Undocumented Immigrants Try, But Fail To Get Obamacare

NOV 7, 2015 @ 08:36 AM
Bruce Japsen

Tens of thousands of undocumented immigrants across the country who signed up for federally subsidized health coverage under the Affordable Care Act this year have been kicked off private insurance plans by the government following review of their eligibility status.

A window into the government’s eligibility process for individual coverage under the law came into public view after health insurance giant Humana HUM -1.13% (HUM) disclosed in its quarterly earnings report that individual commercial membership dropped 11 percent thanks to largely to a loss of 150,000 members due to termination by the Centers for Medicare & Medicaid Services (CMS) “for lack of proper immigration documentation and/or income status,” the Louisville-based insurer said.

It’s unclear whether the government actually paid any claims for undocumented immigrants for any period of time. The “data matching” eligibility system allows a three-month period for consumers to resolve documentation issues.

Humana says the “federal marketplace is responsible for determining applicants’ eligibility, and informs carriers which individuals to enroll based on this determination.” The issue was significant enough to trigger a drop in Humana’s overall individual commercial insurance business to 963,700 subscribers at the end of the third quarter compared to 1,085,800 at the end of the 2014 third quarter.

But the problem is not limited to Humana.

The Obama administration disclosed coverage ended this year as of June 30 for about 423,000 people across the country “who failed to produce sufficient documentation on their citizenship or immigration status,” according to a September report linked here.

Humana’s earnings report indicates that the issue hasn’t gone away given the impact on the insurer’s enrollment for July, August and September.

“Eligibility verification continues by CMS after this enrollment occurs,” Humana spokesman Tom Noland said in a statement to Forbes. “CMS has a process in place for enrollees with unresolved data matching issues, giving them 95 days to provide adequate documentation. CMS terminates individuals who do not provide sufficient documentation within 95 days; carriers are not involved in this process and do not have control over who loses coverage.”

The Obama administration said the marketplaces this year moved to “regular monthly action for consumers with unresolved data matching issues” related to citizenship, immigration status or “household income inconsistencies.”

http://www.forbes.com/sites/brucejap...get-obamacare/