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Thousands may lose Affordable Care Act health coverage absent residency and income verification

By Ashley N. Southerland on August 25, 2014
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The Centers for Medicare & Medicaid Services (“CMS”) recently announced that it had identified and contacted more than 300,000 people to obtain proof of their citizenship or legal residency status. Failure to provide this documentation by September 5 could result in these individuals losing their Affordable Care Act (“ACA”) health coverage, effective September 30. This loss of coverage conforms to the ACA’s prohibition on coverage for individuals illegally residing in the United States.

As of May 2014, according to CMS, about 1 million people who had signed up for private health insurance plans under the ACA had failed to provide required proof-of-citizenship or legal residency status. By August, however, that number had been cut by more than 660,000.

In addition to residency issues, another 1 million people who signed up for ACA coverage failed to verify their incomes, according to the Department of Health and Human Services’ June 2014 report on the Marketplace. This income verification is required under the ACA to determine, among other things, an enrollee’s eligibility for premium subsidies. See 45 C.F.R. § 155.320(c). To date, CMS has not said how many of these cases have been resolved. Unlike the residency requirement, no deadline has yet been set to cancel coverage for these individuals absent provision of the necessary information.

  • Posted in:
    Health Care and Life Sciences
  • Blog:
    Health Law
  • Organization:
    Crowell & Moring LLP
  • Article: View Original Source

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