Obamacare beset by new 'discrepancies': What are they and how serious?

Some 2 million people who signed up have discrepancies in their data, Obama administration officials say. Most are being resolved, but it is a fresh test for Obamacare.

Some 2 million Americans who signed up for health insurance on Obamacare exchanges face data discrepancies over things like income and immigration status – problems that need to be ironed out to keep their coverage.

That sounds bad. Is this a major new problem for the Affordable Care Act (ACA)? The answer is actually far from clear at this point.

The news does not mean, as some headlines have implied, that 2 million ACA enrollees are likely to lose their coverage or be proved ineligible for the subsidies they’re getting. So far, the Department of Health and Human Services (HHS) is saying that the “vast majority” of discrepancies are being resolved without affecting people’s coverage, the Associated Press reports.

Here’s what it does mean: With a large number of applications in play, it’s worth watching to see how big a minority will end up ineligible for subsidies or insurance. The law’s core goal, after all, is to get as many uninsured Americans covered as possible.

HHS is blunt about the risk: “You must take action to upload or mail in documents [requested to resolve discrepancies]. It is possible your tax credit or coverage could depend on it,” the agency said in a Wednesday blog post.

More broadly, the data check is a reminder that glitches and challenges for the Obamacare insurance marketplaces didn’t end back in December, when a “tech surge” patched the troubled website HealthCare.gov so first-year enrollment could go forward.

On its face, the 2 million figure represents about 1 in 4 Obamacare enrollees. And a good many of those people have more than one discrepancy in their applications.

Here’s what the AP has reported:

• Some 2.1 million enrollees were "affected by one or more inconsistency" as of the end of April, according to a May 8 HHS document.

• The number today remains near that figure, a department spokeswoman says. About 1.2 million have mismatch issues with income data, 505,000 with immigration data, and 461,000 with citizenship data.

• The number of people affected may really be higher, because the Obama administration says the 2 million figure reflects only consumers who signed up via the federally maintained website or call centers. Some states ran their own exchanges, meaning about one-third of ACA enrollees aren’t tracked in the tally of 2 million.

If people provided false information – knowingly or by mistake – the review process now under way could result in changes such as a revision of tax subsidies or even being dropped from coverage. People won’t lose benefits while the review is taking place.

Although the number of applications flagged for review is large, the general fact of data discrepancies is not surprising, says Elizabeth Carpenter, a director at the consulting firm Avalere Health in Washington. To some degree, it’s par for the course, given patterns of human error, federal records that can be out of date, and a complex law where it simply takes awhile “for things to start working at full speed.”

HHS has a blog post answering consumer questions about the data review.

And department spokeswoman Julie Bataille, in a separate blog post, described how discrepancies have arisen. “The typical family of four generated 21 separate pieces of information that required verification, and all were attested to under penalty of perjury,” she wrote.

In some cases, the application doesn’t match government records, such as when the spelling of a name on a birth certificate doesn’t match the spelling on a license or when a job change means the Internal Revenue Service has out-of-date income data.

“As part of our due diligence process and to be a good steward of taxpayer money, if consumers don’t provide sufficient proof to support the information they attested to, they will have their eligibility ended or changed to reflect what is recorded in trusted data sources,” Ms. Bataille wrote.