330,000 got insurance-aid data, IRS says

Workers take calls for Vermont’s health-care exchange earlier this month in Burlington, Vt.
Workers take calls for Vermont’s health-care exchange earlier this month in Burlington, Vt.

WASHINGTON - More than 330,000 people have managed to get deep enough into new government health-insurance websites to learn how much financial assistance they will receive purchasing coverage, the Internal Revenue Service said Saturday.

That figure is arguably the most robust measure released to date by President Barack Obama’s administration of how many Americans are successfully applying for financial help in purchasing a private insurance plan.

Calculation of financial assistance is a step that follows filing an application and tells applicants how much of a tax credit - if any - they can use to purchase a private health plan.

This figure does not include shoppers who were found to likely qualify for Medicaid earlier in the shopping process.

It also does not measure enrollment in health-law programs. The White House has said it will not release that information until next month.

The IRS said it has also received and responded to more than 1.3 million requests from the marketplace for personal data used to apply for Patient Protection and Affordable Care Act programs, such as household income and family size.

The IRS said it is currently receiving about 80,000 such data requests each day. It is one of about a half-dozen agencies that send information to a federal data hub, along with the Department of Homeland Security and the Social Security Administration.

“Our IT systems are working well and providing both the historical tax data and the computation service accurately and quickly through the government’s data hub,” IRS spokesman Terry Lemons said. “The requests are being processed within seconds.”

This federal data hub determines eligibility for premium tax credits for the 36 states using the federal insurance marketplace and also for some, but not all, of the state-based exchanges. California, for example, opted to use its own technology to determine who qualifies for which programs.

The federal data hub was built by the contracting firm Quality Software Service Inc.

The Obama administration announced this week that the firm would take on a new role as healthcare.gov’s general contractor, overseeing efforts to fix the website’s problems.

Healthcare.gov pings this federal data hub to verify a consumer’s identity and also when shoppers indicate in their applications that they would like to apply for financial assistance with coverage.

The Department of Health and Human Services has said that, as of Thursday, 700,000 applications have been filed through the federal and state insurance exchanges.

Middle-income Americans who earn less than 400 percent of the federal poverty line (about $45,000 for an individual) can use federal tax credits to purchase a private plan.

In the 26 states that expanded Medicaid, those below 138 percent of the poverty line (about $15,000 for an individual) will probably gain access to the public insurance program.

In the weeks leading up to the health law’s launch, insurance plans raised concerns that the federal data hub was making these determinations inaccurately. Washington state, which runs its own marketplace but relies on the federal hub for eligibility verification, announced Friday that 8,000 people had received inaccurate determinations. Its marketplace, Washington Healthplanfinder, spent the past week investigating the problem.

“The investigation revealed that the two systems were using different parameters to establish estimated household income,” Healthplanfinder chief executive Richard Onizuka said in a statement.

“As a result, some Washington Healthplanfinder applicants did not receive the correct tax credit information related to their premiums.”

Onizuka said the issue has since been resolved and that he expects the eligibility determinations to now function accurately.

“Exchange staff acted immediately and implemented a system fix on Oct. 23, 24 hours after identifying root cause, so that no further applicants will be impacted,” he said.

Lemons referred questions regarding the accuracy of the determinations to the Health and Human Services Department, which did not respond immediately to a request for comment.

Front Section, Pages 6 on 10/27/2013

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