Tens of Thousands at Risk of Losing ACA Insurance Coverage

The federal government will terminate health insurance coverage under the Affordable Care Act for 115,000 individuals who failed to prove they were United States citizens or legal immigrants. Furthermore, another 363,000 people could lose their financial aid because of income reporting discrepancies.

The federal government will terminate health insurance coverage under the Affordable Care Act for 115,000 individuals who failed to prove they were United States citizens or legal immigrants. Furthermore, another 363,000 people could lose their financial aid because their incomes could not be verified, according to the CMS.

During a conference call on Monday, Andrew Slavitt, principal deputy administrator at CMS, said some of the people who will lose their coverage due to discrepancies in immigration and citizenship records could be reinstated retroactively if they provide the required documents.

As of September 14, 115,000 cases were not resolved, and as a result these individuals with citizenship and immigration data matching issues will no longer be covered by the federal marketplace on October 1.

However, The New York Times reported that consumers and the lawyers working with them claimed some people experienced difficulties transmitting the requested immigration and citizenship documents through HealthCare.gov, while others mailed the documents but never heard back from the government or the contractor.

In addition, discrepancies in federal tax records and reported income could cause 363,000 consumers to lose their financial subsidies. These individuals have until September 30 to provide updated income information, otherwise the government could reduce or eliminate their subsidies.

“We are committed to keeping coverage affordable for the millions of Americans who depend on it, and to doing so in an efficient, transparent way that protects taxpayers,” CMS Administrator Marilyn Tavenner, said in a statement. “It’s critically important that consumers who still owe income-related documents to the Marketplace send them in by September 30 so we can continue to hold down their costs.

Although these individuals would still be eligible for coverage, they may no longer be able to afford it. Plus, some may have to repay some or all of the subsidies they have received, the Times reported.

Income discrepancies do not necessarily mean that consumers have supplied false information. CMS is using 2012 tax return information to double check data, but consumers could have switched jobs since then.

In May, 966,000 individuals had immigration and citizenship matching issues and 1.2 million households had income-related discrepancies. Since then, CMS has reduced these open claims by 88% and 70%, respectively.

“We are pleased that the number of individuals who were at risk of losing their Marketplace coverage, or seeing changes in their costs because of data matching issues has been dramatically reduced in the last 3 months,” Tavenner said.