IRS, CMS on track to meet health law deadlines, officials say

With the disastrous launch of HealthCare.gov in October 2013 still fresh in their minds, officials say they are on high alert and expect IT systems to perform well under the strain this time.

The next few months will be taxing for IT systems supporting the implementation of the 2010 health care law. Open enrollment for existing and new customers begins Nov. 15, and HealthCare.gov is preparing for a flood of visitors looking to renew or update their coverage, or obtain insurance for the first time. Those visitors will be making data calls on IRS systems, when they enter information about their income and family size as part of the application process.

At a Sept. 10 hearing of the Health Subcommittee of the House Ways and Means Committee, IRS Commissioner John Koskinen and Deputy Principal Administrator of the Centers for Medicare and Medicaid Services Andy Slavitt assured lawmakers that HealthCare.gov and the information exchange process between IRS and CMS will be tested and ready by the time of open enrollment.

Koskinen pointed to a July 3 report of the Treasury Inspector General for Tax Administration that IRS responses to queries from HealthCare.gov via the data hub connector were accurate 99.97 percent of the time, even during the problematic launch period of HealthCare.gov.

Members were also concerned about the potential for unexpected tax bills being sent to Americans who thought they qualified for a premium support subsidy. Under the health care law, insurance carriers received payments from the government for insurance premiums on the basis of reported income by policyholders. The carriers get the money, but the payments are considered advance tax credits paid to the individuals and families that qualify. Those individuals are responsible to the IRS for the difference between the tax credits that were paid out in advance and what they actually are qualified to receive based on their income for tax year 2014.

"If the data is wrong, thanks to the horribly poor implementation of the Affordable Care Act, hundreds of thousands of Americans could be hit with a nasty surprise when they do their taxes next year, and could be forced to pay back hundreds or even thousands of dollars," said subcommittee Chairman Rep. Kevin Brady (R-Texas).

Koskinen said he had been meeting with IT, program, and business staff every two weeks since January to make sure that the IRS IT systems are ready for the flood of filers, and can process and verify income and coverage data on new forms that will be submitted by filers who have received tax credits. The IRS IT staff is getting its work done, Koskinen, despite a lack of support from appropriators, who denied the Obama administration's fiscal 2014 budget request of $300 million "for building and improving technology systems and processes" to support the tax agency's implementation. "Nonetheless the IRS continues to deliver on this mandate given to us by Congress by refocusing needed funding from other IT and agency priorities," Koskinen said.

Slavitt, who has been at the helm of implementation for about two months, told lawmakers that CMS was planning to test a new system that automatically re-enrolls users in their existing plans if they don't make changes during the open enrollment period. He said a group of "alpha insurers" were testing the system this week, and wider testing with all carriers offering plans under the law would conduct end-to-end testing in October. The auto-enrollment function would run when the open enrollment period ends on Dec. 15.

In addition, CMS is still working on pieces of HealthCare.gov that were "targeted for the first year of development, but [have] not been completed, such as such as more automated back end functionality and launching an online exchange for small businesses and their employees," Slavitt said.