House Republicans think Sebelius is holding out on them.
GOP leaders on the House Ways and Means Committee say the U.S. Department of Health and Human Services has been withholding information about paid exchange plan enrollment levels.
Chairman Dave Camp, R-Mich., and Rep. Kevin Brady, R-Texas, chairman of the Ways and Means health subcommittee, make the allegation in a letter sent Tuesday to HHS Secretary Kathleen Sebelius.
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HHS officials have said that the issuers of the private "qualified health plans" sold through the exchanges collect the plan premium payments at the federal exchanges and at most of the state-based exchanges.
The plan issuers are the ones that now have the paid enrollment numbers, not HHS, and HHS won't have complete, accurate plan payment data until tech teams finish work on automated exchange information reporting systems, officials have said.
At a Ways and Means HHS budget hearing March 12, Sebelius said, in a response to a question from a committee member, that any federal paid enrollment numbers "are aggregate numbers based on only those customers who would be qualified for either cost-sharing or [advanced premium tax credit subsidies], and that's not at all the entire look of the marketplace."
Camp and Brady say the answer Sebelius gave was not accurate.
The Centers for Medicare & Medicaid Services told carriers in January, in an answer to frequently asked questions, that they must give CMS a template recording "effectuated" enrollment data every month, the lawmakers write.
The "effectuated enrollment" numbers represent the number of people who have paid the plan premiums, Camp and Brady say.
"Please provide this information in its most updated form immediately," Camp and Brady say. "It will give the committee and the American people real-time information about the number of individuals who have paid their first month's premium and are eligible for a tax credit or cost-sharing subsidy."
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Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
