Eligibility For Health Insurance Was Not Properly Checked, Audit Finds

HHS's Office of the Inspector General has released the results of an audit that found the health insurance marketplaces run by the federal government and some states failed to ensure individuals who enrolled in health plans provided accurate information.

The audit found deficient internal controls used by the federal government, California and Connecticut did not always effectively verify consumers' Social Security numbers, whether they were eligible to purchase health insurance plans through the exchanges and their citizenship status.

The audit also found the federal and California marketplaces did not always resolve inconsistencies in eligibility data, and the Connecticut marketplace did not always properly determine eligibility for insurance affordability programs.

Covered California did not agree with the OIG's findings that identity proofing of applications was not always performed and citizenship was not always verified. Subsequently, the OIG removed its recommendation concerning that issue. Connecticut did not agree with the OIG's finding that its exchange did not verify applicants' citizenship. After receiving additional documentation concerning the issue from Connecticut the OIG removed its finding and the related recommendation on citizenship verification. 

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