Committee Leaders Press Administration for Documents on Incomplete Appeals Program

February 6, 2014

WASHINGTON, DC – House Energy and Commerce Committee leaders yesterday sent a letter to Health and Human Services Secretary Kathleen Sebelius regarding the inability to process appeals of errors in the applications of those applying for and obtaining health care coverage through the health care law’s exchanges. The letter was signed by full committee Chairman Fred Upton (R-MI), Oversight and Investigations Subcommittee Chairman Tim Murphy (R-PA), full committee Vice Chairman Marsha Blackburn (R-TN), Chairman Emeritus Joe Barton (R-TX), Health Subcommittee Chairman Joe Pitts (R-PA), and Michael C. Burgess, M.D. (R-TX), Vice Chairman of the Oversight and Investigations and Health Subcommittees.

The leaders write that the president’s health care law “requires that exchange applicants be notified by an exchange in the case of an ‘inconsistency or inability to verify’ the information contained in the application. Despite these requirements, the Washington Post recently reported that ‘tens of thousands of people who discovered that made mistakes as they were signing up for a health plan are confronting a new roadblock: the government cannot yet fix the errors.’”

The Energy and Commerce Committee Oversight and Investigations Subcommittee uncovered that the exchanges opened for enrollment before the back end systems were fully built, including the payment feature necessary to transfer payments to insurers and the appeals process necessary to correct errors in applications. The leaders continued, “As a result, individuals who wish to make an appeal over their coverage to the administration can only do so via mail.”

“On October 1 the American people learned the hard way that despite assurances from the administration, the health law was not ready for prime time. More than four months later, the exchanges are still not fully built or functional and people trying to comply with the individual mandate are left to pay the price for the administration’s incompetence,” said Oversight and Investigations Subcommittee Chairman Murphy.

The committee leaders are requesting HHS explain the “process currently utilized to handle appeals via mail,” how many individuals have filed for appeals, what type of issues are being raised in appeals and “whether those mistakes are the result of or other factors.” The members are also seeking, “All documents, including communications, relating to or referring to the appeals process required by the PPACA and the status of the appeals process, including the computer systems supporting that process.”

Read the complete letter online here.