Health

Report: Obamacare Marketplaces Are STILL Susceptible To Fraud

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Juliegrace Brufke Capitol Hill Reporter

Marketplaces within the Affordable Care Act (ACA) — or “Obamacare” — infrastructure remain susceptible to fraud, according to Government Accountability Office (GAO) findings released Monday.

In spite of GAO warning the government of shortcomings and suggesting changes in 2014 and 2015, new GAO findings show major flaws in categories like eligibility determination and enrollment processes that have yet to be corrected. Coverage and subsidies were approved for 15 falsified applications, for example.

Using the same methodology from February, when it was exposed that illegal immigrants are successfully obtaining government-subsidized coverage, GAO found that seven out of nine fake applications were approved.

“For these seven successful applicants, we obtained APTC subsidies totaling about $2,700 on a monthly basis, or about $33,000 annually,” the report reads. “In the eighth case, our applicant was approved for Medicaid coverage.”

Of the 15 applications approved for subsidies and coverage, just three were unable to utilize their policies because initial payments weren’t processed successfully.

Fake applicants who failed to provide necessary documentation or inconsistent information were also able to maintain or gain coverage, GAO finds.

Three out of seven applicants were able to provide partial documentation and engaged in clear inconsistencies after speaking with a marketplace phone operator while two out of three who provided no documentation at all were able to hold onto their policies.

GOP lawmakers slamming the findings, lambasted the administration for its failure to verify information and put the necessary safeguards in place to protect American taxpayer dollars from fraud.

“When a fire is raging, the first thing you do is grab a hose – but there is no urgency by the administration to address the inferno of fraud. It’s déjà vu all over again as it seems the situation only continues to get worse, and we all are paying the price,” House Energy and Commerce Committee Chairman Fred Upton said in a statement. “The nonpartisan watchdog reports underscore that there is still tremendous weakness in how the federal marketplace operates and immediate action must be taken to ensure all avenues for fraud are impossible.”

House Ways and Means Committee Chairman Kevin Brady of Texas agreed, noting that the Affordable Care Act has seen its fair share of issues since implementation.

“This report unfortunately tells us more of what we already know — that the Obamacare federal exchanges have been riddled with problems since day one,” he said in a statement. “The fact that the exchanges are so susceptible to fraud is just further proof that the President’s health care law is not working as promised — and wasting billions of taxpayer dollars in the process.”

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