Oba­macare signups sus­pected of be­ing flawed; GOP to in­ves­ti­gate

Modern Healthcare - - THE WEEK AHEAD -

The 2014 open en­roll­ment pe­riod ended on a tri­umphant note for the Obama ad­min­is­tra­tion with more than 8 mil­lion in­di­vid­u­als ul­ti­mately signed up for health­care cov­er­age.

But a re­port re­leased this month by HHS’ Of­fice of the In­spec­tor Gen­eral sug­gests that many of those en­roll­ment ap­pli­ca­tions are flawed.

HHS was un­able to re­solve 90% of the 2.9 mil­lion dis­crep­an­cies found in ap­pli­ca­tions sub­mit­ted through Health­Care.gov dur­ing the first three months of ex­change op­er­a­tions, ac­cord­ing to the re­port.

Repub­li­cans were quick to seize on that re­port as ev­i­dence that, de­spite en­roll­ment suc­cesses, im­ple­men­ta­tion of Oba­macare continues to be a mess. They will dig into the de­tails of the OIG re­port at a Wed­nes­day hear­ing be­fore the House En­ergy and Com­merce Com­mit­tee’s Sub­com­mit­tee on Health. Of­fi­cials from the watch­dog agency are ex­pected to tes­tify. The re­port “shows that the back-of­fice piece didn’t work as well as ex­pected,” said Stephen Par­ente, a health­care pol­icy ex­pert at the Univer­sity of Min­nesota. Roughly three-quar­ters of the dis­crep­an­cies dealt with ei­ther in­come or im­mi­gra­tion sta­tus.

The prob­lems with in­come could be par­tic­u­larly trou­bling be­cause that in­for­ma­tion is used to de­ter­mine federal sub­si­dies, which are avail­able to in­di­vid­u­als with in­comes up to 400% of the federal poverty thresh­old. Nearly 90% of in­di­vid­u­als en­rolled through the federal ex­change were deemed el­i­gi­ble for sub­si­dies.

“That’s the thing that could re­ally be a mess here,” Par­ente said. “If the sub­sidy is wrong, then there’s go­ing to be a claw-back.”

—Paul Demko


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