All You Need To Get Obamacare Is A Flimsy Fake Identity
A "secret shopper" undercover operation by the GAO -- the Government Accountability Office -- found fraud easy to commit in the Obamacare exchanges, writes Paula Bolyard at PJM:
Using fake information during an undercover "secret shopper" investigation, the GAO created 18 fictitious identities through the federal exchange by telephone, online, and in-person. In 17 of 18 attempts the GAO was able to obtain premium subsidies and health insurance with fake information through telephone and online applications. According to the report, 11 out of 12 fake applications for the federal exchanges were approved, with credits totaling $2500 per month ($30,000 per year).During the investigation, fake shoppers provided fake documents, such as Social Security numbers and proof of income and citizenship. They found that "Federal contractors made no effort to authenticate documents applicants provided" and the fake ID and income information proved to be no impediment to enrollment. According to the report, the Center for Medicare and Medicaid Services (CMS) is not required to authenticate documentation. "The contractor told us it does not seek to detect fraud and accepts documents as authentic unless there are obvious alterations," the GAO said.
As of July 2014 the fake enrollees continue to receive subsidized coverage for the 11 applications, including 3 applications where GAO did not provide any requested supporting documents.
When the GAO made attempts to sign up for federal subsidies in person, they were unable to obtain assistance in five of six attempts. "One navigator said assistance was not available because HealthCare.gov was down and another [declined] to provide assistance," the preliminary report said, noting that navigaors have received tens of millions of dollars in federal grants to provide assistance to those in need of healthcare.
I imagine that the insurance companies may investigate but only after a claim has been made.
My sister purchased insurance through a company, making payments regularly and then made a claim. She was denied because there were too few employees to count as a business. She was denied individual coverage because of her pre-existing condition. I can't remember now if they refunded her money, but even if they did, it was a savings for them.
For insurance companies, it's a win-win situation. They collect your money if you don't get sick and if you do, they can deny coverage. I'm not sure how this would work with the new regulations, but it seems that insurance companies always find a way to come out on top.
Jen at July 23, 2014 6:13 AM
The fun thing is, the D.C. Circuit ruled yesterday that the ACA does not authorize subsidies for insurance purchased through healthcare.gov -- it's only permitted for state-operated exchanges. The case will no doubt proceed to SCOTUS, but of course precedent always has a large influence, and the D.C. Circuit has set it.
Cousin Dave at July 23, 2014 6:58 AM
Reminds me of the liar's loans for the housing bubble. The people taking the applications really didn't care what was on them as long as they were making their sales numbers.
This story comes with a twist, the on-line computer system was able to perform where their human counterparts were not. In that sense we may have passed an inversion point where the average robot is better than the average human at the same task. Hmmm. Maybe some day they'll keep us as pets.
Canvasback at July 23, 2014 7:32 AM
Hmm let's see how many ways I can come up with to scam money out of this loophole.
1. As a insurance company scam. Remeber this is getting gov't (taxpayer) $ sent to a insurance company. So if I become an insurance company, I create 500 fake people all needing subsidies and sell them insurance. Since the people are fake, they will never get sick. Gov't pays the subsidy to my insurance company, if there is any $ each of those 500 have to kick in I'd just be paying myself, and I'd probably get a medal from Dems. for insuring so many poor people.
2. Illegal alien scam. Juan just needs to get fake id, and he gets majorly subsidized insurance, on taxpayer dime.
3. Rich person scam. Another way is a rich person makes a fake poor person id and uses that to get the subsidy, and insurance. If sick he goes in as poor person so taxpayers pay instead of him,insurance company gets money and pays out normally, wouldn't care if person is who they say he is or not unless excessive treatments are requested.
4. Crooked Dr scam. A Dr creates a few fake people, and charges insurance company for services never rendered. As long as he doesn't make any of the charges non-routine or excessive, insurance company won't check. If they ever do, Dr claims he performs services, not his job to check if people are who they say they are.
Basically with each you are stealing money from taxpayers, insurance company won't check, because they are paid through subsidy
Joe j at July 24, 2014 6:48 AM
So far my medical insurance has jumped another 25% (plus the 26% the Democratic Governor of California gifted the insurance companies last year), I've lost my primary care physician, my specialist, my dentist, and my dental coverage.
I do, though, receive a separate bill every month for six buck plus change to pay for someone else's pediatric dental coverage.
Whoever runs on the Democratic ticket is going to have a hell of a time winning the independent vote.
Gog_Magog_Carpet_Reclaimers at July 24, 2014 7:47 AM
"Whoever runs on the Democratic ticket is going to have a hell of a time winning the independent vote."
Unfortunately the money taken from you is being used to buy other peoples votes.
Joe J at July 24, 2014 10:20 AM
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