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Medicaid agency director tries to dispel 'myths' about Obamacare systems

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The agency director tasked with implementing portions of President Obama’s health care law hit back at “myths” surrounding recently published rules on how Americans’ income levels will be scrutinized before they obtain government-subsidized health insurance.

Marilyn Tavenner, director of the Center for Medicare and Medicaid Services (CMS), penned a blog post to address critics who say the Obama administration will rely on the honor system for the first year that state-by-state health insurance markets, or “exchanges,” are in operation.


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“Unfortunately, there have been some mischaracterizations of these regulations and confusion about how the Marketplace will work when it opens later this year,” Ms. Tavenner said. “Let’s do a reality check on some of the myths that have been circulating.”

Ms. Tavenner said the federally run exchanges will review samplings of income data, and states will be allowed — for the first year of implementation — to “decide whether and how to conduct such verifications.”

Republicans have attacked this system as an opening for waste, fraud and abuse of the health care system.

Ms. Tavenner, in her posting, assured Americans that applicants’ income levels will be cross-checked and monitored in several ways.

“No matter which type of Marketplace is operating in a state, the Marketplace will always check the income information submitted by individuals against electronic income data sources such as tax filings, Social Security data and current wage information. … Moreover, the IRS will reconcile advance payments of the premium tax credit when consumers file their annual tax returns at the end of the year, and it will recoup overpayments and provide refunds when they occur,” she wrote.

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