The subsidies provided by the Patient Protection and Affordable Care Act (ACA) to help pay for individuals’ health insurance cost taxpayers billions of dollars per year. So the public has a right to insist that only those people who most need that assistance are actually getting subsidies.
But evidently, that often hasn’t been the case.
A Government Accountability Office (GAO) report released Wednesday shows that the Centers for Medicare and Medicaid Services (CMS) and other federal agencies have not been as thorough as they should have been when processing applications for coverage under the ACA, aka Obamacare.
Applicants are required to submit several identifying documents in order to prove eligibility for subsidies to help pay for health insurance.
But more than 400,000 subsidized health insurance plans were provided to people in 2014 despite the fact that their personal details could not be fully confirmed, according to the GAO investigation.
Further, 11 of 12 fictional GAO investigators managed to get health insurance subsidies using either fake or incomplete information. That rate of fraud suggests an even larger problem.
As much as $1.7 billion could potentially have been spent on subsidies for people who wouldn’t otherwise have qualified for that financial assistance, simply because the government failed to do its due diligence.
That should outrage even supporters of the ACA. After all, the legislation was pitched as providing access to quality health care to Americans who otherwise couldn’t get it.
If those who don’t need that help are getting it fraudulently, that abuse hurts everyone by taking funds away from those who do need it. It also cheats the taxpayers who are paying much of the bill.
Meanwhile, ACA costs continue to rise.
That shouldn’t come as a surprise. Obamacare is, in effect, another costly federal entitlement program.
And as the massive legislation’s critics warned, widespread fraud and inefficiency in Medicare and Social Security should have been a sign that the ACA also would produce such waste.
The CMS must be required to immediately improve the process of confirming applicant information, such as by establishing a method to track queries to the Internal Revenue Service, Social Security Services and other agencies.
There should also be a thorough investigation of the CMS and other agencies that handle health care applications under the ACA to check for other potential fraud.
This is hardly the first evidence of inefficiency and mismanagement related to the ACA, which has turned into a troubled and bloated program.
Whether to apply triage or put it out of its misery will be a decision awaiting the next president and the next Congress.
And that should make Obamacare’s future a high-profile issue in this year’s presidential and congressional elections.