The Department of Health and Human Services Office of the Inspector
General said in two reports that some "internal controls" were
ineffective in verifying eligibility at the marketplaces run by the
federal government, California, Connecticut and some other states.
Applicants for subsidies must enter income data, Social Security
numbers and other information into the online systems. The maximum
household income allowed for a subsidy is four times the federal
poverty level, or about $94,200 for a family of four.
"The deficiencies in internal controls that we identified may have
limited the marketplaces' ability to prevent the use of inaccurate
or fraudulent information when determining eligibility of applicants
for enrollment in qualified health plans," the inspector general
The watchdog's reports mark the second potential setback in two days
to the 2010 healthcare law. The U.S. Supreme Court on Monday limited
its mandate to provide universal contraception coverage for women.
The Centers for Medicare and Medicaid Services, which administers
Obamacare, said in a statement it was actively reaching out to
consumers to verify information and "resolve inconsistencies to make
sure that individuals and families get the tax credits and coverage
they deserve and that no one receives a benefit they shouldn't."
The HHS inspector general's findings, dismissed by the White House
as based on 'outdated information,' prompted fresh complaints from
Republicans in Congress, whose attention in recent weeks had been
redirected to other issues in the runup to November's mid-term
"When Obamacare was passed, its chief architects told us they would
have to pass the bill to find out what was in it," said Senator
Orrin Hatch, the top Republican on the Senate Finance Committee.
"Today's report confirms what we knew was not included: safeguards
to protect hard-earned taxpayer dollars from an incompetent
The California marketplace had difficulties verifying citizenship
and lawful presence, while the federal marketplace had difficulty
verifying Social Security numbers, the inspector general said.
[to top of second column]
A companion report found that the federal and some state insurance
marketplaces could not, in their early months of operation, resolve
most inconsistencies between applicants' self-supplied information
and data received through other federal sources, most commonly
citizenship and income levels.
The federal marketplace was unable to resolve 2.6 million of 2.9
million inconsistencies as of the first quarter of 2014, because of
systems not fully operational from October through December last
White House Press Secretary Josh Earnest dismissed the inspector
general reports as being based largely on "outdated information"
from late 2013, when the Obamacare website was struggling to
He said more work needs to be done to resolve inconsistencies, such
as slight variations on a person's name between federal databases,
but these do not necessarily indicate problems with applications
that have been submitted.
(Reporting by David Lawder, with; additional reporting by Jeff
Mason; Editing by Gunna Dickson)
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