Are you surprised that some fake accounts were set up when ObamaCare was launched? I’m not and I am also not that surprised that some fake accounts were granted plans and taxpayer-funded subsidies to pay for them. But this does surprise me: some fake accounts were re-enrolled again this year undetected. It’s a reminder that the Administration’s priority has always been getting people into the ObamaCare system. Not actually existing is apparently no impediment.
According to the a new report from the Government Accountability Office (GAO), the federal exchange website, Healthcare.gov, approved 11 fictitious applications submitted as part of their undercover sting. GAO investigators submitted fake applications with fabricated documents or missing information and were approved. The fictitious applicants received $30,000 in subsidies to help them pay for their plans.
About half of the applicants received termination notices but after a quick call to the federal exchange, five of the six had their plans reinstated with even bigger subsidies. The sixth was pending when the sting ended.
GAO found that the Centers for Medicare and Medicaid Services (CMS) is not required to identify fraud and is not trying to do so. Yet, CMS claims fraud isn’t a problem. How would they know?
Eleven is not a big number, but if that many got past the supposed gatekeeper during a sting operation, isn't it likely that other fake applicants have received subsidies? How many more fraudulent accounts are out there that CMS is unaware of, but that we’re footing the bill for?
The Wall Street Journal explains:
The report found that the Centers for Medicare and Medicaid Services, which oversees implementation of the 2010 health law, isn’t required to detect fraud and that CMS officials acknowledged “limited ability” to respond to fraud attempts. CMS told the GAO that there haven’t been signs of a significant level of fraud.
CMS also told the GAO that subsidized policies may have remained in effect in 2014 because the agency directed contractors not to terminate policies or subsidies if an applicant submitted any documentation.
The marketplace has a multi-layer verification process, including checking an application filer’s identity and eligibility in real-time, according to Health and Human Services, the parent agency of CMS.
Enrollment was discontinued for about 226,000 consumers who failed to produce sufficient documentation of their citizenship or immigration status at the end of March 2015.
“Over the last year, we have made continuous improvements to our processes and communications for those with a data matching issue as we work to bolster the integrity of the process,” said Meaghan Smith, a HHS spokeswoman. “We look forward to working with the GAO as we continue to make additional improvements.”
After last year’s GAO undercover report was released, HHS said it would work with the agency to strengthen its verification process.
“There are serious questions about the integrity of the subsidies,” said Sen. Rob Portman (R., Ohio), chairman of the Senate Permanent Subcommittee on Investigations. “We need to fix it going forward. One of the questions we’re going to be asking at this hearing was if this lax enforcement was done to boost enrollment, or was it just plain mismanagement.”
HHS promised to work with GAO to strengthen its verification process and we see just how little work they’ve actually gotten done. We probably shouldn’t have high hopes for the future until the Affordable Care Act is gone.