Beginning October 1, 2013, U.S. citizens and lawful aliens began using Health Insurance Marketplaces to obtain health coverage through the Affordable Care Act (ACA). Marketplaces review applications to determine their eligibility for, or exemption from, Insurance Affordability Programs. When an individual files an application, Marketplaces send their Social Security number (SSN), name, and date of birth to the Centers for Medicare and Medicaid Services (CMS). CMS then electronically sends this identity information to SSA for verification. SSA either verifies the information or sends a non-verified response to CMS.
The objective of our audit was to assess SSA's Affordable Care Act (ACA) – Health Insurance Exchange (HIX) SSN verification process.
To accomplish our objective, we reviewed ACA-HIX SSN verification policies and procedures and interviewed SSA and CMS officials. We also determined whether SSA could provide additional information to CMS to enhance program integrity.