Data Inadequacies Undermine CMS's Oversight of the Inconsistency Resolution Process for the Federal Marketplace

Ensuring that only eligible applicants can enroll in qualified health plans (QHPs) and insurance affordability programs depends on the integrity of the enrollment process. A key part of that process involves resolving inconsistencies between self-attested information submitted by applicants and data received through Federal and other data sources. In June 2014, CMS reported to OIG that the Federal Marketplace was unable to resolve most inconsistencies from the first open enrollment period because the eligibility system was not fully operational. This report follows up on our earlier work, focusing on CMS's data management and resolution of prior inconsistencies.