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Experts worry over information problems on ACA coverage applications

Health Care and Health Insurance
by Brian Stentz
How satisfied are ACA exchange enrollees?
How satisfied are ACA exchange enrollees?

Millions of Americans were able to successfully apply for health insurance coverage as part of the Obama administration's various efforts ahead of the sign-up deadline earlier this year. However, it seems that a healthy portion of those who got in under the wire might have some issues with their documentation that could prove problematic going forward.

More than 2.1 million people nationwide - or about 25 percent of those who signed up for ACA coverage - had at least one discrepancy on their applications discovered by the federal government, and as a consequence might face some adverse action, according to a report from the Associated Press. In addition to slowing down the process of getting claims processed, people who incorrectly filled out their applications may end up receiving premiums that end up being higher than they were originally quoted, or might even have their coverage discontinued altogether.

What are the issues?
When it comes to what, actually, was incorrect about the data submitted on these applications, the answers vary widely, the report said. Some consumers misreported their income, while others exaggerated their citizenship or even immigration statuses. These issues have sparked investigations from various congressional committees, and could prove extremely problematic for the federal and state exchanges going forward.

On the other hand, the Obama administration contends that many of these issues can be sorted out within the next few months alone, and the U.S. Department of Health and Human Services now has procedures in place which would allow it to immediately discontinue the coverage of any Americans whose actual information would make them ineligible to buy plans through the government marketplaces. Julie Bataille, communications coordinator for the health care rollout, told the news agency that the millions of Americans who submitted such information created the problems because it is now out-of-date, and not because they lied on their forms.

Nonetheless, if any consumers are disenfranchised by these investigations and changes to - or outright cancelation of - their coverage, it might be wise for private health insurers to swoop in and try to provide Americans with other options so that they can remain compliant with the new coverage mandates now put into place. This could be a boon for insurers' business overall, but at the same time, it may also provide significant benefits to the consumers as well.

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