Not only is the federal health-care exchange having trouble sending Medicaid enrollments to the state agencies that run the program, it turns out that it’s erroneously telling people they’re eligible for Medicaid.
Consumers applying for insurance through the federal exchange, HealthCare.gov, put their income information into the site’s subsidy calculator, which then informs them whether they qualify for Medicaid or what price they’ll pay for insurance on the exchanges — and some of these determinations are clearly wrong. According to USA Today, insurance brokers say that people making as much as $80,000 a year are being told they qualify for Medicaid, which makes them ineligible for private-insurance subsidies. The people who call the HealthCare.gov hotline to explain they couldn’t be eligible for Medicaid are told they’re eligible if the site says they are.
The problems don’t stop there: HHS says it will start sending Medicaid application files to states this week, but the data sent so far has been insufficient to allow states to determine Medicaid eligibility, according to the National Association of State Medicaid Directors.
Those files aren’t always accurate, either. Stephanie Goodman, a spokesman for the Texas Health and Human Services Commission, says that some of the files for people allegedly eligible for Medicaid in Texas include people who don’t reside in the state or are already enrolled in the program.
HHS has told states that it will not penalize them for enrolling ineligible people in Medicaid if the department said they were eligible.