Health reform implementation

GOP again accuses Sebelius of misleading ObamaCare testimony

 

House Ways and Means Committee Chairman Dave Camp sent a letter to Health and Human Services Secretary Kathleen Sebelius on Tuesday saying she had been “evasive and perhaps misleading” in her testimony before the committee earlier this month.

{mosads}Administration officials have repeatedly said they’re not able to break down enrollees by who has made a payment because they only have access to information about those selecting plans on the HealthCare.gov website, as consumers are expected to pay the insurers directly after enrolling.

Sebelius reiterated that claim in her March 12 testimony to the House panel.

But Camp (R-Mich.) and Rep. Kevin Brady (R-Texas) say they have uncovered “new evidence” that “strongly suggests that the administration knows who has enrolled and paid their first month’s premium.”

The congressmen pointed to an online regulations portal run by the Centers for Medicare and Medicaid Services (CMS) that says insurers are required to inform the agency of “the full enrollment and payment profile” for consumers on a monthly basis.

Camp and Brady are demanding HHS provides them with the information immediately.

“As we have said previously, information about who has paid his or her premium is collected by individual issuers and is not reported to CMS directly by enrollees,” HHS spokeswoman Joanne Peters said in a statement.

“Until the automated payment and reporting system is completed and fully tested, and CMS is able to access individual enrollment and payment information from individual 834 forms, the payment information that CMS receives from insurers is neither final nor complete,” she added. “When we have accurate and reliable data regarding premium payments, we will make that information available.”

The administration has been criticized for releasing enrollment figures that include people who have selected a plan but have not completed the process by making their first premium payment.


The Obama administration has said 5.2 million people had selected a plan through the new exchanges through the middle of March, but the number of people who have actually purchased coverage is likely significantly lower.

Analysts estimate that as many as 20 percent of enrollees haven’t paid their first month’s premium, meaning that roughly 1 million of those counted as enrollees do not actually have insurance coverage.


Critics have warned that the administration’s numbers are inflated because not everyone who selects a plan will complete the final step needed to obtain coverage.

HHS is presently developing a back-end system to track enrollees who have made premium payments.


The administration has said it has some knowledge of how many have paid premiums — the insurers have transmitted to the federal government information about those who have finalized there are enrollment and are eligible for premium tax credits. The administration says this data is not final nor complete because not all issuers have reported back.


Republicans have held dozens of hearings on the botched ObamaCare rollout, and this is not the first time they’ve accused Sebelius of providing misleading testimony.

In January, House Oversight Committee Chairman Darrell Issa (R-Calif.) threatened to investigate Sebelius for “false and misleading” testimony to Congress. The administration rebuked Issa for making those charges and delivered a point-by-point rebuttal of his accusations.