WASHINGTON -- Thousands of consumers risk losing financial aid for health care premiums under the Patient Protection and Affordable Care Act unless they clear up lingering questions about their incomes, officials in President Barack Obama's administration said Monday.
The Health and Human Services Department said some people who got coverage have reported incomes that don't match what the government has on record. At least 279,000 households with income discrepancies face a Sept. 30 deadline to submit documentation. If not, their premiums will be adjusted up or down in November.
Those consumers would still have a policy, but many risk seeing their financial subsidies slashed. Some may no longer be eligible for help with their premiums, although others could be entitled to a bigger tax credit that would lower what they pay. Andy Slavitt, a senior official overseeing the HealthCare.gov website, said the government has no way of knowing at this point.
Slavitt also said at least 115,000 people who could not prove they were citizens or legal U.S. residents will lose coverage Sept. 30.
The administration said it has made repeated attempts to reach those consumers, but immigrant advocacy groups say that in some cases the government has lost documents that prove eligibility. People living in the country illegally are not entitled to coverage under the law.
Florida and Texas top the list of citizenship- and immigration-related cancellations, with 35,100 and 19,600, respectively. But the administration did not report any information for states such as California and New York that are running their own insurance marketplaces. That omission means total cancellations could be significantly higher.
Slavitt said people whose immigration and citizenship documents were lost by the government can apply to have coverage reinstated.
"We recognize that we still have work to do here," said Slavitt, a tech executive brought in by the administration to oversee the complex operations of the health care program. "The situation that occurred this year [with data discrepancies] is not a one-time event. This is something that we all have to recognize is a built-in part of helping people get coverage."
The health care law offers subsidized private insurance to people who do not have coverage through their jobs. Insurance exchanges, or marketplaces, are operating in every state. The federal government is taking the lead in 36 states either because of political opposition to the law or because some states ran into problems.
Eighty-five percent of the 8 million who got coverage under the law have received financial aid, which is keyed to income, household size and other factors.
Without it, the coverage would be unaffordable for many. The government says the average consumer is paying $82 a month on a premium of $346. That works out to an average monthly subsidy of $264.
Data discrepancies involving income, citizenship and immigration started to emerge soon after the open enrollment season ended in mid-April. As of May 30, there were about 1.2 million households with income discrepancies. Slavitt said there has been considerable progress resolving such cases.
"I'm hopeful and confident people will respond," he said, referring to Monday's announcement.
All of the 6.7 million people who received health insurance tax credits for this year will face a final accounting when they file their 2014 income tax returns. Those who under-reported their income will owe money, and the Internal Revenue Service will reduce any tax refunds accordingly. Those who received too small a tax credit will get a bigger refund.
A Section on 09/16/2014