"First they ignore you, then they ridicule you, then they fight you, then you win." -- Mahatma Gandhi

AP: “Probe: Bogus Enrollees Kept Getting Obamacare”; Democrats Upset At The Probe, Not Its Findings‏

July 27th, 2015 by mopns · No Comments

The AP reported, “Phony applicants that investigators signed up last year under President Barack Obama’s health care law got automatically re-enrolled for 2015. Some were rewarded with even bigger taxpayer subsidies for their insurance premiums, a congressional probe has found.

“The nonpartisan Government Accountability Office says 11 counterfeit characters that its investigators created last year were automatically re-enrolled by HealthCare.gov, even though most had unresolved documentation issues. In Obama’s terms, they got to keep the coverage they had.

“Six of those later were flagged and sent termination notices. But GAO said it was able to get five of them reinstated by calling HealthCare.gov’s consumer service center. That seemed to be a weak link in the system.

“The five bogus beneficiaries who were reinstated even got their monthly subsidies bumped up a bit, although GAO did not ask for it. The case of the sixth fake enrollee who appealed was under review.

“HealthCare.gov does not appear to be set up to detect fraud, GAO audits and investigations chief Seto Bagdoyan said in prepared testimony for a Senate Finance Committee hearing Thursday. A copy was provided to The Associated Press.

“HealthCare.gov’s document-processing contractor ‘is not required to seek to detect fraud,’ said Bagdoyan. ‘The contractor personnel involved in the document-verification process are not trained as fraud experts and do not perform antifraud duties.’”

At a Senate Finance Committee hearing, Chairman Orrin Hatch (R-UT) said, “For this investigation, GAO created fictitious identities to apply for premium tax subsidies through the federal health insurance exchange.  We learned last year that 11 out of 12 fake applications were approved. [The Center for Medicare and Medicaid Services (CMS)] accepted fabricated documentation with these applications without attempting to verify its authenticity and enrolled fake applicants while handing out thousands of dollars in premium tax subsidies.

“Now, a year later, GAO has reported that nothing has changed and that, if anything, there are more problems.  Worst of all, the administration has known about these problems for over a year now and has apparently not taken the necessary steps to rectify them.  While CMS says that it is balancing consumer access to the system with program integrity concerns, I think it’s pretty clear just what’s going on here.

“Since the federal exchange was first implemented, success has been measured by the number of applicants that have signed up for insurance.  Indeed, last year, when the administration reached its initial enrollment goal, critics of the law were told that we had been wrong all along and that the law was, despite all the evidence to the contrary, working just fine.

“However, with these findings from GAO, it seems obvious, at least to me, that the administration has been preoccupied with signing up as many applicants as possible, ignoring potential fraud and integrity issues along the way.”

According to a follow-up AP report, Senate Democrats are upset–not at the lack of controls for fraud through Obamacare at CMS, nor at the failure of CMS to address this issue after knowing about it for at least a year. No, Senate Democrats are upset that the GAO launched the probe at all.

“Senior Democrats are pushing back against an undercover government probe of President Barack Obama’s health care law. Investigators signed up bogus beneficiaries, then got their coverage renewed – with bigger taxpayer subsidies. Oregon Democratic Sen. Ron Wyden said Thursday the probe did not uncover any real-world fraud . . . .

“But GAO’s audits chief said the investigation exposed real concerns. He said it was relatively easy for GAO’s fictitious characters to get and keep coverage. He added that HealthCare.gov seems to put a higher priority on getting people covered than on verifying they are entitled to benefits.”

President Obama has put forth a nominee to be the new administrator at CMS. This was necessitated by the departure of the previousadministrator, Marilyn Tavenner, earlier this year.

Meanwhile, The New York Times noted the news of Tavenner’s new job yesterday. “Marilyn B. Tavenner, the former Obama administration official in charge of the rollout of HealthCare.gov, was chosen on Wednesday to be the top lobbyist for the nation’s health insurance industry.

“Ms. Tavenner, who stepped down from her federal job in February, will become president and chief executive of America’s Health Insurance Plans, the trade group whose members include Aetna, Anthem, Humana, Kaiser Permanente and many Blue Cross and Blue Shield companies. . . .

“On Aug. 24, she will succeed Karen M. Ignagni, a former health policy specialist at the A.F.L.-C.I.O., who has led the industry’s lobbying arm for 22 years. . . .

“Most recently, Ms. Tavenner was the administrator of the Centers for Medicare and Medicaid Services, the federal agency that insures one in three Americans and has an annual budget of more than $800 billion. As administrator, she was in charge of HealthCare.gov. . . .

“Senator John Barrasso, Republican of Wyoming, described the selection in more negative terms. ‘While millions of Americans are still being hurt by Obamacare’s soaring costs and fewer choices,’ he said, ‘Ms. Tavenner’s appointment shows how the law has created a cozy and profitable relationship for some.’”

Related:

Politico: Obamacare Is Still “Highly Unpopular, And Significant Structural Issues Remain”

Obamacare Reality In CA: Long Waits For Doctors, Lack Of Physicians For Medicaid Patients, Yet Costs To State Exploding‏

AP: “Health Law Impacts Primary Care Doc Shortage”

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