SALT LAKE CITY -- Some Utahns enrolling their families into the public health coverage under the Affordable Care Act are finding that not everyone they want to enroll is covered. It’s a glitch – or communication gap – that has tens of thousands of Utahns left in limbo without coverage.
Kenneth Hunt enrolled his family of six for the new health insurance plan through healthcare.gov in November, ditching the coverage he had in the private sector for nearly twenty years. But then, he ran into a problem.
“My children weren't accepted,” Hunt said.
Healthcare.gov thought Hunt’s four daughters might qualify for coverage through a state program, essentially kicking his kids out of the federal system. The communication between federal and state platforms didn’t happen like it was supposed to.
“You may think that your whole family is on one policy, but keep in mind that it’s possible that part of your family could be kicked out of that system without the system even disclosing that information to you,” Hunt said of the situation.
Judi Hilman with Arches Health Plan explained.
“Healthcare.gov sends a ‘flat file’ to the state and says, ‘you deal with it’ and that data is supposed to be useful,” Hilman said.
Nic Dunn with the Department of Workforce Services said: “You have about 24,000 Utahns who have applied on healthcare.gov. They were told they might be eligible for Medicaid, but because the federal system wasn’t set up to talk to our system yet, the applications were stuck in limbo.”
The problem and concern now for the Hunt family, and thousands of others, is no coverage for some of their loved ones for months, time some don’t have to spare.
“If they get hurt or if they get sick, obviously I can be on the line for thousands of dollars,” Hunt said. “That’s a risk I don’t feel like I should have to take.”
Healthcare.gov looks at a family’s income and how many members there are to make a rough guess if the kids would qualify for Medicaid or CHIP, but it’s the state that ultimately makes that determination. If people applied for coverage on healthcare.gov and got kicked to the state like the Hunt family, if they are eligible for Medicaid or CHIP, that eligibility will start from the date they applied.