TOPICS > Health

Health care law data discrepancies threaten coverage for 300,000

August 13, 2014 at 6:17 PM EDT
The Obama administration warned that more than 300,000 people could lose health care coverage if they can’t show proof that they are U.S. citizens or legal residents. Judy Woodruff talks to The Wall Street Journal’s Louise Radnofsky about the long-standing glitch that prompted the warning, reaction from immigration activists and who has the best chances of getting their policies renewed.

JUDY WOODRUFF: There’s a new complication with the health care law and insurance coverage. Roughly eight million people signed up through the health care exchanges. But it’s been clear this summer that there are cases of discrepancies with information of some of the newly enrolled, calling their eligibility into question in some cases.

Immigration status is now a part of this. Yesterday, the Obama administration warned that more than 300,000 people could lose coverage if they can’t show proof they are U.S. citizens or legal residents.

Reporter Louise Radnofsky is covering all this for The Wall Street Journal.

And we welcome you back to the program.

LOUISE RADNOFSKY, The Wall Street Journal: Thank you for having me.

JUDY WOODRUFF: So, Louise, who are these people who are being questioned or getting these letters?

LOUISE RADNOFSKY: Well, originally, there were about a million people for whom the system couldn’t verify that they were in the United States legally, and therefore entitled to access coverage under the law.

The administration has whittled that down to about 310,000 people now that they say they haven’t heard from after they have asked them multiple times to send in more information.

JUDY WOODRUFF: So — and how did this come to light? What caused this to bubble to the surface for the administration?

LOUISE RADNOFSKY: There appeared to be a long standing glitch in the system in which it was particularly difficult to ascertain data supplied by people who were illegally resident in the United States or naturalized citizens, but were not born here.

Essentially, the data that was being drawn on from the Department of Health and Human — the Department of Homeland Security, the other DHS, wasn’t — wasn’t working to get their information available in time.

JUDY WOODRUFF: So they literally couldn’t verify what people were saying; is that it?

LOUISE RADNOFSKY: They couldn’t.

And at one point, people couldn’t enter document numbers that actually existed at all in order to get through the system. So they just sort of tried to progress as best as they could and then were planning to send information later.

JUDY WOODRUFF: So, remind us about the eligibility requirements. For people to sign up for health care coverage under the program, they had to be what?

LOUISE RADNOFSKY: They had to be legally in the United States.


LOUISE RADNOFSKY: This was a very highly charged issue at the time that the law was being debated.

As a result, unauthorized immigrants are not only not eligible for tax credits towards the cost of coverage. They’re not allowed to shop on at all.

JUDY WOODRUFF: So, they’re being told — as you said, over a million notices went out. They have heard back from many of these people. They have cleared it up; 300,000 people, though, they haven’t heard back from.

What are they — what happens to them? What do they have to do?

LOUISE RADNOFSKY: Those people have until September 5 to start sending information, either uploading it or mailing it in to the Department of Health and Human Services.

If they don’t, they would lose their coverage entirely. It’s not just a question of their tax credits being cut off and this being settled next year in taxes in time. Their plans will be terminated by their insurance company.

JUDY WOODRUFF: So the administration is literally prepared to shut them off, even after a year or less than a year of coverage?


It’s certainly something that immigrant activists are very concerned about. They never really liked the provision in the first place and felt it was somewhat spiteful to deny people the access to the exchange at all. But they say that here the government may be moving quite hastily.

JUDY WOODRUFF: What do people in the administration say to you about this? Do they honestly believe that most of these people are illegal, that they’re not citizens or are not here legally, or do they think that there are just honest mistakes that were made?

LOUISE RADNOFSKY: They say that they’re in a position to process through and find out whether people who submitted information in good faith do have data on file in the federal government that can verify what they’re saying.

And that’s why they’re going to these extra measures. But they say they do need to hear from the people.

JUDY WOODRUFF: So they don’t really know? They honestly don’t know? Is that what you’re saying?

LOUISE RADNOFSKY: It’s a data-matching error, they describe it as, yes.


So, at this point, two million people — we started out saying some two million people are being investigated for some sort of discrepancy. This is a big number of the eight million.


And it gets to the idea that there were a number of flaws in that went beyond the widely publicizes ones that being understood at the outset, where they couldn’t just get through a system that kept seizing up on them. The underlying data in some cases has been very problematic to verify, particularly because you have a number of people with complicated circumstances, like not being born in the United States, which here is proving to be very complicated, or their income has changed.

That’s the other million people among that two million that we were talking about here. What they earned in 2012 does not appear to match up very closely with what they are saying they expect to earn in 2014. That, incidentally, is often the sort of thing that happens when people are suddenly looking to buy insurance on their own.

JUDY WOODRUFF: So, how does that get reconciled?

LOUISE RADNOFSKY: Well, for that, again, the administration is asking for more information for people.

But for those people, because it’s about their tax credits and not about their coverage entirely, there is also an expectation that it will sort of get sorted out around tax filing season. The Republicans aren’t very happy about that, but certainly that’s the way it’s being planned out.

JUDY WOODRUFF: Now, there is a renewal process that has to take place. What is the administration saying about that? Do they expect that to go smoothly? What are they looking at?

LOUISE RADNOFSKY: The administration decided to automatically renew policies for people, unless they asked to change them in some way, precisely because it was worried about a bunch of people falling out of the system.

The people whose policies are going to be renewed are generally people who were able to get through the system relatively smoothly the first time, and don’t have these additional circumstances complicating their applications that appear to have disproportionately affected immigrants.

JUDY WOODRUFF: So, they don’t look to — they don’t expect to have a significant problem?


But immigrant groups are also concerned that there are ongoing problems that will persist into the next enrollment season, particularly for these people that the administration is very keen to make sure, in cases where they’re in the United States illegally, are signed up for coverage.

JUDY WOODRUFF: Well, the watching goes on of the health care law.

Louise Radnofsky, we thank you.