About 100,000 Californians who haven't yet proved their citizenship or legal residency in the U.S. face losing their Obamacare coverage in October, state officials said.
Covered California, the state-run insurance exchange, enrolled more than 1.2 million people during the rollout of the Affordable Care Act this year. For most consumers, the exchange said, it could verify citizenship or immigration status electronically with a federal data hub.
However, Peter Lee, the exchange's executive director, said Thursday that about 100,000 people must still submit proof of eligibility or risk losing coverage in October. He estimates that most of the people affected are legal residents.
People living in the U.S. illegally aren't eligible for health law coverage. The issue is particularly acute in California, which has a large immigrant population.
Last week, U.S. officials said the federal exchange serving 36 other states had more than 300,000 people who had not documented their citizenship or residency and risk losing coverage.
Lee said Covered California has been trying to clear up these inconsistencies and has already processed 600,000 documents to prove eligibility. The state will start sending notices to affected consumers early next month and follow up with more communication.
"If individuals are not able to provide that proof by late September or October, we will have to terminate their coverage," Lee said at an exchange board meeting Thursday. "This is not something we want to do."
Consumer advocates emphasized the need to communicate clearly in the government notices and offer information in many languages.
"We need to make sure those notices go out in clear language," said Carla Saporta, health policy director at the Greenlining Institute, a nonprofit group.
Lee said he welcomed outside input to avoid potential confusion. He attributed much of the problem to paperwork issues, not evidence of fraud.
"We are quite confident where people have not provided information it's not because they are not citizens," Lee said. "Rather, it's a challenge of getting the information to us."
The need to resolve these paperwork issues has led the exchange to pull service center workers away from taking customer calls. As a result, the exchange reported, call center performance has suffered.
In July, the state said, only 38% of calls were answered within 30 seconds, well short of the state's 80% goal. Nearly a third of callers abandoned their calls, according to exchange data. Long wait times have been a persistent problem for Covered California.
The top query at the call center came from people asking about the status of their application for Medi-Cal, the state's Medicaid program for lower-income residents. California is still sorting through about 400,000 Medi-Cal applications.
Enrollment in Medi-Cal is open year round. The next enrollment window for individual health insurance starts Nov. 15.