Watch: What People Need to Know If They Face a Data Matching Issue

By Jose L. Plaza

Millions of Americans have benefited from the new coverage provisions made available by the Affordable Care Act, and at the end of the third open enrollment period for marketplace coverage, about 12.7 million individuals had enrolled.

To ensure that individuals keep their new coverage, Enroll America hosted a webinar moderated by SpeakHispanic and in partnership with the Center on Budget and Policy Priorities and the Centers for Medicare and Medicaid Services to walk through the steps people need to take if they received a notice from the marketplace about a “data matching issue.”

Watch the recording for an overview of why people might face data matching issues, and what steps they need to take if they do:

During the application process, individuals must provide the marketplace with information about their household situation, e.g. projected annual household income. The marketplace verifies this information to determine eligibility for coverage (with or without financial help). A “data matching issue” means that the marketplace cannot verify the information submitted by the applicant. Individuals in this situation will receive a notice from the marketplace asking for additional documentation.

Consumers have 90-95 days to correct any issues in their application from the date of submission, or risk losing their coverage.

In order to purchase coverage through the marketplaces, individuals must:

  • Live in the United States
  • Be a U.S. citizen or in the U.S. legally
  • Cannot be incarcerated

As discussed during the webinar, the three main reasons someone would need to submit documentation to the marketplace would be to verify lawful immigration status, citizenship, and/or eligibility for financial assistance. Communities affected by this issue could be more likely to be uninsured in the first place, and local organizations have a key role to play to help consumers navigate these situations.

During 2015, 223,000 households had a data matching issue related to their annual household income that resulted in an adjustment to the amount of financial help they received, and 117,000 individuals lost coverage because of a citizenship or immigration status issue. Local coalitions and groups that work directly with immigrant groups have a role to play to ensure that those most disenfranchised by language barriers and lack of access to technology and health insurance information understand the steps they need to take to keep their coverage.

How does one know if someone has a data matching issue? Every consumer receives an official notice of eligibility letter; that letter will let them know what, if any, documents they are still missing.

Looking to connect someone to help? Remember, the Get Covered Connector (available in English and Spanish) can link people to in-person assistance in their community if they need help resolving a data matching issue.


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