Half a Million at Risk of Losing Insurance Because of Missing Obamacare Paperwork

by | September 16, 2014

By Noam N. Levey

As many as half a million people who signed up for health insurance under the Affordable Care Act this year may lose coverage or need to pay more because they haven't submitted proper documentation, the Obama administration warned Monday.

Some 115,000 people are poised to be cut from insurance rolls at the end of the month because they haven't verified their citizenship or immigration status.

Another 363,000 people haven't sent in required forms proving their income, a key requirement for calculating the size of government subsidies some consumers are eligible to receive under the law.

Together, that represents about 10 percent of those who signed up for coverage on new federal marketplaces created by the law.

It does not include people in states operating their own marketplaces this year.

Without proper income documentation, some consumers may be forced to repay subsidies that they improperly received, cautioned the Department of Health and Human Services' Andy Slavitt, who oversees the marketplaces.

The law allows Americans who don't get health benefits at work to shop among plans on the marketplaces. Those making less than four times the federal poverty level _ or about $94,000 for a family of four _ qualify for subsidies.

The marketplaces are closed to foreigners who are not legally in the country.

The reconciliation of consumers' income and immigration information is a key part of the complex new marketplaces. But that process has come under increased scrutiny because the Obama administration and some states that are running their own marketplaces had so much difficulty starting the markets.

That slowed the process and led to widespread confusion. Many consumers have grown frustrated, and insurance industry officials are concerned that renewing coverage for people next year may become very difficult because of unresolved verification issues.

The Obama administration may face a backlash from consumers who will be asked to repay hundreds or thousands of dollars in subsidies that they weren't entitled to receive.

Slavitt said Monday that the health agency has made significant progress clearing a backlog of those with incomplete information, including 851,000 people with missing immigration documentation and 897,000 households with missing income documentation.

He and other Obamacare supporters point to signs that the law has helped expand coverage to millions of Americans and that the marketplaces appear to be restraining the cost of insurance in many states.

"All the evidence is showing us the Affordable Care Act is working for millions of Americans," he said.

But Slavitt would not say how many of the cleared cases led to termination of coverage or adjustments in premiums.

That number is key to gauging how many of the 8 million people who signed up for coverage have remained in health plans and whether the law's expansion of coverage looks to be enduring.

It is also unclear how many more people face changes in their coverage in the 14 states that did not rely on the federal government to operate their marketplaces. The Obama administration did not release data on those states Monday.

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