Government Accountability Office: Obamacare Is A Big Bowlful Of Fraud

Obamacare Is A Big Bowlful Of Fraud, Say Investigators – Conservative Base

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Just as detractors of President Barack Obama’s healthcare power grab predicted in the midst of Democrat lawmakers shoving their unread law down the throats of the American people, the finished product is living up to expectations: it is filled with deceit, waste, misconduct, and “a big bowl of fraud,” according to several attorneys and investigators who spoke with the ConservativeBase.com’s editor.

Although non-profit, conservative watchdog groups have frequently reported corruption, misconduct, malfeasance and deception within the Obama administration’s signature program known as Obamacare, the Democrats and their news media partners found it relatively easy to dismiss the watchdogs’ reports by claiming a right-wing conspiracy.

However, when the Government Accountability Office (GAO) officials – who report to the U.S. Congress and are reputed to be nonpartisan at least when their reports prove the Democrats’ point of view – released their latest “indictment” of the Patient Protection and Affordable Care Act (PPACA) on Friday, the majority of denizens in American newsrooms ignored the GAO’s disturbing report describing its undercover operation.

The PPACA requires the health-insurance marketplace to review application information to verify applicants’ eligibility for enrollment and to review eligibility for income-based subsidies or Medicaid for those claiming such entitlements. The verification process includes reviewing and validating information about an applicant’s Social Security number, if one is provided; citizenship, status as a national or lawful presence; and household income and family size.

GAO investigators reported that they tested application and enrollment controls for obtaining subsidized health plans available through the federal Health Insurance Marketplace (Marketplace) (for New Jersey and North Dakota) and two selected state marketplaces (California and Kentucky). Although 8 of these 10 fictitious applications failed the initial identity-checking process, all 10 were subsequently approved by the federal Marketplace or the selected state marketplaces.

According to GAO officials: “To perform our undercover testing of the federal and selected state eligibility and enrollment processes for the 2015 coverage year, we created 18 fictitious identities for the purpose of making applications for health-care coverage by telephone and online.18 The undercover results, while illustrative, cannot be generalized to the full population of enrollees. For all 18 applications, we used publicly available information to construct our scenarios.

“We also used publicly available hardware, software, and materials to produce counterfeit or fictitious documents, which we submitted, as appropriate for our testing, when instructed to do so. We then observed the outcomes of the document submissions, such as any approvals received or requests to provide additional supporting documentation.”

Four applications used Social Security numbers that, according to the Social Security Administration (SSA), have never been issued, such as numbers starting with “000.” Other applicants had duplicate enrollment or claimed their employer did not provide insurance that meets minimum essential coverage. For 8 additional fictitious applicants, GAO tested enrollment into Medicaid through the same federal Marketplace and the two selected state marketplaces, and was able to obtain either Medicaid or alternative subsidized coverage for 7 of the 8 applicants:
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* Three were approved for Medicaid, which was the health-care program for which GAO originally sought approval. In each case, GAO provided identity information that would not have matched SSA records. For two applications, the marketplace directed the fictitious applicants to submit supporting documents, which GAO did (such as a fake immigration card), and the applications were approved. For the third, the marketplace did not seek supporting documentation, and the application was approved by phone.

* For four, GAO did not obtain approval for Medicaid; however, GAO was subsequently able to gain approval of subsidized health plans based on the inability to obtain Medicaid coverage. In 1 case, GAO falsely claimed that it was denied Medicaid in order to obtain the subsidized health plan when in fact no Medicaid determination had been made by the state at that time.

* For one, GAO was unable to enroll into Medicaid, in California, because GAO declined to provide a Social Security number. According to California officials, the state marketplace requires a Social Security number or taxpayer-identification number to process applications.

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According to officials from the Centers for Medicaid & Medicare Services (CMS), California, Kentucky, and North Dakota, the marketplaces and Medicaid offices only inspect for “supporting documentation that has obviously been altered. So if the documentation submitted doesn’t show such signs, it wouldn’t be questioned for authenticity.

The latest survey by Rasmussen Polling shows that only 32% of likely voters believe the government should require every American to buy or obtain health insurance. Most voters (56%) continue to oppose Obamacare’s insurance requirement, and this is the highest level of opposition in nearly two years. Twelve percent (12%) remain undecided.

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Obamacare Premiums To Soar 3 Times Faster Than Feds Claim – Daily Caller

Obamacare premium costs will soar 20.3 percent on average in 2016 instead of the 7.5 percent increase claimed by federal officials, according to an analysis by The Daily Caller News Foundation.

The discrepancy is because the government excluded price data for three of the four Obamacare health insurance plans when the officials issued their recent forecast claiming enrollees would face only a 7.5 percent average rate increase in 2016.

When data for all four plans are included, premium costs will actually rise on average 20.3 percent next year. The 2015 Obamacare price hike was 20.3 percent.

The Obamacare program’s federal exchange operates in 37 states where officials declined to set up state-run exchanges. Officials in the U.S. Department of Health and Human Services Center for Medicare Services, which manages Obamacare, only calculated price changes for the health insurance program’s Silver plan, thus ignoring data for the Bronze, Gold and Platinum plans.

The CMS officials said they did so because the IRS uses the Silver plan as a “benchmark” for tax purposes. That approach, however, gave consumers an incomplete picture of what is happening in the health insurance marketplace through the Obamacare program.

The DCNF analysis reviewed price data for all four plans obtained from CMS, insurance companies, state insurance regulators and the nonpartisan National Conference of State Legislatures.

The 20.3 percent figure is the average for all plans. Premium increases in some states will be much higher. In Utah, for example, some enrollees in an individual plan will face a 45 percent price jump. In Illinois, the highest price hikes for individuals in the federal exchange will be 42.4 percent. Some insurers in Tennessee will experience a 36.3 percent price rise.

Wayne Winegarden, a senior fellow in business and economics at the Pacific Research Institute, told TheDCNF that CMS 7.5 percent forecast number is “misleading and a meaningless statistic” that “isn’t actually relevant to any individual in any state. If you go across the four different metals, what happened in the Gold plan, what happened in the Platinum plan, what happened to the Bronze plan?”

Charles Gaba, a data analyst who tracks Obamacare trends and is an Obamacare supporter, reported earlier this year that Obamacare consumers in all 50 states will experience an average 14.4 percent increase. His analysis can be found on his web site, acasignups.net.

“I was hoping they would include all of the rates,” Gaba told TheDCNF. “I would love it ideally if they had all the medal levels.”

Gaba called the CMS price analysis, “fairly representative, but there’s the Gold, the Platinum, the Bronze, the catastrophic plan even, and there’s also a variety of Silver plans. So there are a bunch of different ones in addition to the benchmarks which they did not include.”

The difference between premium cost projections based only on the Silver plan and those that result from using all four plans can be dramatic. Silver enrollees in Pennsylvania, for example, will experience a 10.6 percent increase. Using all four plans, the average price hike for Obamacare enrollees is 20.3. Time Insurance Co. pulled out of Obamacare after state officials rejected its 61 percent increase request.

South Dakotans using Silver will pay 24.7 percent more this year. But among all exchange users in the state, the average increase will be 39 percent. Dakota Care hiked its Obamacare exchange prices 63 percent for 2016, while Blue Cross Blue Shield raised its rates by 43 percent.

In South Carolina, the Silver increase will be 10.8 percent, compared to 23.4 percent when all four plans are considering.

Some worrisome trends appear when specific Silver plan offerings are measured against other medal levels. The National Conference of State Legislators has begun tracking Obamacare price hikes by levels.

In Colorado, for example, Silver customers will see a 12.94 percent price hike. But Gold users will face a 20.33 rate increase and Platinum enrollees will see a 29.80 percent price rise, according to NCSL data.

Idaho Silver customers will have an 8.69 percent increase. But Bronze customers will face 11.03 percent rise and Gold will face 15.9 percent, according to NCSL. Idaho did not offer Platinum coverage for 2016.

The mainstream media was quick to embrace the 7.5 percent number, claiming it reflected the real- world experience of most Obamacare customers. The Washington Post’s Amy Goldstein reported in a story filed last Saturday that “the [CMS] analysis includes all plans being sold in the 37 states that will continue to rely on the federal exchange next year.”

In fact, Platinum, Gold and Bronze price changes were excluded from the federal analysis.

Thomas Miller a resident fellow at the American Enterprise Institute, told TheDCNF that CMS is “always trying to put the best face on things going forward.” But, he said, “you got your initial press release. Only a few people catch up with what might be the final results.”

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