Rep. Fred Upton (R-Mich.) said on Tuesday he had “serious” questions about reports that no system exists within healthcare exchange to address inconsistencies, which could lead to inappropriate subsidies and health plan enrollments.
Reports from the HHS Office of Inspector General (OIG) found that insufficient systems were in place to verify the eligibility of individuals to enroll in health plans through the Affordable Care Act (ACA) marketplace or to confirm their eligibility for subsidies based on income.
The report concluded that approximately 90 percent of inconsistencies in documentation – many pertaining to income and citizenship – were unable to be resolved through the ACA marketplace.
“Sadly, the most consistent part of the health law’s implementation has been the millions of ‘inconsistencies’ without a system in place to address them,” Upton, the chairman of the House Energy and Commerce Committee, said. “Vital portions of the exchanges still sit incomplete, generating serious questions about the system’s ability to process inconsistencies or handle next year’s open enrollment period.”
Upton said the reports underscored the perils of the “reckless” rollout of the healthcare law and its disregard for taxpayer dollars.
HHS was unable to resolve 2.6 million of 2.9 million inconsistencies in documentation because the Centers for Medicare and Medicaid Services (CMS) system wasn’t fully operational, according to the reports.
“These reports are very troubling,” Sen. Roy Blunt (R-Mo.) said. “Americans deserve to know how the federal government spends their hard-earned dollars – and whether their money is being misused on wasteful and fraudulent Obamacare payments.”
Former HHS Secretary Kathleen Sebelius certified in January that the online healthcare exchanges would be able to verify eligibility for tax credits and cost-sharing assistance.