Several Hundred Thousand Medicaid Enrollments could Fall Victim to Federal Obamacare Exchange Glitches

States are warning that they may not process Medicaid enrollments from people who have signed up for the health program through the troubled HealthCare.gov site, raising the prospect that several hundred thousand low-income people who thought they had obtained insurance actually may not have it. 

The federal health-insurance site, which serves residents in 36 states, is designed to sell policies from private insurers. But some people who apply for coverage through the site discover they are eligible instead for Medicaid, the joint federal-state health-insurance program for the poor and disabled.

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So far, the federal government has been unable to transfer full Medicaid applications to states, potentially leaving people who sought to sign up for Medicaid through HealthCare.gov without coverage. 

In all, some 183,396 people who submitted coverage applications through HealthCare.gov were determined to be eligible for Medicaid through Nov. 2, according to data published by the Department of Health and Human Services. Many thousands more are believed to have received similar assessments in the month since then. 

The department had said it was trying to find a way to send the full enrollment data to the states. But on Friday, it wrote to state health officials telling them that the function was still being tested. Meanwhile, the administration proposed sending states partial files about enrollees that the states could process if they choose. 

State officials are balking at accepting partial information. In some cases, they say, HealthCare.gov may have improperly determined people are eligible for Medicaid because their income is too high or they don't meet residency requirements. 

Texas, where 11,682 people were deemed eligible for Medicaid by HealthCare.gov in October, has said it is reluctant to proceed with accepting enrollments from those people based on interim files sent by the federal government. 

"It is critical to verify the accuracy of the information before we take that step," said Kyle Janek, the head of the state program, in a letter to HHS dated Tuesday. 

Other states have said privately that they share those concerns, said Matt Salo, head of the National Association of Medicaid Directors. "There may be a lot of states that don't jump at this option," he said.

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