Massive Obamacare fraud: Fictitious enrollees all got $60K government subsidies

September 14, 2016

Submitted by:  Veronica Coffin

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The Government Accountability Office (GAO) recently conducted an “undercover enrollment testing” of Obamacare, aka the (Un)Affordable Care Act, by submitting applications for fictitious, i.e., fake people.

The GAO discovered that EVERY ONE of its fictitious enrollees not only was accepted to Obamacare but received government, i.e., taxpayer, subsidies totaling $60,000 a year.

The reason is because, as shown by the GAO’s undercover test of the Obamacare system, anyone can sign up for Obamacare — and have it paid for by taxpayers — without having to prove their identity or citizenship or demonstrate that they qualify for government subsidies based on income.

VoodooCare

From the GAO’s September 2016 report to Congress, Patient Protection and Affordable Care Act: Results of Undercover Enrollment Testing for the Federal Marketplace and a Selected State Market for the 2016 Coverage Year:

Our undercover testing for the 2016 coverage year found that the eligibility determination and enrollment processesof the federal and state marketplaces we reviewed remain vulnerable to fraud, as we previously reported for the 2014 and 2015 coverage years. For each of our 15 fictitious applications, the marketplaces approved coverage, including for 6 fictitious applicants who had previously obtained subsidized coverage but did not file the required federal income-tax returns. Although IRS provides information to marketplaces on whether health-care applicants have filed required returns, the federal Marketplace and our selected state marketplace allowed applicants to instead attest that they had filed returns, saying the IRS information was not sufficiently current. The marketplaces we reviewed also relaxed documentation standards or extended deadlines for filing required documentation. After initial approval, all but one of our fictitious enrollees maintained subsidized coverage,even though we sent fictitious documents, or no documents, to resolve application inconsistencies.

For each of our 15 fictitious applications, the federal or state-based marketplaces approved coverage at time of application—specifically, 14 applications for qualified health plans, and 1 application for Medicaid. Each of the 14 applications for qualified health plans was also approved for APTC subsidies. These subsidies totaled about $5,000 on a monthly basis, or about $60,000 annually. These 14 qualified-health-plan applications also each obtained CSR [cost-sharing reduction] subsidies, putting the applicants in a position to further benefit if they used medical services.

In the case of 8 of the fictitious applicants, the GAO submitted fake citizenship and/or social security documentation, but every one of these applications was also approved and received subsidies.

According to the GAO, in 2015, about 1.4 million people received $4 billion in Obamacare subsidies even though they had failed to submit required tax information. 

ZeroHedge reports that the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services responded to the GAO’s report, insisting they have a “robust verification process” aimed at “protecting taxpayer dollars”:

“The [Obamacare] marketplace takes seriously the responsibility to protect taxpayer funds, while making coverage available to eligible people. We have a robust verification process to make sure people get benefits they are eligible for while protecting taxpayer dollars.

Within HealthCare.gov we have multiple checks to verify that applicants provide correct eligibility information on their applications, and GAO deliberately circumvented those checks by giving false information, which is against the law for actual applicants.

We appreciate the work the GAO and HHS Office of Inspector General to improve marketplace operations and take action when provided with recommendations or other information. That’s why we have repeatedly requested, and remain disappointed, that we still have not received specific details or recommendations from the GAO relating to their fraudulent applications. Specific and actionable information will enable us to analyze and understand what occurred and whether we can make improvements to our processes or procedures. […] We are also working closely with issuers through the Healthcare Fraud Prevention Partnership to identify trends, schemes and specific bad actors.”

Blah, blah, blah, blah . . . .

So my question to the useless GOP who are a majority in both houses of Congress is:

Why haven’t you still not repealed Obamacare? What more evidence do you need that it’s not working and an unconscionable waste of taxpayer dollars? What are you waiting for?

 

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