Highlight on Connecticut: 30,000 Access Health Customers at Risk of Losing Coverage, Subsidies

An estimated 30,000 customers of Connecticut’s Health Insurance Exchange, Access Health CT, could reportedly see a drop in subsidies or even lose coverage in December because they failed to submit required information regarding income and citizenship used to verify their continued eligibility. The Exchange recently implemented the process of verifying eligibility to address discrepancies in information provided during the application process.

Who’s affected?

Those affected by the eligibility verification are Connecticut residents who purchased coverage through Access Health and provided income and citizenship information that the Exchange was not able to verify through either federal or state data sources. Access Health CEO Jim Wadleigh stated that customers affected were sent four letters (in the consumer’s indicated language of preference when their Access Health account was created) asking them to verify the information provided on their applications for coverage.

The Exchange is gearing up to check the information of the 30,000 enrollees against the federal and state data sources in order to determine what discrepancies still exist. For customers who are still missing information will have their coverage cut off or, if income cannot be verified, will have their premium subsidies reduced or eliminated.

Eligibility verification

The Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) allows consumers to receive coverage and financial assistance based on the information provided in their applications. Documentation of such information must be provided within 90 days, after which Exchanges must use information they can obtain from official sources. When the information from federal sources does not match up with the consumer’s application, subsidies and even coverage may be cut off.

For most of the year, however, federal and state Exchanges did not terminate coverage or subsidies for these reasons. Wadleigh said Access Health officials were reluctant to be the first Exchange in the country to terminate coverage for enrollees who were paying their premiums and thus waited for federal guidance on the issue, reported the Hartford Courant.