A federal data-matching problem on Healthcare.gov may be costing U.S. health insurers members--and money.
The Department of Health and Human Services (HHS) hasn't been able to resolve glitches that are costing some consumers their subsidies, reports Kaiser Health News. Since people who sign up for coverage through Healthcare.gov often can't afford a health plan without subsidies, insurers may be losing new members.
The HHS Office of Inspector General found that between October and December of 2013, there were about 2.9 million data inconsistencies, which occurred when Healthcare.gov couldn't cross-check enrollee information, particularly income estimates, with other information, FierceHealthPayer previously reported.
And the problems have continued since then. Almost 225,000 consumers either had their tax credits adjusted or taken away entirely in 2015 because the government couldn't verify facts on their applications.
Ammer Cabrera, an agent with Miami-based Sunshine Life and Health Advisors, told KHN that it's become an "epidemic." At least 10 percent of about 100,000 people the agency enrolled for 2015 exchange plans have lost their tax credits, she said.
"People are not always clear what is happening in their case and what they need to send" to rectify the problem, Judy Solomon, vice president of health policy at the Center on Budget and Policy Priorities, told KHN.
But HHS says it has been addressing the issues. "We've worked hard to improve our processes so that data-matching issues are resolved quickly and easily, and conducted large outreach campaigns to inform consumers of their responsibility for providing supporting documentation to verify their eligibility information," HHS said in a statement to KHN.
To learn more:
- read the Kaiser Health News article