How Many Illegal Aliens Have Received Obamacare?

For months, the Administration has delayed revoking coverage under the Affordable Care Act (Obamacare) to aliens who cannot establish their lawful presence. (Washington Times, Sept. 22, 2014) While the original deadline to sign up for coverage for the year was March 31, 2014, for the past six months, the Administration has allowed all of the nearly one million applicants who initially provided immigration information “inconsistent” with the government’s records to keep their coverage until the end of September, giving them until September 5, and then until September 30, to submit documentation verifying their legal status. (Id.; Washington Examiner, Sept. 15, 2014; State Column, Sept. 16, 2014) According to the latest information the government has released, as of Sept. 5, 115,000 had not submitted documents and were set to lose coverage today. (Id.)

During the debate leading up to Obamacare’s passage, the President promised that illegal aliens would be ineligible for subsidized coverage, but in practice, the law’s faulty enrollment process does not live up to this promise because it does not require aliens to present their immigration documents up front. (See Remarks by President Obama to Congress, Sept. 9, 2009; FAIR Legislative Update, Apr. 16, 2014) Rather than requiring enrollees to present documents at enrollment to prove their eligibility before receiving subsidized health insurance under the federal exchanges, the Centers for Medicare and Medicaid Services (CMS) instead allows individuals to sign up by simply attesting to their eligibility and describing their immigration documents. (See GAO Report, July 23, 2014; see also FAIR Legislative Update, Apr. 16, 2014) CMS then attempts to verify the information provided, such as a Social Security or green card number, with the information the government has on file. (Id.; see also CMS Press Release, Aug. 12, 2014) If there is what CMS calls an “inconsistency” or an “immigration data-matching issue,” meaning the enrollee may be in the country illegally, CMS will reach out to the enrollee to ask for the documentation, but in the meantime, the enrollee continues to receive the coverage. (Id.)

By the end of the 2014 open enrollment period, which was originally March 31, but which the Administration extended until April and even beyond in some circumstances, nearly one million applications on the federal exchanges had such “immigration data-matching issues,” leading to a six month long process where CMS attempted to allow as many of these enrollees as possible to keep their coverage. (Id.; see Washington Post, Mar. 25, 2014) In a press release last August, CMS admitted that by May, 970,000 people with citizenship or immigration data-matching errors had enrolled. (CMS Press Release , Aug. 12, 2014). (Id.) CMS also stated that by August, it had been able to “close” 450,000 cases by contacting enrollees by mail, email, and phone. (Id.) However, it did not explain what happened to the “closed” cases: whether most or all of these enrollees had indeed been able to prove they were legally in the country, and if so, how CMS was able to finally verify their documentation. (Id.) Nor did the Administration provide statistics on how so many inconsistencies arose in the first place. (Id.) The press release also established the September 5 deadline for the 310,000 enrollees who had not responded, and explained that it had sent a letter to all informing them that their coverage would end if they did not meet the deadline. (Id.; see also USA Today, Aug. 13, 2015; Idaho Statesman, Aug. 13, 2014; Bangor Daily News, Aug. 13, 2014; al.com; Aug. 13, 2014; Chicago Sun-Times, Aug. 13, 2014; Charlotte Observer, Aug. 13, 2014; San Antonio Express News, Aug. 12, 2014; azcentral.com, Aug. 13, 2014; Salt Lake Tribune, Aug. 14, 2014;Columbus Dispatch, Aug. 14, 2014; nj.com, Aug. 14, 2014)

However, once Sept. 5 arrived, CMS again extended the deadline until September 30 for the 115,000 enrollees who failed to meet it. (State Column, Sept. 16, 2014) It also created a new, 60 day enrollment window for those who do lose coverage to regain their coverage, meaning that even the September 30 deadline is not exactly a hard deadline. (Kaiser Health News, Sept. 6, 2014)

Furthermore, it is not just the federal exchange that is dealing with immigration related discrepancies, but the state run exchanges as well. For instance, Covered California, the California health care exchange, sent out notices on September 5 to 98,000 families who bought coverage telling them that it could not verify their legal status, and that they had until September 30 to send documents. (Kaiser Health News, Sept. 29, 2014) However, because as of September 29, 50,000 had still not done so, Covered California says it also will accept documents after the deadline. (Id.)

On September 22, true immigration reformer Sen. David Vitter (R-LA) sent a letter to the Administrator of CMS, Marilyn Tavenner, demanding answers. (Sen. Vitter Press Release, Sept. 22, 2014) “The Obama Administration,” the Senator explained, “has been granting deadline extensions, making excuses, and turning a blind eye to falsified documents by illegal immigrants. Enough is enough, and they need to provide answers to why they think illegal immigrants should be eligible for Obamacare.” (Id.) Senator Vitter then demanded CMS provide information including: how many individuals with immigration related inconsistencies have been found to be illegal aliens, how CMS is verifying the information they receive, and how is the Administration planning to get back funds that the government has already paid out to illegal aliens. (Id.) It is “critical,” Vitter concluded, that the Administration “dramatically improves the verification process” before Obamacare’s second open enrollment period. (Id.)

When the second open enrollment period begins, which is fast approaching on November 15, Americans will be able to sign up for health insurance on the exchanges for the 2015 year, but there is no sign the Administration has fixed these issues. (See Washington Post, Nov. 22, 2013) It seems possible that some of those who never did resolve their immigration discrepancies can simply sign up for the next plan year in a few weeks.

This article was originally published in FAIR’s Legislative Update on September 30, 2014.