“Obamacare’s web exchanges are “vulnerable to fraud,” according to a watchdog report Monday that says government investigators were able to get taxpayer-subsidized coverage for fake enrollees despite a brand-new safeguard against chicanery on the law’s insurance exchanges.
The Government Accountability Office said six fictitious applicants who were able to obtain private coverage and subsidies under the Affordable Care Act during its testing in 2014 were successful again in 2016, even though none of the “enrollees” had filed a 2014 tax return.”
“The GAO said that after a payment-processing error booted two of its fake enrollees, four of them were able to retain coverage — two filed paper forms that didn’t ask about the 2014 return, and two lied and said they’d filed returns.
The GAO said one of its lying customers had to verbally reassure a marketplace representative and then received a warning in May about filing a 2014 return, though coverage remained in place as of August.
“Our undercover testing for the 2016 coverage year found that the eligibility determination and enrollment processes of the federal and state marketplaces we reviewed remain vulnerable to fraud, as we previously reported for the 2014 and 2015 coverage years,” the GAO said.” - GAO: Obamacare exchanges still vulnerable to fraud, Investigators able to sneak fake enrollees by safeguards, Washington Times, 09/12/2016
Link to entire article appears below:
http://www.washingtontimes.com/news/2016/sep/12/gao-obamacare-exchanges-still-vulnerable-fraud/
‘The implementation of major legislation such as the Affordable Care Act (ACA) often results in fiscal outcomes that differ significantly from prior projections. Whenever this happens it leads to many questions, much confusion, and several claims and counter-claims. Rarely is it immediately clear whether the law is working differently than envisioned, or whether the unexpected outcomes are due to inevitable projection errors having nothing to do with the law.
On rare occasion, however, a prior projection proves so far off that its significance must be noted. Two weeks ago my colleague Brian Blase uncovered such a development with respect to the ACA’s Medicaid expansion. Recall that the ACA considerably expanded Medicaid eligibility – an expansion made optional for the states in a later Supreme Court ruling. It turns out that the 2015 per-capita cost of this Medicaid expansion is a whopping 49% higher than projections made just one year before.
This disclosure can be found on page 27 of the 2015 Actuarial Report for Medicaid, released this July. Here is how the report described the issue:
“While the newly eligible adult per enrollee costs in 2014 were slightly lower than estimated in last year’s report ($5,488 compared to $5,517, or about 1 percent lower), the estimated per enrollee costs for 2015 in this year’s report are substantially greater ($6,366 compared to $4,281, or about 49 percent higher).”’ - The Soaring Costs of the ACA’s Medicaid Expansion, economics21.org, 08/01/2016
Link to the entire essay appears below:
http://www.economics21.org/html/soaring-costs-aca%E2%80%99s-medicaid-expansion-1989.html
“Paul Vondra is just the sort of person the architects of Obamacare had in mind.
The 59-year-old Bellevue resident is a temporary worker contracted through a New Jersey agency to work as a mail clerk for a major local bank. He doesn’t own a car, so he bikes each day to his job in the Strip District.
His agency has offered him a choice of two Affordable Care Act-qualified plans. But Mr. Vondra, who makes less than $25,000 annually and has no dependents, said the cheapest plan carries a monthly premium of $165, or $800 a year, and a yearly deductible of $2,500.
Also, the plan’s co-insurance — the amount he would be responsible for after he has met his deductible — is $4,500, while out-of-pocket hospital costs are capped at $10,000.
“It might as well be $10 million,” he said.
He’s not alone. Officials at local health centers and clinics say they’re seeing more people like Mr. Vondra whose access to insurance has not translated into access to care.”
Annette Fetchko, administrator at the Catholic Charities Free Health Care Center, Downtown, said the center has helped secretaries, security guards, custodians, seasonal construction workers and others who have insurance but who still can’t afford to fill prescriptions or follow through on a doctor’s referral to see a specialist.
As a result, she said, the center has broadened its mission, with a focus on ensuring access to care regardless of insurance status.
“At the end of the day, the underinsured are no different than the uninsured,” she said.” - Affordable Care Act: Access to insurance is no guarantee a person will have access to care, Pittsburgh Post-Gazette, 09/05/2016
Link to the entire article appears below:
http://www.post-gazette.com/business/healthcare-business/2016/09/05/Access-to-insurance-is-no-guarantee-a-person-will-have-access-to-care/stories/201609040115
