Affordable Care Act Update [9/17/14]: Consumers Should Keep Submitting Paperwork

The Obama administration announced on Monday that 115,000 consumers will lose their health coverage under the Affordable Care Act on October 1 because they did not submit the proper paperwork proving their legal immigration or citizenship status.

An additional 363,000 consumers may see their financial assistance affected because they did not accurately report their income. More than eight in 10 people who applied for health coverage in the federally facilitated marketplace qualified to receive this financial assistance (also known as premium tax credits or premium subsidies).

Consumers who received a notice from HHS saying they will lose their health insurance can take these steps to protect their coverage.

Consumers with immigration or citizenship discrepancies

Consumers who received a notice from HHS saying there is a discrepancy with their immigration or citizenship records need to mail in or upload documentation. The deadline to submit this documentation was September 5, but consumers may qualify for a special enrollment period that will allow them to get their health coverage back.

HHS has notified health insurers that these consumers can submit their documentation and be determined eligible for marketplace coverage for up to 60 days after their coverage is terminated. Consumers submitting verifying documentation within that 60-day window can request coverage that is retroactive to the date their coverage was canceled, or they can request coverage that begins the following month.

Consumers with income discrepancies

As of Monday, there are still more than 200,000 households who have income-related inconsistencies (also known as “data matching” inconsistencies). This week, HHS is sending notices to people stating that the income they put on their application doesn’t match what’s on record, which could affect their financial assistance. These consumers won’t lose their health insurance, but having an inconsistency might affect whether their coverage is affordable. For a lot of consumers, this financial assistance is the make-or-break factor in being able to afford health care.

Consumers should submit their paperwork as soon as possible to avoid having the amount of their financial assistance changed. The deadline to submit this paperwork is September 30.

We encourage navigators and assisters to urge consumers to mail in their documentation ASAP. If consumers fail to do so, the amount of their financial assistance might change, which could affect their 2014 taxes.

For more information, consult CMS’ helpful webinars about data matching inconsistencies here and here.

Healthcare.gov’s tips for consumers:

If you receive a notice referencing September 30: 

• Continue to pay your monthly insurance premium on time.
• Mail your documents to:
  • Health Insurance Marketplace
    Attn: Supporting Documentation
    465 Industrial Blvd.
    London, KY 40750
• When mailing documents, it’s important to include the bar code page from the end of your notice. This helps the marketplace match the documents to the correct application.
• Make sure you mail copies of your documents and keep the originals for your records. 
• If you need assistance or would like to meet with someone in person, you can find local help at https://localhelp.healthcare.gov/.
• You can also get assistance through the call center: 1-800-318-2596 (TTY: 1-855-889-4325).

For more consumer-friendly information on this topic, visit https://www.healthcare.gov/blog/the-marketplace-might-need-more-information-from-you/.