Republican lawmakers said Wednesday their suspicions about Obamacare’s anti-fraud measures have been validated and it is “egregious” that 11 out of 12 government investigators were able to get subsidized Obamacare over the phone.
Seth J. Bagdoyan, an acting director for forensic audits at the Government Accountability Office, told the House Ways and Means Committee the government is shelling out $2,500 a month, or $30,000 per year, for the false applicants.
“These findings, although preliminary, are quite troubling,” said Rep. Charles Boustany, Louisiana Republican who chairs the committee’s oversight panel.
Mr. Bagdoyan said the 12th applicant could not get covered because the investigator declined to provide a Social Security number.
He said the investigation is ongoing and that he could not go into detail about the undercover applicants at this point.
For months, Republicans have cast doubt on the Centers for Medicare and Medicaid Services’ ability to cross-check Americans’ claims when they apply for coverage and financial assistance on the health care law’s new exchanges.
They said the GAO’s early findings only bolster their suspicions.
“It’s another federal program that is going to be easily scammed and easily accessed by someone willing to commit fraud,” said Rep. Kenny Marchant, Texas Republican.
Roughly 8 million Americans selected a health plan on the exchanges during the law’s first sign-up period from October to mid-April, exceeding expectations. But tech problems on the web-based system and reports of inaccurate subsidy amounts flowing to applicants have undermined the administration’s victory lap.
For its part, the administration noted that investigators relied heavily on call centers, that false attestations to the government violate federal law and that the administration is constantly cross-checking applicant data. Mismatches can result in penalties and loss of coverage.
“As the GAO notes in its interim report, the steps we take to ensure that individuals and families get the premium support and coverage they deserve, and that no one receives a benefit they shouldn’t, are ongoing and have not concluded,” CMS Aaron Albright said. “While the Marketplace has several layers of safeguards in place to verify consumer data, including requiring consumers to submit accurate information to qualify for health coverage, we are examining this report carefully and will work with GAO to identify additional strategies to strengthen our verification processes.”
Ways and Means Democrats highlighted the limited and preliminary nature of the investigation.
“It is important to keep in mind that the motivation for the fraud fabricated as part of the GAO investigation for a real person would be a desire to receive insurance coverage,” said ranking member Sander Levin, Michigan Democrat. “There would be no financial windfall, as any government subsidy goes directly to insurance companies and not to the consumer seeking that insurance. In fact, people committing these frauds would be risking severe fines and possibly jail time.”