On the launch of and state-based exchanges, a major fear gripped undocumented sections of the American population – could the Immigration authorities use the information submitted for getting health coverage on Obamacare marketplaces to take action? The people living undocumented in the country feared that if they disclose their family income and status while applying for the coverage, the personal information they divulge might create problems later. The fear was so strong that most of these groups did not participate in Obamacare exchange enrollment, and preferred to stay away from better health insurance coverage.

To cull this fear and help these communities enroll with the system, the administration planned to allay the other issues this population generally faced including issues with internet connectivity, lack of education, etc. In fact, the administration went as far as to make an official statement that the U.S. Immigration and Customs Enforcement wouldn’t use the information divulged for enrolling on exchanges for immigration checks. All these measures added together motivated these specific groups to enroll with the system without fear.

However, 310,000 people have been contacted with a notice that prompts enrollees to prove that they are U.S. citizens or legal residents, and a failure to do so might result in a stop on the issued healthcare benefits. The CMS has specifically asked enrollees to share additional documentation that establishes them as a citizen or legal resident. This information was to be sent by September 5, 2014. If enrollees are not able to provide this proof, their healthcare benefits and health insurance plans will be voided after September 30th.

State Exchange

For now, people who have received more than five similar notifications in the past to prove their citizenship are being contacted first. CMS wants to minimize disenrollment resulting from this measure, and that is the primary reason behind issuing so many reminders to people who haven’t yet responded with their documents. Even if the department finds any kind of discrepancies between an individual’s application and his documents, enrollment might still stay in force. However if the enrollee is undocumented, he will be considered an illegal immigrant and all health insurance benefits will be withdrawn.

On a larger scale, this move is a part of the reconciliation process initiated by the Department of Health and Human Services. The reconciliation process was initiated after the six-month enrollment period ended.  Currently, more than 2 million enrollees are a part of this reconciliation process that is fixing issues ranging from incomes reported for subsidy qualification to citizenship status. The reconciliation process is a by-product of the troubled exchange rollout that marred Obama exchanges in October last year.

As a part of this process, 970,000 people were highlighted for reconciliation on the grounds of citizenship status. Up to now, 450,000 enrollees have been reconciled with the system and their health plans remain in place. Another 210,000 people are in the process, and the remaining 310,000 people haven’t responded to repeated notices and reminders. Florida has the largest numbers of people, 93,800, who haven’t responded to prior such requests; followed by Texas with 52,700 people, and Georgia with 20,900 applications.

Other than a slew of reminders and contact points, the administration has also established community specific organizations that can help these enrollees with questions, doubts, and guidance on process compliance and document submission. At this time, education and outreach are working.

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