Unemployment Insurance Program Letter No.4-15- U.s. Department Of Labor

section 1413(c)(3)(A)(ii), ACA, must “determine such eligibility on the basis of reliable,

third party data, including information described in sections 1137 . . . of the Social Security

Act, obtained through such an arrangement.” For this reason, health insurance exchanges

seek to obtain confidential UC information through IEVS to determine individuals’ eligibility

for Medicaid and health insurance exchange subsidies.

Department of Labor (Department) regulations at 20 CFR part 603, issued in September

2006, address the requirement, as a method of administration to insure full payment of UC

when due under section 303(a), SSA, that states maintain the confidentiality of UC

information. These regulations specify to whom, and under what circumstances, confidential

UC information may, or must, be disclosed. Subpart C of part 603 governs the required

disclosure of confidential UC information to participants in IEVS; the IEVS regulations

predated the 2006 final rule and were not amended by that rule except for renumbering.

Under section 1137, SSA, the Medicaid program is a required participant in IEVS and is

therefore covered under the mandatory disclosure requirements of 20 CFR part 603, subpart

C. As described below, the health insurance exchange is treated as a Medicaid program for

IEVS purposes and, thus, is also covered by the mandatory disclosure requirements.

4. Applicability of section 1413, ACA, to state UC programs. The Department of Health and

Human Services (HHS) has responsibility for administering both IEVS and the ACA

provisions applicable to health insurance exchanges. HHS requires that IEVS be used to

determine eligibility for Medicaid (as required for that program under section 1137(b)(2),

SSA, and 20 CFR 603.21(b)), each state’s Children’s Health Insurance Program (CHIP), and

advance payments of the premium tax credit, where the state Medicaid agency will request

information from the state UC agency as it currently does to determine eligibility for

Medicaid. HHS has determined that, based on section 1413(c), ACA, and section 1137,

SSA, participants in IEVS are required to share wage information identified in section

1137(a)(2), SSA, subject to the safeguards requirement in section 1137(a)(5). HHS

determined that, in each state, participants in IEVS are required to share with the health

insurance exchange, which is the entity making Medicaid eligibility assessments and

determinations.

With respect to protecting confidential UC information, the safeguards in section

1137(a)(5)(A), SSA, apply to data exchanges for, or with, the health insurance exchanges.

This includes the requirement that information released under section 6103(l) of the Internal

Revenue Code be exchanged only as needed to assist in the valid administrative needs of

authorized programs.

Thus, whatever information a state UI agency has been sending to an IEVS required

participant for Medicaid eligibility purposes must, under section 1137, SSA, be sent to the

health insurance exchange for purposes of determining eligibility under the ACA for both

participation in the exchanges to obtain private health insurance, and for Federal subsidies for

such insurance. This applies both to wage information and to claims information, if that

information is requested.

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