WNYT.com

Some consumers risk losing health law tax credits

Updated at: 09/15/2014 5:52 PM
RICARDO ALONSO-ZALDIVAR

(AP) WASHINGTON - WASHINGTON (AP) — Thousands of consumers risk losing financial aid for health care premiums under President Barack Obama's law unless they clear up lingering questions about their incomes, administration officials said Monday.

The Health and Human Services Department said some people who got coverage have reported incomes that don't square with 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 any help with their premiums. It's also conceivable that some could actually 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.

Separately, Slavitt said that at least 115,000 people who could not prove they were citizens or legal U.S. residents will lose coverage on Sept. 30.

The administration says it has made repeated attempts to reach those consumers, but immigrant advocacy groups say in some cases the government has lost documents sent in to 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 immigration mega-states like California and New York, which 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 nation's newest social 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. New 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.

Nearly 9 in 10 people — 85 percent — of the 8 million who got coverage under Obama's law have gotten 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, although about 279,000 remain in the federal exchange states.

"I'm hopeful and confident people will respond," he said, referring to Monday's announcement.

All of the 6.7 million people who got 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 back, and the Internal Revenue Service will reduce any tax refunds accordingly. Those who got too small a tax credit will get a bigger refund.

Like most aspects of the health care law, the issue of data discrepancies is politically sensitive.

Supporters of the law fear that people will lose coverage or be discouraged from enrolling because of technicalities. Critics say the administration has not done enough to ensure that only those who legally qualify get benefits.

(Copyright 2014 by The Associated Press. All Rights Reserved.)