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Problems Abound with Health Law Immigration Papers

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

More than 200,000 immigrants who bought insurance through President Barack Obama's health care initiative could lose their coverage this month if they don't submit proof this week they are legally in the country, but language barriers and computer glitches are hindering efforts to alert them.

The government mailed letters in English and Spanish last month notifying about 300,000 people that if immigration and citizenship documents aren't submitted by Friday, their coverage under the Affordable Care Act will end Sept. 30.

However, few seem to be responding. U.S. Health and Human Services officials released information Tuesday showing that 239,000 of the original 300,000 were still receiving final notices.

Immigration advocates say the notices in only two languages don't take into account the wide variety of immigrant languages. They say many who received the letters already have filed the documents either by mail or via computer, but the paperwork was not processed. And they fear most who haven't responded don't understand the gravity of the situation or think they have already complied.

A line at the bottom of the letter advises the recipients to call a phone number if they need the notice translated, said Amy Jones of the Southeast Asian Mutual Assistance Associations Coalition Inc. in Philadelphia.

"People do not know what they say or that they're important. Many have been putting them aside or throwing them away," Jones said. Her agency, which has helped 450 immigrants sign up for health insurance under the new law, is calling enrollees to see if they received a letter and help them keep their coverage.

Early on, some enrollment counselors said they did not input immigration or citizenship information to the glitch-plagued federal website so they could complete the applications. Later, they sent in the documents when the upload feature was working. Federal health officials said Tuesday the upload feature is working for most consumers.

Of the 8 million people who signed up for private coverage through the Affordable Care Act, about 1 million immigrants originally received notices asking for proof they are here legally and nearly 700,000 have been verified. Under the health care law, immigrants who are in the country illegally are not eligible for the program or to receive insurance subsidies.

Florida and Texas have the largest numbers of immigrants whose immigration and citizenship information on file with the government conflicts with what they wrote on their health insurance applications.

Nearly 100,000 in Florida received letters from the feds, yet two of the largest health advocacy groups in South Florida said they've gotten very few phone calls seeking help.

Vicki Tucci, an attorney with Legal Aid in West Palm Beach, said she's heard from fewer than 20 clients, despite meeting with thousands during open enrollment. A few thought the letter was a scam and ignored it, she said.

Perhaps most frustrating, she said all but one of the letter recipients she spoke with had already sent in the documents.

"They had their certified mail receipt with them to prove that they sent it," Tucci said.

However, even those who uploaded the documents by computer to must still call the government's helpline to see if they were received.

Federal health officials on Tuesday disputed much of what the advocates alleged, saying they checked their records in August and only sent letters to consumers who they hadn't yet heard from despite multiple attempts. Consumers can call the helpline for a real time update to verify if the documents had been received, said Health and Human Services spokesman Benjamin Wakana.

Bhagawat Bastola sent in his documents when he first applied for health coverage. Nevertheless, the 24-year-old from Nepal recently received two letters asking for them again. He re-sent them, but Jones' agency called the helpline Friday and was unable to confirm whether the government had received them. Without confirmation, he worries he may lose coverage.

Federal health officials indicated consumers like Bastola are receiving multiple requests because staffers are still processing the documents. The officials said they're working as quickly as possible to sort through them, but didn't give a timeframe.

In other cases, used information from consumers and checked it against databases with other government agencies like the Department of Homeland Security, where the information isn't updated as quickly or may contain errors, especially for naturalized citizens, advocates said.

Consumers who have submitted the requested documents but have not received confirmation by the deadline will remain covered while their application is being processed, said Wakana.

He says only those who don't submit documents are at risk of losing coverage. Those who lose coverage may be liable for paying back at least part of any subsidy they received, up to a cap.