Eligibility for subsidies not properly checked, audit finds

The HHS inspector general issues two reports concluding the federal health marketplace and some state exchanges had inadequate safeguards to stop people who were ineligible from getting tax credits to help pay for premiums.

The New York Times: Eligibility For Health Insurance Was Not Properly Checked, Audit Finds
An independent audit of insurance exchanges established under the health care law has found that federal and state officials did not properly check the eligibility of people seeking coverage and applying for subsidies, the latest indication of unresolved problems at HealthCare.gov. In a report to Congress on Tuesday, the inspector general for the Department of Health and Human Services, Daniel R. Levinson, said that the exchanges, which enrolled eight million people, did not have adequate safeguards "to prevent the use of inaccurate or fraudulent information when determining eligibility" (Pear, 7/1).

The Wall Street Journal: Reports Fault Controls Of Health Exchanges
The federal health exchange and some state exchanges had problems resolving inconsistencies on applications and making sure people were eligible for their insurance plans, according to two inspector-general reports released Tuesday. The problems plagued the exchanges in the early rollout of the Affordable Care Act last fall. Between October and December, the federal exchange was unable to resolve about 90% of data inconsistencies on insurance applications-;2.6 million of 2.9 million-;because the system for determining eligibility didn't work, according to one of the reports by the Department of Health and Human Services' inspector general (Armour, 7/1).

The Washington Post: Health-Care Exchanges Are Not Properly Ensuring Applicants' Eligibility, Probe Finds
A pair of reports, issued Tuesday by the Department Health and Human Services' Office of Inspector General, conclude that "internal controls" for evaluating applications were not always effective at verifying people's Social Security numbers, their citizenship, and whether they are eligible to buy health plans through the marketplaces because they cannot find affordable insurance elsewhere (Goldstein, 7/1).

The Hill: Inspector General Reports Find Problems With Obamacare Eligibility
Republicans have been hammering the administration over the issue, arguing many people ineligible for subsidies are nonetheless receiving them. They argued the latest reports suggest tax dollars are being wasted on people receiving federal subsidies who should not be getting them. "When ObamaCare was passed, its chief architects told us they would have to pass the bill to find out what was in it," said Sen. Orrin Hatch (R-Utah), Senate Finance Committee ranking member. "Today's report confirms what we knew was not included: safeguards to protect hard-earned taxpayer dollars from an incompetent bureaucracy" (Al-Faruque, 7/1).

Associated Press:  Health Care Coverage Signups Dogged By Data Flaws
Digging out from under the data problem is one of the top challenges facing newly installed HHS Secretary Sylvia Mathews Burwell. Spokesman Aaron Albright said more than 425,000 inconsistencies have been resolved so far, more than 90 percent of those in favor of the consumer (Alonso-Zaldivar, 7/2).

Fox News: ObamaCare Coverage For Millions In Jeopardy As Watchdog Finds Widespread Data Flaws
The Obama administration is struggling to resolve data discrepancies that could jeopardize coverage for millions who sought health insurance on the federal exchange HealthCare.gov, according to a watchdog report on the still-rocky implementation of ObamaCare (7/1). 

Los Angeles Times: Federal Audit Faults California Exchange For Lax Enrollment Practices
Federal auditors found that California's health insurance exchange was lax at times in verifying consumers' eligibility for Obamacare coverage. The report issued Tuesday by the Inspector General's Office at the U.S. Department of Health and Human Services also cited the federally-run exchange and Connecticut's insurance marketplace for similar deficiencies. Auditors said lax internal controls may have limited the exchanges' "ability to prevent the use of inaccurate or fraudulent information when determining eligibility of applicants for enrollment" (Terhune, 7/1).

The CT Mirror: Federal Auditors Question Access Health CT's Internal Controls
Federal auditors reported Tuesday that they found deficiencies in the internal controls used by the health insurance exchanges run by Connecticut, California and the federal government. The problems could have limited the marketplaces' ability to prevent people from using inaccurate or fraudulent information when applying for coverage as part of the health law commonly known as Obamacare, the auditors said. Connecticut's exchange, Access Health CT, inaccurately determined that several hundred applicants were eligible for federal assistance in paying insurance premiums or health care costs, failed to promptly send enrollment information from 139 customers to insurers, and didn't always verify the identity of people who use the exchange's call center in accordance with federal guidance, the auditors reported (Becker, 7/1).