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Ask HN: SSn in health care

3 points by allard ↗ HN
If the American Health Information Management Association advises (link below) against using the Social Security number as an identifier in health care then why did healthcare.gov (the machinery there) send our SSns to the insurance companies?

http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_049016.hcsp?dDocName=bok1_049016

2 comments

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thejteam
I'm pretty sure it is a requirement of the Affordable Care Act. Sending the Social Security number does not mean it will be used as an identifier, but the health insurance company need the number for IRS reporting. They need it:

1)So that the IRS can verify you have health insurance. Technically, this could be done directly from healthcare.gov, but the insurance companies need to report the people who buy insurance off exchange anyway so why duplicate effort.

2)At least in the past few years insurance premiums have been tax deductible for the self-employed, so I imagine the insurance companies report this to the IRS. I am not 100 percent sure this is done, though.

3)Another one I am not 100 percent sure on. The IRS may verify medical expenses paid through an HSA. Having out of pocket totals from the insurance companies may help with this. They may also verify the medical expense tax deduction.

ansible
Just because you shouldn't use it as an identifier doesn't mean you don't need that information in the general case.

SSN as identifiers are bad in the case of: non-citizens, babies, and fraud (may have multiple people with the same ID).

However, if you are dealing with government services (especially anything that touches on taxes or benefits) you'll probably need to provide a valid SSN. And then also be prepared to deal with oddball cases too.