ObamaCare Exchange Is Wide Open To Fraud, Feds Find
INVESTOR'S BUSINESS DAILY
Integrity: An undercover operation shows how ridiculously easy it is to defraud ObamaCare. Even after officials learned investigators had set up several bogus accounts in June of last year, they failed to catch any of them.
The Government Accountability Office report reads like something out of the Onion — that comical fake news site. Except this isn't funny.
A dozen undercover auditors tried to enroll in ObamaCare using fake Social Security numbers, phony IDs and bogus citizenship papers.
The auditors should have been an easy catch, since ObamaCare had promised to build a "data hub" that would instantly check such information against records at the IRS, INS, Social Security and Homeland Security.
Instead, 11 of the 12 got their coverage, along with hundreds of thousands of dollars in improper subsidies.
This tragic comedy of errors went on for 16 months. For example, when the Healthcare.gov exchange later asked the undercover "enrollees" to submit supporting documents, they replied with counterfeits, if they replied at all. Yet none of them lost their coverage.
In one case, the investigator sent zero documents in response to that request, then called the exchange to ask about his status and was told, "Your application status is complete."
The GAO even made its undercover operation public in June 2014 and "shared details of our work with CMS (Centers for Medicare and Medicaid Services, the agency in charge of ObamaCare) during the course of our testing."
Yet for the next 10 months, not one of these bogus enrollees was caught. In fact, the ObamaCare exchange automatically re-enrolled all 11 of them this year and in several cases boosted their subsidy payments.
After the initial report came out, CMS claimed, "The marketplace has several layers of safeguards in place to verify consumer data, including requiring consumers to submit accurate information to qualify for health coverage," and promised, "We are examining this report carefully and will work with GAO to identify additional strategies to strengthen our verification processes."
That promise was a farce.
CMS admits that its contractors aren't required to detect fraud and aren't equipped to do so. Plus, it turns out that some time last year, CMS "waived certain document filings requirements."
So if applicants sent anything in, even if it wasn't what they'd been asked for, "it would be deemed sufficient," and they could keep their ObamaCare plans, according to the GAO. The auditors suspect that at least a few of the fake enrollees maintained their coverage because of this lowered standard.
CMS also admitted that it's trying to balance the "efficiency" of the enrollment process with "program integrity." But the GAO investigation makes it clear that the Obama administration could hardly care less about program integrity, since cleaning up ObamaCare rolls would result only in cutting down the all-important enrollment numbers.
Incredibly, CMS claimed that there has been "no indication of a meaningful level of fraud."
Well, when you're actively not looking for it, you aren't likely to find it.
CMS also told the auditors that there's little reason for anyone to defraud ObamaCare, since the subsidy checks go to the insurers, not the enrollees. This claim overlooks the obvious fact that someone enrolling under false pretenses — say, an illegal alien — can get heavily subsidized health insurance.
These subsidies, mind you, are supposed to cost $28 billion this year alone, and top $100 billion a year within a decade. At that scale, even if only a small share of ObamaCare enrollees aren't U.S. citizens or aren't eligible for some other reason, the taxpayer hit will be enormous.
The public already hates ObamaCare. When it learns that the Obama administration has practically put the welcome mat out for fraud, the Democrats' health care overhaul is going to be even less popular.
The Government Accountability Office report reads like something out of the Onion — that comical fake news site. Except this isn't funny.
A dozen undercover auditors tried to enroll in ObamaCare using fake Social Security numbers, phony IDs and bogus citizenship papers.
The auditors should have been an easy catch, since ObamaCare had promised to build a "data hub" that would instantly check such information against records at the IRS, INS, Social Security and Homeland Security.
Instead, 11 of the 12 got their coverage, along with hundreds of thousands of dollars in improper subsidies.
This tragic comedy of errors went on for 16 months. For example, when the Healthcare.gov exchange later asked the undercover "enrollees" to submit supporting documents, they replied with counterfeits, if they replied at all. Yet none of them lost their coverage.
In one case, the investigator sent zero documents in response to that request, then called the exchange to ask about his status and was told, "Your application status is complete."
The GAO even made its undercover operation public in June 2014 and "shared details of our work with CMS (Centers for Medicare and Medicaid Services, the agency in charge of ObamaCare) during the course of our testing."
Yet for the next 10 months, not one of these bogus enrollees was caught. In fact, the ObamaCare exchange automatically re-enrolled all 11 of them this year and in several cases boosted their subsidy payments.
After the initial report came out, CMS claimed, "The marketplace has several layers of safeguards in place to verify consumer data, including requiring consumers to submit accurate information to qualify for health coverage," and promised, "We are examining this report carefully and will work with GAO to identify additional strategies to strengthen our verification processes."
That promise was a farce.
CMS admits that its contractors aren't required to detect fraud and aren't equipped to do so. Plus, it turns out that some time last year, CMS "waived certain document filings requirements."
So if applicants sent anything in, even if it wasn't what they'd been asked for, "it would be deemed sufficient," and they could keep their ObamaCare plans, according to the GAO. The auditors suspect that at least a few of the fake enrollees maintained their coverage because of this lowered standard.
CMS also admitted that it's trying to balance the "efficiency" of the enrollment process with "program integrity." But the GAO investigation makes it clear that the Obama administration could hardly care less about program integrity, since cleaning up ObamaCare rolls would result only in cutting down the all-important enrollment numbers.
Incredibly, CMS claimed that there has been "no indication of a meaningful level of fraud."
Well, when you're actively not looking for it, you aren't likely to find it.
CMS also told the auditors that there's little reason for anyone to defraud ObamaCare, since the subsidy checks go to the insurers, not the enrollees. This claim overlooks the obvious fact that someone enrolling under false pretenses — say, an illegal alien — can get heavily subsidized health insurance.
These subsidies, mind you, are supposed to cost $28 billion this year alone, and top $100 billion a year within a decade. At that scale, even if only a small share of ObamaCare enrollees aren't U.S. citizens or aren't eligible for some other reason, the taxpayer hit will be enormous.
The public already hates ObamaCare. When it learns that the Obama administration has practically put the welcome mat out for fraud, the Democrats' health care overhaul is going to be even less popular.
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