American Elephants

ObamaCare’s Clumsy Law Invites Fraud, Waste and Abuse! by The Elephant's Child

On the day President Obama signed the Affordable Care Act into law in 2010, HHS received authority from the Office of Personnel Management (OPM) to make as many as 1,814 new hires under an emergency “Direct Hiring Authority” order.  The administration ordered that expansion of employment despite a government-wide hiring freeze. The disdain for regulations and laws is of long-standing. 1,684 of those positions have been filled.

HHS started hiring in May 2010, and has hired 86 criminal investigators, and exactly two “consumer safety officers.” 261 ‘consumer safety officers’ were authorized, and 50 criminal investigators. Regulations, authorizations, what, at this point, does it matter? “We now have the Obamacare police” said the head of Judicial Watch, which has filed hundreds of FOIA requests. “Given the confusion and problems of the law’s implementation, we would need a small army to police all the waste, fraud, and abuse that is already evident.”

The delayed implementation of the employer mandate means that the IRS and the health insurance exchanges will be unable to determine whether individuals are eligible for taxpayer-funded subsidies and will instead rely on the honor system. Experts say this could result in billion of dollars in waste, fraud, and abuse.

Forbes writer Avik Roy says the reason for moving ahead with the new scheme is obvious. The Obama administration is focused on making sure that enough Americans enroll in ObamaCare subsidized health insurance, because once they receive subsidies, it will be politically impossible for Republicans to re peal ObamaCare in the future.

Roy added: “Deliberately encouraging tens of billion of dollars of waste, fraud, and abuse in order to achieve a political objective is profoundly immoral.” But that has never bothered the administration. Ignoring key parts of the health care law is not even constitutional.

NCPA’s Health Policy Blog points out that a long-standing problem in the individual insurance market is collecting the premiums. The individual market is made up of people with tentative work histories, and money may be tight in a given month. Insurers attempt to compensate by requiring automatic  withdrawals from bank accounts or prepayment of premiums on a quarterly basis, but aside from a grace period of a week or so, failure to pay means cancellation of the policy.

The regulations allow for a 90 day grace period, but that is just asking for trouble. During the first month of delinquency, the insurer must 1) notify HHS of non-payment.2) notify providers of the possibility of denied claims 3) notify the insured that he is in trouble 4) continue to collect the advanced tax credit 5) return the tax credit to the Treasury 6) issue a termination notice to the insured at the end of the grace period, and 7) determine if the insured has a disability as defined by the Americans With Disabilities Act, and make “reasonable accommodations” for such individuals.  This all adds to the costs.

NCPA suggests that most people will do this because you can get 12 months of coverage for 9 months of premiums with absolutely no premium.

But it’s all going to work, if badly, and people will be eager to transfer into a single-payer plan to fix the shortcomings of ObamaCare, won’t they?

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