Question: Are you saying that the Exchange is going to accept whatever the applicant tells them without verification? That’s crazy.
Answer: Depending on an individual’s specific circumstances, the Exchange can verify the information, from the following sources:
- Social Security Number (SSN) (Social Security Administration [SSA]) (An individual does not have to provide an SSN if he or she does not have one.)
- Residency data
- Citizenship status (SSA and Department of Homeland Security [DHS])
- Immigration status (DHS)
- American Indian or Alaska Native status
- Household size (IRS)
- Household income (IRS, SSA, Equifax, potentially other sources)
- Access to other coverage (Medicaid, CHIP, Medicare, TRICARE, Department of Veterans Affairs, Peace Corps, other Marketplaces, the SHOP, and potentially other sources)
Finally, the Exchange can and will ask an applicant to fax a copy of a pay stub, utility bill, green card, etc. After all that, the Exchange may have to “take their word for it” and let the IRS sort it out at tax time.