According to a report from the Ways and Means Committee of the United States House of Representatives, state, federal and local agencies, along with insurers, will exchange protected personal health information of individuals seeking coverage through a state-based Marketplace, or Exchange.
Protected health Information receives strict protections under the Health Insurance Portability and Accountability Act (HIPAA). The Department of Health and Human Services (HHS) ruled that agencies can trade PHI to verify that applicants for insurance through an Exchange are getting the minimum amount of health insurance coverage needed. Individuals do not have to authorize the release of PHI, and HHS will be permitted to work with federal programs (such as Tricare, Medicare, VHA) to determine applicable cost and coverage for individuals.
HHS takes the position that the release of PHI is permitted because it relates to eligibility for or enrollment in a health plan. The PHI will be used only to verify applicant eligibility for minimum essential coverage and determine advance payments of the premium tax credit.
Opponents of health care reform point to the privacy issue as another motivation for dismantling health care reform.
