Managers of the new public health insurance exchanges had trouble resolving applicant information conflicts, or even counting the conflicts. Officials at the U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) come to that conclusion in a review of applicant data inconsistencies at the new Patient Protection and Affordable Care Act (PPACA) exchanges.
Investigators looked into the matter to see how exchanges were handling obvious, basic problems with consumers’ “qualified health plan” (QHP) applications from October — when the first individual QHP open enrollment period began — until December 2013. States and the District of Columbia ran 15 exchanges, and the U.S. Department of Health and Human Services (HHS) ran the other 36 exchanges.
The exchanges were supposed to use information from a variety of sources, including tax information and credit history information available through a federal data hub, to verify the information on consumers’ applications. The exchanges were checking to see whether the consumers were eligible to buy QHP coverage, and whether the consumers were eligible for help with paying for the coverage.
See also: What if you lie to a PPACA exchange?
During the period reviewed, the HHS exchanges had counted 2.9 million inconsistencies and resolved 300,000, investigators say. Four states with state-based exchanges — Colorado, Minnesota, Nevada and Oregon — had no data on inconsistencies.
Massachusetts, Nevada, Oregon and Vermont said they were too busy dealing with computer problems to resolve inconsistencies during the study period. The managers of the California and Colorado exchanges said they got off to late starts with resolving inconsistencies because of changes they made in their procedures for handling inconsistencies.