New York’s health-insurance exchange is vulnerable to incidences of fraud and abuse, an audit conducted by the Department of Health and Human Services found.
The system is incorrectly verifying applicants eligibility, causing some consumers to get benefits they’re not entitled to, according to the HHS report. Out of the 45 random samplings selected from a pool of 379,932 applicants, HHS found problems with 28 applications — or 62 percent.
HHS found the system has problems confirming household income information, which is used to determine whether someone qualifies for federal subsidies, and with determining which plans an applicant is eligible for.
The Government Accountability Office found similar problems with the federal Obamacare exchange earlier this year. People were using fake identities and documentation to receive coverage and federal funds.
Kentucky, Colorado, Vermont, Minnesota, Washington, and the District of Columbia are also facing audits.
The Office of the Inspector General suggested the New York exchange modify its enrollment system to check for inconsistencies.
The Affordable Care Act has been plagued with issues ranging from website glitches to a projected rise in premiums since its rollout in 2013.
Obamacare co-ops, which received $2.4 billion in federal loans to create nonprofit alternatives to private insurance companies, have largely been tanking financially, having lost $614 million in 2014 alone.
Exchanges in 29 states and the District of Columbia saw a net loss of 238,119 enrollees between March and June of this year.
According to Americans for Tax Reform, the decrease in enrollment could prove to be problematic for the program in terms of long-term sustainability.
The Congressional Budget Office released a report in March projecting premiums under the program will increase by 8.5 percent annually, faster than the 4.3 percent increase expected from private insurance companies by 2018.
The White House website claims the ACA reduces the deficit, lower health care costs and is “cracking down on waste, fraud, and abuse.”
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