Credit check required for ACA insurance exchanges?

[Erose999]

One of my RW "acquaintances" on Facebook recently posted about the Obamacare insurance exchanges requiring a credit check and that those with bad credit may have to pay a higher premium. He did not attribute a source to these claims.

Anyone know if thats true? I haven't read up on the exchanges much as my state doesn't have one and the federal exchange insurance seems pretty shitty.

[Shivering Jemmy]

1. Wrong

[Sedona]

2. No, they are just using Experian to verify idenity

[Erose999]

13. Why would the gov't need to use a credit reporting agency to verify identity though? I mean isn't

that why we have a social security number? I mean they don't pull my credit report when I pay my taxes.

[PoliticAverse]

20. It isn't just identity, they need to determine if you are acutally eligible for subsidies

which you aren't if you are employed at a company that offers you qualifying health insurance.

Equifax Workforce Solutions (a/k/a TALX Corporation, a/k/a The Work Number, a wholly owned subsidiary of Equifax Inc.) was recently awarded a federal contract by the Department of Health and Human Services (HHS) to verify the incomes, employment, and employer-sponsored health coverage status (including price) of American consumers who apply for federal tax credits to offset insurance premium costs under the Obamacare insurance mandate (as stipulated by the Patient Protection and Affordable Care Act (PPACA)).

https://www.annualmedicalreport.com/credit-reporting-agency-equifax-workforce-solutions-hired-by-hhs-to-verify-incomes-obamacare-insurance-subsidies/

[Erose999]

21. I don't understand why the IRS couldn't do that though? Do credit agencies have access to more info

that the IRS?

[PoliticAverse]

56. They go to the IRS and Social Security Administration for the information first, if they can't give

Last edited Wed Oct 9, 2013, 03:51 PM - Edit history (1)

the info needed then they use Equifax to verify employment/income.

http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/income-verification-8-5-2013.pdf

Q: Will Marketplaces be verifying the income of consumers as a part of the eligibility process for
advance payments of the premium tax credit and cost-sharing reductions

A: Yes. According to 45 CFR
155.320(c)(3), Marketplaces will always use data from tax filings and
Social Security data to verify household income information provided on an application, and in many
cases, will also use current wage information that is available electronically. The multi-step process
begins when an application filer applies for insurance affordability programs (including advance
payments of the premium tax credit and cost-sharing reductions) through the Marketplace and affirms or
inputs their projected annual household income. The applicant’s inputted projected annual household
income is then compared with information available from the Internal Revenue Service (IRS) and Social
Security Administration (SSA). If the data submitted as part of the application cannot be verified using
IRS and SSA data, then the information is compared with wage information from employers provided
by Equifax. If Equifax data does not substantiate the inputted information, the Marketplace will request
an explanation or additional documentation to substantiate the applicant’s household income.

[Mojorabbit]

30. I also don't get how The credit agency has access to info

regarding one's health insurance status. Is this something new? I can see them having info re your debt but i had no idea they had this info.

[Chan790]

36. Because Equifax's TALX division manages HR services for corporations as a contractor.

When combined with what they know as a credit agency, they know more about you (and everybody) than you know about you. They're a nearly-omniscient privacy monster; people should be far more scared of them than they are of the NSA.

"O brave new world. That has such people in't!" - The Tempest (Act. V, Scene I), Wm. Shakespeare

[Mojorabbit]

41. Thank you for answering my question

I had no idea they did this!

[Sgent]

61. Look up Medical Information Bureau

Health insurance info is exchanged among insurers much like credit information is among lenders.

[Mojorabbit]

68. Thank you

I can see why they would do that. I was unaware till today that experian had a branch that dealt with health insurance. I thought they were just involved in financial matters. I appreciate the information.

[VanillaRhapsody]

51. Unless that insurance is more than 9.5% of your salary and you as an individual make less than

$45,000 a year.

[Zorra]

52. Exactly. I absolutely detest multi-national corporations, and have no problem verifying my identity

to my government.

[NYC_SKP]

3. Lies.

[hlthe2b]

8. I'm glad that that is the case as I have lots of friends/collegues/family who have suffered

periods of "slow credit" due to the economy and/or job loss the past several years. It is THEY who ACA is at least largely intended to help, given they are now out of employment-offered insurance pools.

[mac56]

4. Dismissable. Many, many people have posted here on DU about their enrollment experiences

and not one has mentioned any sort of credit check.

I do believe your acquaintance has been sold a bill of goods.

[Niceguy1]

7. it can effect

Automotive insurance rates

[leftyohiolib]

5. Anyone know if thats true? really you have to ask?

rw=lie

[pipoman]

9. Maybe.

The insurance industry has done this for years. It would be unseemly in this case because many or most people using the program are low to lower middle income I suspect..

[Yo_Mama]

16. Unseemly is more of a moderate expression than I would use.

I hope very much this is not true.

[GladRagDahl]

6. Hmmm....There are some news reports that they are

This is one. http://www.clickorlando.com/news/credit-scores-impacting-new-affordable-care-act-insurance-plans/-/1637132/22341034/-/l0jmq3z/-/index.html

[ScreamingMeemie]

10. Here is a debunking of that...

http://www.dailykos.com/story/2013/10/08/1245476/-Ridiculous-Florida-TV-Station-Claims-Credit-Scores-Affect-ACA-Premium-Prices#

snip-
No, Anne, credit scores don't impact the price of premiums. These things do: your age, where you live, and whether or not you smoke. Also, of course, the level of subsidies received on the exchange will contribute to the final sticker price for a given individual.
This just isn't true -- remember that Florida's 'marketplace' is run by the federal government. Were this the case, which it's not, wouldn't we be hearing reports of this problem from all 36 states whose marketplaces are being run by the feds? Well, we're not, because this story is not true.

Nobody is being denied access to an ACA health plan in Florida because of their credit score. Credit is absolutely irrelevant to this process.

The individual spreading this lie, Anne Packham, seems to be the 'lead Navigator' in Florida -- was she specifically chosen by the Florida GOP to spread disinformation, fear and lies about the ACA? Based on this report, that seems very possible.

-snip

The comments from other navigators in other states are particularly interesting.

[hlthe2b]

11. ^^This^^

ScreamingMeemie, please make a separate thread on this debunking.... It is THAT important, IMO.

[ScreamingMeemie]

12. Done...

I particularly loved this comment:


Just reread the TV news comment and realized that
Anne Packham was described as licensed by the state to help people navigate the system. If Florida is not running its own exchange and the federal government is running the program, as they are in so many red states, what does the state of Florida have to do with signing people up. Is she working for an insurance company? We do not work for insurance companies. We work for the exchange. We are not allowed to recommend any plan. The consumers must make their own decision as to which company and which plan they feel is the best for them. Or is she a shill for Rick Scott trying to convince people that this is an invasive and humiliating procedure?

[NYC_SKP]

14. Good find! Though I don't think the GOP chose her.

I did a little research, I think she's just giving answers instead of saying "I don't know".

[Erose999]

22. The DailyKos piece doesn't attribute any sources though.

[ScreamingMeemie]

34. sigh...

http://www.clickorlando.com/news/Lead-health-care-navigator-in-Florida-provides-wrong-information-on-credit-scores/-/1637132/22341034/-/md8ohn/-/index.html

Ann Packham tells Local 6 she was incorrect about Affordable Care Act


Starting January 1, 2014, insurance companies must adhere to minimum premium rating rules for individuals and small businesses.
Health plans will be allowed to adjust premiums only for the following factors:
*Self-only or family enrollment;
*Geographic area;
*Age (except the rate cannot vary by more than 3 to 1 for adults); and
*Tobacco use (except the rate cannot vary by more than 1.5 to 1).


That is from the ACA. I suggest you read it before going screaming off into the woods based on a news report from a Florida television news report.

[Mojorabbit]

35. I hope to see more mainstream denials than kos

not that I don't trust them. I have a feeling it will be settled one way or another before the day is done.

[ScreamingMeemie]

37. Okay...here...

Ann Packham tells Local 6 she was incorrect about Affordable Care Act

http://www.clickorlando.com/news/Lead-health-care-navigator-in-Florida-provides-wrong-information-on-credit-scores/-/1637132/22341034/-/md8ohn/-/index.html


It is extremely disappointing to see this kind of stuff happen on DU.

[Mojorabbit]

39. I disagree

This is the place where things are researched and debunked. It is the place that comes up in search engines. It if great that we have threads like this.

[ScreamingMeemie]

42. While making half us look like idiots...

Idiots as in, I saw this one thing on facebook, linked to this news station in Florida...so it's true!

Research first is always a great idea.

[Mojorabbit]

44. I disagree again

A person who is trained to be a navigator goes on the local news and says this. She is supposed to be an expert on the subject. We get one denial on daily kos. Finally after a ruckus, she admits she made an error today. I have not seen it on facebook but this IS my local news. Only an idiot would NOT ask if she was correct or not.

[ScreamingMeemie]

45. Ummm no, and we'll have to agree to disagree.

A wildly ridiculous comment made by one tiny person should not equal an "I refused to be budged even when presented with the facts" thread on DU. (and I am not a blind Obama follower and I am also not particularly fond of ACA as my posting history the last 5 years will show) It's Freerepublic-type idiocy, and I wish we didn't play along.

[Mojorabbit]

49. I don't see anyone refusing to be budged. I see people asking questions.

I personally learned a lot today about Experian. I am not a blind supporter either so I ask questions
and I look for answers from reliable sources.

[Tarheel_Dem]

55. DU; aka The New Libertarian Haven. The spreading of unfounded rumors seems to be just one more....

arrow in the quiver, and sadly it's coming from both sides. NorquistDogLake is a perfect example. They tried to kill the ACA in it's cradle, and have done everything in their power to ensure it doesn't succeed. This is a disturbing trend. Thanks for debunking the FB chatter.

[Mojorabbit]

67. Why do you all have to drag libertarians into every conversation?

They have nothing to do with the subject of this thread.

[Tarheel_Dem]

69. Au contraire! They have everything to do with it.

[cthulu2016]

17. Trolls have been spreading that (one) report far and wide.

[geek tragedy]

19. And recommending such threads as well. It's a theme with them nt

[Yo_Mama]

15. They are using Eperian to check identity

However when your app finally goes to the insurance company you have chosen, it may be that in some states they are using credit scoring to figure out whether to reject it. (Credit scores can be used as a proxy for ill-health/higher medical expenses.)

I am trying to find out whether this is legally allowed in some states. There does not seem to be any provision in ACA requiring an insurance company to accept every application it does get from the exchange.

If so, this is part of the law that should be changed.

[grantcart]

27. first part is correct but the second part is not.

Once you finish the application on line there is no further acceptance/decline by the insurance company.,


No preexisting conditions can be considered.


Only age and location can be used for application purposes.

[Mojorabbit]

38. Are you working in the system? I am just trying to figure out

if you have inside experience and information.

[PoliticAverse]

18. Equifax, Experian will earn millions doing ID checks for new health care exchanges;

will their systems work?"

When consumers try to sign up at just-launched health care exchanges next week, they might be surprised that credit bureau Experian and its telephone help desk may stand in the way. And those seeking a subsidy will be confronted by Equifax’s controversial The Work Number product, a massive database the firm now holds which includes week-by-week paystub information for tens of millions of Americans.

As states around the country prepare to open their health care exchanges for business, the technology that will be used to positively identify consumers’ identities and other information is being called into question. Equifax has a contract that could pay $330 million over five years to make sure consumers don’t lie about their income when applying for subsidies. Experian is part of an $80 million contract to supply technology that will make sure consumers are who they say they are when they sign up.

Read the rest at: http://bobsullivan.net/privacy/credit-bureaus-stand-between-americans-and-new-health-care-exchanges-can-they-answer-the-calls/

[grantcart]

23. this is simply not true

Equifax has a contract that could pay $330 million over five years to make sure consumers don’t lie about their income when applying for subsidies.

They are simply confirming, in cases where some ambiguity, the identity of the application.

All income figures come from your tax filings.

[PoliticAverse]

29. Experian confirms ID, Equifax confirms income/employment...

In fact they testified as to their readiness to do so in front of Congress in Sept:

From: http://www.benefitspro.com/2013/09/10/panel-told-ppaca-implementation-on-track

Lynn Spellecy, a corporate lawyer for Equifax Workforce Solutions, said the subsidiary of the well-known credit reporting company is ready to help verifying income and employment.

[grantcart]

43. Your own link confirms my point: the IRS is the main source for income data.

They are using IRS returns.

I know that for a fact because we just submitted an amended return 4 weeks ago and that was what was used.

And that is stated in your own link:

The hub will ping federal agencies such as Social Security, Homeland Security and the Internal Revenue Service to verify identity, legal residence and income.

Now in the event that someone isn't filing IRS statements because their income is too low and they have no taxable income I would imagine that for those applicants they would have to Equifax to certify income.

We couldn't lie about our income because we were never asked about our income.

I suspect that the sentence by the blogger you quoted should have read like this

Subsidies will be determined by IRS returns and in cases where there are no returns Equifax will be used to make sure consumers don’t lie about their income when applying for subsidies.

Some type of service is needed to give real time confirmation of income if you are going to give subsidies in real time.

BTW one of the main talking points on RW sites against the ACA is that it will be easy to misstate your income and cheat on the subsidy.

[PoliticAverse]

47. Actually it refutes your point that the credit reporting agencies have nothing to do with income

verification and only identity when you wrote:

"They are simply confirming, in cases where some ambiguity, the identity of the application.

All income figures come from your tax filings".

It is correct that Equifax data is only used if the exchange can't verify your data from the IRS or SSA:

http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/income-verification-8-5-2013.pdf

Q: Will Marketplaces be verifying the income of consumers as a part of the eligibility process for
advance payments of the premium tax credit and cost-sharing reductions

A: Yes. According to 45 CFR
155.320(c)(3), Marketplaces will always use data from tax filings and
Social Security data to verify household income information provided on an application, and in many
cases, will also use current wage information that is available electronically. The multi-step process
begins when an application filer applies for insurance affordability programs (including advance
payments of the premium tax credit and cost-sharing reductions) through the Marketplace and affirms or
inputs their projected annual household income. The applicant’s inputted projected annual household
income is then compared with information available from the Internal Revenue Service (IRS) and Social
Security Administration (SSA). If the data submitted as part of the application cannot be verified using
IRS and SSA data, then the information is compared with wage information from employers provided
by Equifax. If Equifax data does not substantiate the inputted information, the Marketplace will request
an explanation or additional documentation to substantiate the applicant’s household income.

[grantcart]

50. All income does come from the IRS except for those who did not file because

their income is too low or other exigent circumstances.

The main point is that credit agencies don't have a significant role in determining the subsidies.

They don't even have a central role in providing the key data.

Their role is to provide data when and where the federal agencies don't have data.

The statement "All income comes from your tax data" is correct but slightly incomplete in that it didn't address the situation covering the relatively small percent of the people who don't have tax data.

[enlightenment]

40. It's a little more than that.

http://democrats.energycommerce.house.gov/sites/default/files/documents/Smith-Equifax-PPACA-Contractor-2013-8-6.pdf

https://www.fbo.gov/?s=opportunity&mode=form&tab=core&id=d8930d51efdc56a5110920f04a68ae72&_cview=0

They are most definitely checking "current sources of income and employment verification" - initially by using IRS data, but on a continuing basis they will use their in-house data collection.

To determine eligibility for Advance Premium Tax Credits and eligibility in Medicaid or CHIP, the data hub will
use Internal Revenue Service data. On a continuing basis, CMS will use data supplied by TALX to identify "changes to an individual’s income through periodic data validations; and as part of processing individuals’ requests to seek an eligibility determination for insurance affordability programs."

http://www.mckennalong.com/media/library/2035_SOTS%204%205%2013.pdf

[grantcart]

46. You are correct and that confirms my main point

1) subsidies are being determined primarily by IRS data

2) If people are filling because their income is too low then they would use credit agencies to confirm

3) the reason that they use the services is to speed up the time it takes to make a determination of subsidy so that applicants can get it in real time as they apply.


When they give you the subsidy they do tell you that if you have an increase in income then the subsidy can be revised.

This is a little bit like 'damned if you do and damned if you don't'.

One of the main attacks by the RW on the subsidies is that it was suggested that it would be easy to cheat on.

Everything about the use of the credit agencies seems to be consistent with good management practices and the credit agencies have only a secondary information providing role and are not involved in the decision making process, as others have alleged.

[enlightenment]

48. Not arguing what they are contracted to do,

although I absolutely disapprove of another for-profit, private corporation (two, actually - the contract for identity verification went to Experian and the one for income went to Equifax) being used as an arm of the government . . . but that's just the dying embers of my democratic principles kicking up a fuss. After all, the Supreme Court of the Land has told me corporations are people, too, so I can rest easy.

As to your last comment - on that I think we'll have to wait and see if people with the same subset of state/income/age/smoker or not are being quoted the same rates. Presumably, if all things are equal then their quoted premium should be the same whether their FICO score is 400 or 800 - if they're not, then someone is going to have to explain why.

It may or may not happen - I'd like to think not, but the "fine print" is notoriously difficult to locate in all this and the devil, as they say, is in the details.

[grantcart]

53. It is unfortunate that we seem to be developing a knee jerk reaction to any for

profit enterprise that is involved in getting the government's work done.

Part of the problem is a lack of awareness of just how the government actually conducts its business. Medicare is held up as the gold standard, as it should, of government single payer health insurance. There are no government offices that handle Medicare insurance forms, that is all contracted out:

http://www.acponline.org/residents_fellows/career_counseling/medclaimsproc.htm

Medicare claims are processed by non-government organizations or agencies that contract to serve as the fiscal agent between providers (hospitals, doctors, and other health care providers) and the Federal Government. These claims processors are known as "intermediaries" and "carriers." They apply Medicare coverage rules to determine the appropriateness of claims.

In this case the ACA uses all kinds of sub contractors

Cheryl Campbell, a senior vice president of CGI Federal, Inc., said her company is "confident" its part of the job will be ready Oct. 1. The Virginia-based contractor is building the federally run marketplace, with Washington running the markets or taking the lead in 35 states.

Michael Finkel, an executive vice president of QSSI, Inc., delivered a status report on the lynchpin of the system, a federal data hub that functions as the router for verifying key eligibility data. The hub will ping federal agencies such as Social Security, Homeland Security and the Internal Revenue Service to verify identity, legal residence and income. Finkel said his Maryland-based company expects the hub to be ready as planned.

John Lau, program director for Serco, said his company is staffing up to handle paper applications and other tasks.

Use of these highly specialized subcontractors for very particular functions that lie outside of the government's immediate scope of expertise should not be confused with the less welcome practice of taking established general skills and moving them from government employment to private contractors (for example an electrician working on a military base).

The focus on the credit agencies and their supply of data (identity and in some rare cases income) is an unfortunate diversion of what is actually taking place:

For the first time people are signing up for a government subsidy or service and getting a dollar amount credited to them in real time

In order to do that (which I think is pretty amazing) they need to make sure they have information that is accurate on a real time basis. If the credit agencies are the best ones to provide that key data on a real time basis then I think it is well worth it, but then I got $ 3600 by clicking on a button so I may be biased.

[enlightenment]

57. Yeah - well, I've felt that way most of my adult life

so I don't consider it a "kneejerk" response.

You're free to think it's wonderful.

[grantcart]

58. you will have to define your antecdent before I can tell you if I think it is wonderful

[enlightenment]

60. You're right, it was an incomplete sentence.

"It" should be defined as the public/private partnership that defines the underlying operation of the PPACA. You think it's a good thing and nothing to worry about - I disagree.

[grantcart]

62. How about I won't charachterize your position and you don't charachterize mine.

I am happy when the government can introduce a major new benefit and allocate it directly to the citizen with little red tape and in a few minutes. If to achieve that radical new level in government service they have to use some sub contractors who have particular and unique skills and done in a fiscally prudent way (and is not really dissimilar to how it handles other government processes, like Medicare) then yes please color me happy.

After saving the federal government tens of millions contracting services and paying over a million dollars in income taxes over the last 30 years I filled out an application that took me less than 5 minutes and as a 59 year old diabetic got a $ 3600 subsidy. I have never qualified for any direct government subsidy or benefit but have heard how dehumanizing, time consuming and frustrating it has been for people who have struggled in the past. That it is now none of those things makes me not just happy but proud of what can be done when you have smart, committed and dedicated political leadership.

[enlightenment]

63. Works for me. nt

[KoKo]

26. Unless someone finds out that Bob Sullivan is a RW'er...this was

and interesting and informative article.

[PoliticAverse]

31. I think the problem is that some people claimed they these companies were doing a 'credit check' on

ACA applicants, but although Experian and Equifax are credit reporting agencies in this case
they are were contracted by the Federal Government to verify applicants ID (Experian) and
income/employment (Equifax) and are not giving credit scores on applicants to insurance agencies.

[KoKo]

64. I think there are many worried about their "Credit Score" being barrior to ACA Qualifications

...but, the fact IS that our Government employed these very people to "Qualify" those who are most in need of insurance...SURE DOES RAISE RED FLAGS.

So...that people are having problems getting on Easily to the ACA Program shows there's some problems, and folks are asking "WHY" is not a reason to diss them. IMHO.

[Erose999]

32. Thank you, this is the information I was looking for, attributed to credible sources rather than

blogs, etc.

[PoliticAverse]

33. Note there is no 'credit check' or 'credit score' being reported, the Federal government (HHS)

contracted with Experian to do applicant ID verification and Equifax to do income/employment verification
ultimately to determine who is actually eligible for getting the ACA's health care subsidies (or who is actually
eligible for the expanded Medicaid).

[grantcart]

24. Nope

In order to give an instant subsidy (mine is $ 333 a month) they need to make sure that they are taking application from the right person.

When there is an ambiguity then they use credit services to confirm it.

[JPZenger]

25. Undocumented persons are ineligible for subsidies

The ACA does not allow for federal subsidies for persons who are not legal residents of the US. This verification process is probably supposed to help with that screening.

[Iggo]

28. No.

[kestrel91316]

54. More lies from the RW. They lie ALL the time. Particularly about ACA.

[Tarheel_Dem]

59. Having worked in healthcare financing for the past 30 years, I can tell you that government programs

such as Medicare & Medicaid are contracted out to for-profit insurance companies. The government payroll would burst at the seams if that weren't the case. For us here in NC, Palmetto is our fiscal intermediary for Medicare, and CSC is the contractor for Medicaid. Even if liberals got the single payer system they pine for, they'd still be dealing with government contractors, who are for-profit.

[bluestate10]

65. NO!!!, absolutely not. nt

[bluestate10]

65. NO!!!, absolutely not. nt