security or Permanent Resident Card number doesn't match the information the government has on file, according to CMS.
The agency already has whittled down the total number of people with citizenship or immigration errors from 966,000 people in May. As of Sept. 4, the health care agency reported that no one who had filed additional information about their status has lost health insurance.
Critics have blamed the gap of information on issues with the website or for failing to help consumers who speak a language besides Spanish or English to understand what documents they are missing.
http://www.usnews.com/news/articles/2014/09/16/obamacare-data-mismatch-could-leave-thousands-uninsured-at-election-time
".... officials from the Centers for Medicare and Medicaid Services, the agency that is tasked with implementing the Affordable Care Act, are notifying consumers who have the wrong information on file about their income. The agency also will notify people who have not submitted documentation showing proof of legal citizenship or immigration status that they have passed the Sept. 5 deadline and will lose their health insurance coverage by the end of the month......"
".....If consumers submit the required documents by the end of the month, the health agency will help them sign up for a health plan through a special enrollment period, Andy Slavitt, principal deputy administrator at CMS, told reporters in a phone briefing held Monday.
"If they don’t [get back to the health agency], they will either face an adjustment to their premiums to reflect the income we have on record, or they face the liability or the reconciliation process when they file their taxes,” Slavitt said. If people accidentally submitted income information that was higher than what they were actually making, those who have been overpaying for health insurance may be able to recoup some of the money....."
So, the government has given people a deadline to straighten out their income and residency info, if I'm reading this correctly? This is a bad thing why?
".....If consumers submit the required documents by the end of the month, the health agency will help them sign up for a health plan through a special enrollment period, Andy Slavitt, principal deputy administrator at CMS, told reporters in a phone briefing held Monday.
"If they don’t [get back to the health agency], they will either face an adjustment to their premiums to reflect the income we have on record, or they face the liability or the reconciliation process when they file their taxes,” Slavitt said. If people accidentally submitted income information that was higher than what they were actually making, those who have been overpaying for health insurance may be able to recoup some of the money....."
So, the government has given people a deadline to straighten out their income and residency info, if I'm reading this correctly? This is a bad thing why?
"No. I didnt read it all, too long this early. I will say this".
Perhaps you should read the article before saying anything then, just a thought.
I personally think the proverbial sh1t is going to hit the fan for many come tax time regarding subsidy reconciliation.
Perhaps you should read the article before saying anything then, just a thought.
I personally think the proverbial sh1t is going to hit the fan for many come tax time regarding subsidy reconciliation.
No. I didnt read it all, too long this early. I will say this. Expect immigration, benghazi, and all those allegations about healthcare, tru or not tru to rear they heads again in coming weeks, ahead of the election. It is a last ditch effort to get their base riled enuff to vote.
Also, watch which things go on the back burner, no matter how pressing or important they might be, until after the election....No one wants to take a vote with their name attached to anything that may cost them a vote.
Such as, min wage, immigration, or even the vote on the current mission against ISIL.
Its politics.... And with an article like this, and in the first paragragh, using words like could? Tells me its a hypothetical at best and isnt something I need concern myself with until it turns into fact instead of maybe or could....
Also, watch which things go on the back burner, no matter how pressing or important they might be, until after the election....No one wants to take a vote with their name attached to anything that may cost them a vote.
Such as, min wage, immigration, or even the vote on the current mission against ISIL.
Its politics.... And with an article like this, and in the first paragragh, using words like could? Tells me its a hypothetical at best and isnt something I need concern myself with until it turns into fact instead of maybe or could....
HOW DOES VHC MEASURE UP?
Vermont has spent more than $100 million implementing the Affordable Care Act, and has a federal earmark of $171 million to complete its exchange.
Miller has said he expects the exchange project will take the full earmark to complete.
Kyle McDowell, a project manager for Optum — the state’s new primary tech contractor — said it’s “apples and oranges” to compare Vermont’s situation to other states.
Other states where Optum is doing remediation work have had some of the same problems as Vermont but each state faces “unique challenges,” McDowell said.
Miller said some states have had more success building exchanges, and other less, pointing out that several “gave up,” and chose to go with the federal healthcare.gov website, as Lt. Gov. Scott suggests.
NEW CHAIN OF COMMAND FOR VHC
Officials also announced changes to the management structure of Vermont Health Connect. Responsibility for the exchange will be removed from the Department of Vermont Health Access, Chen said.
Its management will be consolidated under a single chain of command with all contractors and state workers reporting to Miller, who will report to Chen.
The Health Access Eligibility Unit, which makes Medicaid and state subsidy determinations for exchange users, will be moved out of the Department for Children and Families and into the exchange’s new chain of command.
Chen thanked DVHA commissioner Mark Larson for his work on Vermont Health Connect and said Larson will continue to work on “many other important tasks that (DVHA) has to accomplish.”
Larson, who stood off to the side during Tuesday’s press conference, was not asked to speak.
For much of its first year, Larson was the face of Vermont Health Connect. His role has been consistently diminished since Shumlin brought in Miller.
Larson’s deputy commissioner, Lindsey Tucker, was recently transitioned out of her leadership role within Vermont Health Connect. The two were previously the top state officials managing the exchange.
http://vtdigger.org/2014/09/16/state-takes-vermont-health-connect-website-offline-improve-security-user-experience/
STATE TAKES VERMONT HEALTH CONNECT WEBSITE OFFLINE
WINOOSKI — The Vermont Health Connect website was taken down Monday night and will remain offline to allow for improvements to data security and the user experience, state officials said Tuesday.
Customers who need to report changes in income or make changes to their coverage or personal information will need to contact the customer service call center at 855-899-9600. Everyone with health insurance purchased through the exchange is still covered, officials said.
Officials did not say how long the state’s health insurance exchange website will be down, but said that it would be weeks, not days, before the it is back online.
Gov. Peter Shumlin acknowledged people’s frustration with the Vermont Health Connect website, but said it’s being taken offline to ensure a smooth open enrollment period, which begins Nov. 15.
Gov. Peter Shumlin (left) and interim Secretary of the Agency of Human Services Harry Chen announced Tuesday that the Vermont Health Connect website will be offline for repairs. Photo by Morgan True/VTDigger
Gov. Peter Shumlin (left) and interim Secretary of the Agency of Human Services Harry Chen announced Tuesday that the Vermont Health Connect website will be offline for repairs. Photo by Morgan True/VTDigger
“No one is more frustrated than me with the slow process we’ve had,” Shumlin said at a hastily called news conference Tuesday.
Harry Chen, the interim Secretary of Human Services, said the decision to take the website offline “wasn’t made lightly.”
State officials were adamant that the site was taken down as a “proactive step” to enhance security and improve the site’s usability in advance of open enrollment, and not in response to a specific data breach or security threat.
Confidential consumer information was not compromised at any time, Chen said. The need for improved security is a response to changes in the online environment, said Lawrence Miller, chief of Health Care Reform.
The decision was made over the weekend, Miller said, and was largely responsive to warnings about increased security threats.
“We take the advice of our security experts, and when they see the environment changing from a threat perspective, we change to meet that threat,” Miller said.
“You’re careful not to create an attractive target,” he added.
The exchange is disconnected from the federal data hub, Miller said, and income-based subsidy eligibility determinations will be confirmed manually using other federal data sources.
The decision to take the website offline was made with the blessing of the federal Centers for Medicare and Medicaid Services, which is bankrolling the project and continues to be a “close partner” in the project’s development, officials said.
POLICY CHOICES SPARK POLITICAL PUSHBACK
Vermont was the only state to require that individual market insurance products be sold only through a state exchange.
Shumlin’s critics have consistently said that was a mistake, especially given the website’s poor performance.
Vermont was also the only state to require employers with 50 or fewer workers to purchase exchange products, but the website was never able to handle small business customers. Shumlin allowed them to enroll directly with the insurer, a process that will continue through open enrollment this year.
Republican gubernatorial candidate Scott Milne said that Vermonters would do well to remember the website’s failures in the November election.
“It keeps getting worse for Vermonters,” Milne said in a statement, “The catastrophic failure of Vermont Health Connect is putting Vermonters at risk.”
The statement said Milne will continue to meet with medical professionals as he develops a health care platform, and urged Shumlin to do likewise, but it did not articulate a course of action to remediate the exchange or reform health care in the state.
Lt. Gov. Phil Scott issued a statement saying Vermont should transition to the “much simpler and fully functional” federal exchange that “27 other states have successfully used,” and pull the plug on a system that has “created very real problems for thousands of Vermonters.”
Scott’s opponent in the November election, Progressive candidate Dean Corren, said such calls are “cavalier” and ultimately not practical if Vermont wants to preserve state-sponsored subsidies offered through its exchange. Corren will also appear on the Democratic ballot by winning a write-in campaign in the primary.
Shumlin echoed Corren’s statement, saying it was his understanding that Vermont could not offer additional subsidies through the federal exchange.
Libertarian candidate Dan Feliciano, applauded Shumlin’s decision to take the site down, saying it was the right move to protect people’s personal information, which could have been exposed during remediation work.
Feliciano said the website should stay offline “permanently,” and he, too, believes Vermont should join the federal exchange.
“Health care is a technology business, and we shouldn’t kid ourselves,” he said. “I’m concerned that Vermont Health Connect will destroy people’s faith in the state providing technology solutions to further reduce costs and improve efficiency.”
At the news conference, Shumlin said a smooth open enrollment period will restore that faith.
“These actions are being taken so Vermonters will have faith in the system,” he said.
Sen. Patrick Leahy, D-Vt., offered his support for Shumlin’s decision, issuing a statement calling it a “critical step” toward getting the website to function properly.
Leahy said he is hopeful that by taking the website down, the problems and be addressed and its operation can resume quickly.
MAINTENANCE PERIOD WON’T FIX MISSING COMPONENTS
None of the major functions that are still being developed will be launched when the website comes back online, Miller said.
The timeline for adding the missing elements, such as online changes to coverage and personal information or allowing small businesses to use the site, has not changed. Those functions are expected to launch next year.
Fewer people have been using the site in recent weeks, officials said, dampening the impact of taking it offline. Officials will closely monitor call center volumes and wait times to ensure that people are getting the help they need, Miller said.
Before the site was taken down there were 30 new applications and 750 transactions a week taking place online. State officials did not know how many unique visitors the website receives.
Miller said 20 percent to 25 percent of customers with commercial coverage were making premium payments online. Those customers will be contacted by the state, and told to make their payments by mail or through the call center.
Site users are expected to increase with open enrollment when current customers must renew coverage and new ones are expected to sign up.
countinued
WINOOSKI — The Vermont Health Connect website was taken down Monday night and will remain offline to allow for improvements to data security and the user experience, state officials said Tuesday.
Customers who need to report changes in income or make changes to their coverage or personal information will need to contact the customer service call center at 855-899-9600. Everyone with health insurance purchased through the exchange is still covered, officials said.
Officials did not say how long the state’s health insurance exchange website will be down, but said that it would be weeks, not days, before the it is back online.
Gov. Peter Shumlin acknowledged people’s frustration with the Vermont Health Connect website, but said it’s being taken offline to ensure a smooth open enrollment period, which begins Nov. 15.
Gov. Peter Shumlin (left) and interim Secretary of the Agency of Human Services Harry Chen announced Tuesday that the Vermont Health Connect website will be offline for repairs. Photo by Morgan True/VTDigger
Gov. Peter Shumlin (left) and interim Secretary of the Agency of Human Services Harry Chen announced Tuesday that the Vermont Health Connect website will be offline for repairs. Photo by Morgan True/VTDigger
“No one is more frustrated than me with the slow process we’ve had,” Shumlin said at a hastily called news conference Tuesday.
Harry Chen, the interim Secretary of Human Services, said the decision to take the website offline “wasn’t made lightly.”
State officials were adamant that the site was taken down as a “proactive step” to enhance security and improve the site’s usability in advance of open enrollment, and not in response to a specific data breach or security threat.
Confidential consumer information was not compromised at any time, Chen said. The need for improved security is a response to changes in the online environment, said Lawrence Miller, chief of Health Care Reform.
The decision was made over the weekend, Miller said, and was largely responsive to warnings about increased security threats.
“We take the advice of our security experts, and when they see the environment changing from a threat perspective, we change to meet that threat,” Miller said.
“You’re careful not to create an attractive target,” he added.
The exchange is disconnected from the federal data hub, Miller said, and income-based subsidy eligibility determinations will be confirmed manually using other federal data sources.
The decision to take the website offline was made with the blessing of the federal Centers for Medicare and Medicaid Services, which is bankrolling the project and continues to be a “close partner” in the project’s development, officials said.
POLICY CHOICES SPARK POLITICAL PUSHBACK
Vermont was the only state to require that individual market insurance products be sold only through a state exchange.
Shumlin’s critics have consistently said that was a mistake, especially given the website’s poor performance.
Vermont was also the only state to require employers with 50 or fewer workers to purchase exchange products, but the website was never able to handle small business customers. Shumlin allowed them to enroll directly with the insurer, a process that will continue through open enrollment this year.
Republican gubernatorial candidate Scott Milne said that Vermonters would do well to remember the website’s failures in the November election.
“It keeps getting worse for Vermonters,” Milne said in a statement, “The catastrophic failure of Vermont Health Connect is putting Vermonters at risk.”
The statement said Milne will continue to meet with medical professionals as he develops a health care platform, and urged Shumlin to do likewise, but it did not articulate a course of action to remediate the exchange or reform health care in the state.
Lt. Gov. Phil Scott issued a statement saying Vermont should transition to the “much simpler and fully functional” federal exchange that “27 other states have successfully used,” and pull the plug on a system that has “created very real problems for thousands of Vermonters.”
Scott’s opponent in the November election, Progressive candidate Dean Corren, said such calls are “cavalier” and ultimately not practical if Vermont wants to preserve state-sponsored subsidies offered through its exchange. Corren will also appear on the Democratic ballot by winning a write-in campaign in the primary.
Shumlin echoed Corren’s statement, saying it was his understanding that Vermont could not offer additional subsidies through the federal exchange.
Libertarian candidate Dan Feliciano, applauded Shumlin’s decision to take the site down, saying it was the right move to protect people’s personal information, which could have been exposed during remediation work.
Feliciano said the website should stay offline “permanently,” and he, too, believes Vermont should join the federal exchange.
“Health care is a technology business, and we shouldn’t kid ourselves,” he said. “I’m concerned that Vermont Health Connect will destroy people’s faith in the state providing technology solutions to further reduce costs and improve efficiency.”
At the news conference, Shumlin said a smooth open enrollment period will restore that faith.
“These actions are being taken so Vermonters will have faith in the system,” he said.
Sen. Patrick Leahy, D-Vt., offered his support for Shumlin’s decision, issuing a statement calling it a “critical step” toward getting the website to function properly.
Leahy said he is hopeful that by taking the website down, the problems and be addressed and its operation can resume quickly.
MAINTENANCE PERIOD WON’T FIX MISSING COMPONENTS
None of the major functions that are still being developed will be launched when the website comes back online, Miller said.
The timeline for adding the missing elements, such as online changes to coverage and personal information or allowing small businesses to use the site, has not changed. Those functions are expected to launch next year.
Fewer people have been using the site in recent weeks, officials said, dampening the impact of taking it offline. Officials will closely monitor call center volumes and wait times to ensure that people are getting the help they need, Miller said.
Before the site was taken down there were 30 new applications and 750 transactions a week taking place online. State officials did not know how many unique visitors the website receives.
Miller said 20 percent to 25 percent of customers with commercial coverage were making premium payments online. Those customers will be contacted by the state, and told to make their payments by mail or through the call center.
Site users are expected to increase with open enrollment when current customers must renew coverage and new ones are expected to sign up.
countinued
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