Affordable Care Act data discrepancies may affect coverage for 2 million

WASHINGTON – A huge, new paperwork headache for the government also could be jeopardizing coverage for some of the millions of people who just got health insurance under President Barack Obama’s law.

A government document provided to the Associated Press indicates that at least 2 million people enrolled for taxpayer-subsidized private health insurance have data discrepancies in their applications that, if unresolved, could affect what they pay for coverage, or even their legal right to benefits.

The final number affected could well be higher. According to the administration, the 2 million figure reflects only consumers who signed up through the federally administered HealthCare.gov website and call centers. The government signed up about 5.4 million people, while state-run websites signed up another 2.6 million.

For consumers, a discrepancy means that the information they supplied, subject to perjury laws, does not match what the government has on record.

For example, someone who underestimated his income, and got too generous a subsidy as a result, could owe the Internal Revenue Service money next year.

The seven-page slide presentation from the Health and Human Services Department was provided to AP as several congressional committees investigate the discrepancies. Most of the data conflicts involve important details on income, citizenship and immigration status – which affect eligibility and subsidies.

Ensuring that health care benefits are delivered accurately is a priority for HHS nominee Sylvia Mathews Burwell, whose confirmation as department secretary is before the Senate this week.

Responding to the document, administration officials expressed confidence that most of the discrepancies can be resolved over the summer. Nonetheless, the department has set up a system to “turn off” benefits for anyone who is found to be ineligible.

Julie Bataille, communications coordinator for the health care rollout, said many of the discrepancies appear to be due to outdated information in government files – and the “vast majority” of cases are being resolved in favor of consumers. The government is making an all-out effort to reach those with various discrepancies, which officials have termed “inconsistencies.”

“The fact that a consumer has an inconsistency on their application does not mean there is a problem on their enrollment,” Bataille said. “Most of the time what that means is that there is more up-to-date information that they need to provide to us.” For example, for people applying for coverage this year, the latest income information on record with the IRS dates to 2012, in most cases.

The May 8 document provided to the AP said 2.1 million people enrolled through the new health insurance exchanges were “affected by one or more inconsistency” as of the end of April.

The law contemplated there would be verification problems with the new program, and it provided for a 90-day window to clear up discrepancies. During this time, a consumer’s coverage is not affected. Under the law, the administration has the option to extend the 90-day period for this year.

About 60 percent of all the people with discrepancies are still within the initial 90-day period, Bataille said.