Fraud Watchdog Hits Obamacare

New IG Report Reveals ‘Defective’ Obamacare System That Could ‘Jeopardize Coverage For Millions’


SEN. MITCH MCCONNELL (R-KY): “‘It now appears that the Administration’s promises to protect taxpayers from wasteful and fraudulent payments will join ‘if you like your plan, you can keep it’ and lower premiums as just the latest in a string of Obamacare’s broken promises.’” (Sen. McConnell, 7/1/14)


‘Data Discrepancies,’ ‘Inconsistencies,’ ‘Defective’ System

“The Obama administration has been struggling to clear up data discrepancies that could potentially jeopardize coverage for millions under the health overhaul, the government's health care fraud watchdog reported Tuesday.” (AP, 7/1/14)

“The Health and Human Services inspector general said the administration was not able to resolve 2.6 million so-called ‘inconsistencies’ out of a total of 2.9 million such problems in the federal insurance exchange from October through December 2013.” (AP, 7/1/14)

  • “... potentially hundreds of thousands of people are receiving bigger subsidies than they deserve. … Under current rules, people receiving unwarranted subsidies will be required to return the excess next year.” (The Washington Post, 5/16/14)

“Although the Federal marketplace received documentary evidence from applicants related to inconsistencies, it could not resolve the inconsistencies because the system functionality to resolve inconsistencies had not been fully developed.” (HHS Inspector General Report, p. 21, 7/1/14)


Another Broken Promise

“Health and Human Services Secretary Kathleen Sebelius promised to thoroughly vet the salary information that people submitted as part of their health insurance applications.” (The Washington Post, 5/16/14)

HHS Sec. Kathleen Sebelius: “I certify that the American Health Benefit Exchanges (Marketplaces) verify that applicants for advance payments of the premium tax credit and cost-sharing reductions are eligible for such payments and reductions, consistent with the requirements of section 1411 of the Patient Protection and Affordable Care Act…” (Sec. Sebelius, Letter To Vice President Biden, 1/1/14)

  • HHS Sec. Kathleen Sebelius: ‘numerous systems and processes to carry out these verifications’ “As required by the Affordable Care Act and implementing regulations, when a consumer applies for insurance affordability programs, including advance payments of the premium tax credit and cost - sharing reductions, the Marketplace verifies application information provided by the consumer when making an eligibility determination. The Department of Health and Human Services has issued regulations that detail these procedures, and the Marketplaces have implemented numerous systems and processes to carry out these verifications...” (Sec. Sebelius, Letter To Vice President Biden, 1/1/14)