HHS to probe up to two million ObamaCare enrollees for subsidy eligibility

posted at 10:41 am on June 16, 2014 by Ed Morrissey

So much for that victory lap from Barack Obama over having signed up eight million people into ObamaCare. Even while Obama himself lauded the achievement, insurers warned that 20% of those sign-ups would not end up being legitimate enrollments due to non-payment of the premiums. We then discovered that three out of every four enrollees already had health insurance before ObamaCare. Two weeks ago, the AP reported that as many as two million Medicaid enrollees through Healthcare.gov may not be eligible for coverage.

If that 8 million figure looked shaky before this weekend, the New York Times drives a stake through its heart with its report on another eligibility-verification issue. Two million enrollees in exchange plans submitted subsidy-eligibility documentation that differed from other government records, prompting an initial probe of “hundreds of thousands” covered in the exchanges.  Many may have to repay the federal government if they cannot establish a legitimate eligibility, and may end up losing their insurance plan altogether:

The Obama administration is contacting hundreds of thousands of people with subsidized health insurance to resolve questions about their eligibility, as consumer advocates express concern that many will be required to repay some or all of the subsidies.

Of the eight million people who signed up for private health plans through insurance exchanges under the new health care law, two million reported personal information that differed from data in government records, according to federal officials and Serco, the company hired to resolve such inconsistencies.

The government is asking consumers for additional documents to verify their income, citizenship, immigration status and Social Security numbers, as well as any health coverage that they may have from employers. People who do not provide the information risk losing their subsidized coverage and may have to repay subsidies next April. …

Since June 1, the government has notified hundreds of thousands of people that “the information in your application doesn’t match what we found in other records.” Accordingly, the notice says, “you need to follow up as soon as possible and provide more documents to make sure the marketplace has the correct information.”

“If you don’t send the needed documents,” it says, “you risk losing your marketplace coverage or help you may be receiving to pay for such coverage.”

Just how may of those eight million enrollees remain? One million? Fifty thousand? A minyan? What?

This is a direct result of HHS’ failure to produce the necessary enrollment systems by deadline.  The original concept for Healthcare.gov and the state exchanges was an instant eligibility verification system that would integrate the application process with IRS data. That fell by the wayside despite having 42 months and $400 million to build the federal system, plus hundreds of millions if not billions going to states with their own exchanges. Critics warned that going live without those verification checks built into the system would create massive fraud.

It looks like that prediction was even more accurate than first thought. Two million mismatches is 25% of the Obama administration’s claimed success from the open-enrollment period, and HHS has paid $4.7 billion in subsidies already. More than 80% of those private-plan enrollments included subsidy payments, which makes the potential fraud level high indeed.

 


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Schadenfreude, baby.

trapeze on June 16, 2014 at 10:43 AM

HHS to probe up to two million ObamaCare enrollees for subsidy eligibility

Whoa, you using the whole fist there doc?

Flange on June 16, 2014 at 10:43 AM

many will be required to repay some or all of the subsidies

“But, but, but they said it was free!”

/liv

Mark Boabaca on June 16, 2014 at 10:47 AM

But those enrollees where on their honor to submit correct information. I can’t believe that that many people would try to game the system.

Walter L. Newton on June 16, 2014 at 10:47 AM

I’d like a government that probes itself first, before anyone else please.

Difficultas_Est_Imperium on June 16, 2014 at 10:48 AM

The point was to get the number out there in the mind of the public when they were listening. Like the GDP and unemployment numbers.

No one cares about the revisions.

And it is not like this will get any air in the media anyways. I give it 10 seconds of time max on the newscasts.

NWConservative on June 16, 2014 at 10:50 AM

Blame Kathleen. Don’t blame me

cmsinaz on June 16, 2014 at 10:51 AM

Dude…this was all, like, 4 months ago…time to move on..besides..it IS the law of the land.. /s

bimmcorp on June 16, 2014 at 10:51 AM

Fraud happens when the government gives away money? I’m shocked!

Fenris on June 16, 2014 at 10:52 AM

What?! Government teat suckers might lie for more government cheese?!

Wait… that’s “unexpected.”

I think that’s the media phrase for “any moron could see it coming, but we have to cover the Big Zero’s arse.”

Wino on June 16, 2014 at 10:52 AM

obama and all who voted for this, including Roberts, need a rough probe up their azzes.

Schadenfreude on June 16, 2014 at 10:53 AM

The original concept for Healthcare.gov and the state exchanges was an instant eligibility verification system that would integrate the application process with IRS data.

Mention that System Requirement to anybody in IT and they’ll tell you that funny right there.

(I once had an developer attach an MP3 of the other software engineers ROFL when reviewing the last row in the Excel System Requirements Spreadsheet for our task: “The System shall have the capability of modifying its behavior after delivery without vendor involvement.” Seems the systems engineers had run out of time.)

Tsar of Earth on June 16, 2014 at 10:54 AM

4.7 BILLION

Cripe

cmsinaz on June 16, 2014 at 10:55 AM

We need to hire tens of thousands more government workers to get this thing straightened out…

PatriotRider on June 16, 2014 at 11:00 AM

two million reported personal information that differed from data in government records

Well, that’s a comforting thought.

Why wasn’t this “data in government records” used to keep them from enrolling in the first place?

Oh, that’s right…it’s all a scam to begin with, and I guess scammers don’t take kindly to being on the receiving end.

Dr. ZhivBlago on June 16, 2014 at 11:01 AM

Fraud? Nah! Can’t be! King Barack has a magic pen!

GarandFan on June 16, 2014 at 11:03 AM

Obama is exploiting our system. He knows that their is no Federal CFO or audit group that must must certify numbers like this, and like unemployment data.

Fraud is rampant in the government.

The GOP is worried about immigration.

faraway on June 16, 2014 at 11:07 AM

I really thought they had a handle on this health care thingy! / It was obvious from the get go that this was going to be a cluster. Thanks for not letting us down Nurse Ratched.

Deano1952 on June 16, 2014 at 11:07 AM

their there

faraway on June 16, 2014 at 11:07 AM

But these Obamacare posts are about whistling past the graveyard, by next Novemeber Democrats will be openly running on the ACA. Mark my words.

libfreeordie on December 20, 2013 at 10:14 AM

Schadenfreude on June 16, 2014 at 11:08 AM

When premiums decline y’all are going to be pissed!

libfreeordie on May 7, 2014 at 10:18 AM

Schadenfreude on June 16, 2014 at 11:08 AM

Obama will put an end to the audits, now that he’s read it in the papers. Can’t wreck his legacy program!

PattyJ on June 16, 2014 at 11:08 AM

Thanks for saving those classic hits, Schad!!

Deano1952 on June 16, 2014 at 11:10 AM

Are ObamaCare’s Tax Credits Harmless? The Little Understood Dark Side Of The Subsidies

By accepting a tax credit, low-income or lower-middle class families face significant tax ramifications and potential financial risk. Congress has changed the rules twice on consumers for the credits, making the income cliffs steeper, and fully equipping the IRS to claw back overpaid subsidies (unlike the individual mandate penalty).

The flip side of the tax credits is almost unknown to the general public.

Republicans have by and large ignored the tax credit issue unless talking about the budget implications. Perhaps the silence is due to the fact that Congress has voted to change ObamaCare twice to increase the financial risk that families could face when they take the credit.

Since the enactment of ACA, these limits have been amended twice: first under the Medicare and Medicaid Extenders Act of 2010 (P.L. 111-309), and then under the Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayment Act of 2011 (P.L. 112-9). Congress changed the payback protection to vanish at the 400% poverty level and increased the payback amounts at 200% and 300% FPL from what they had been before.

The result will be surprise bills from the IRS in the mail come tax time 2015, in the order of a couple hundred dollars all the way up to full value of any subsidy received if a family crosses the 400% FPL threshold. (This could be $10,000-$12,000 for a family of four, as an example.) Just a few dollars of extra income could result in thousands of back taxes to be paid.

MissMagnolia on June 16, 2014 at 11:18 AM

Many may have to repay the federal government if they cannot establish a legitimate eligibility, and may end up losing their insurance plan altogether

Ed, do you really believe they’ll do a serious review? If I were you, I’d ask how they were going to do the review, and if the answer is outside contracts, I’d be thinking just RICO-style embezzlement of government funds scheme.

Dusty on June 16, 2014 at 11:19 AM

When does the welfare/EBT fraud investigation begin, we want to talk real money it’s right there.

Start in Minneapolis by explaining why there are hundreds of cars with Illinois plates up here every month at exactly the same time.

Bishop on June 16, 2014 at 11:23 AM

The Obama administration is contacting hundreds of thousands of people with

is anyone worried about that statment? is that even their job?

phatfawzi on June 16, 2014 at 11:25 AM

Commies do not govern, they subjugate. That why they want our guns.

RdLake on June 16, 2014 at 11:34 AM

And yet the Republican will not fight over Obamacare. That is all you need to know about the Republican party in D.C. right now.

BroncosRock on June 16, 2014 at 11:34 AM

So this is what that “back end” looks like.

BTW, when the IRS comes collecting the subsidies that got distributed “in error,” will there be penalties and interest attached to them too?

ncinca on June 16, 2014 at 11:37 AM

Heck of a job Barky, heck of a job.

So we beat the Germans and then we beat the Japanese in a few months less than it took to get a non-functioning and over priced website?

yeppers!

jukin3 on June 16, 2014 at 11:38 AM

NWConservative on June 16, 2014 at 10:50 AM

Exceedingly fair response. Two things that will cause problems. If they come back for subsidy refunds, the local press stories will be more than the MSM can bury.

If the govt chooses to “forget” the misapplied subsidies, this becomes the anvil to hammer the democrats this fall.

The bill is still unpopular – and the One’s brilliant foreign policy not to mention an IRS director who just blatantly lied before congress and there just isn’t enough good will to survive. Obama’s favorability ratings are beginning to flirt with numbers in the high 30s. If it consistently breaks through the 40% floor, it will drop hard. At that point, the press will begin to need to protect the next dem presidential candidate and it will be gloves off.

Just a thought about a possible differing scenerio for how this plays out.

Zomcon JEM on June 16, 2014 at 11:38 AM

Just like the ’12 vote returns.

formwiz on June 16, 2014 at 11:41 AM

Wow, another feather in his cap for his ‘legacy’

A prez can only have a legacy if there is a country left after he has completed his term in office.

The way things are going, there may not be any USA left worth living in.

txdoc on June 16, 2014 at 11:44 AM

8 million enrolled. 6 million who formerly had insurance. Net gain of two million. And now two million who signed up may not be eligible? Net gain of zero. So much for the fierce, moral urgency of getting 40 million uninsured their health insurance.

President Zero indeed.

rbj on June 16, 2014 at 11:46 AM

Take it away, Claude!

Newtie and the Beauty on June 16, 2014 at 12:08 PM

And this begs the question

Newtie and the Beauty on June 16, 2014 at 12:09 PM

How much you want to bet the Regime selectively goes after people who didn’t qualify for the subsidies for payback?

IE exempting:

Holder’s People
Democrats

Going after:
Republicans
Non-blacks (and non half-blacks).

ConstantineXI on June 16, 2014 at 12:31 PM

I’m certain the CBO and the OMB will revise their Oblowhardcare cost estimate any day now … once they get their new figures given to them by Barry’s political staff.

Smegley on June 16, 2014 at 12:38 PM

And it is not like this will get any air in the media anyways. I give it 10 seconds of time max on the newscasts.

NWConservative on June 16, 2014 at 10:50 AM

Then how will President Obama find out about it?

RDuke on June 16, 2014 at 12:45 PM

But these Obamacare posts are about whistling past the graveyard, by next Novemeber Democrats will be openly running on the ACA. Mark my words.

libfreeordie on December 20, 2013 at 10:14 AM

Schadenfreude on June 16, 2014 at 11:08 AM

That never get old.

Closet Optimist on June 16, 2014 at 12:46 PM

Nice, so the IRS will be “probing”? So, if you happen to be a registered (D) you’ll get ALL your healthcare insurance subsidized. And if you’re a registered (R) or they suspect your sympathetic to the Tea Party, you get NONE of your insurance subsidized.

Yeah, I think I’ve heard this tune before.

Meople on June 16, 2014 at 12:52 PM

HHS to probe up to two million ObamaCare enrollees for subsidy eligibility
…Naturally, anyone of them with a d-cRAT voter registration gets a FREE PASS !

MicahStone on June 16, 2014 at 1:33 PM

This is what happens when you make the IRS the administrator of welfare programs.

Given that 1)a lot of the problem lies in the (automated) system’s inability to properly “consider” non-W2 income, 2)applicants provide estimates of future income while the system looks at past income, and 3)many caught up in this are lower income/lower middle class folks who don’t understand what is being asked for or why, I suspect Obama/HHS will implement some kind of amnesty that lets flagged applicants hold onto coverage for a generous period of time despite open “issues.” The actual cases of frud will slide by too.

Thousands were bounced by healthcare.gov to Medicaid based on income reporting only. This doesn’t work since many states have strict asset limits for qualification. HHS will probably offer states a $$$ workaround for those people as well.

MaxBC on June 16, 2014 at 1:39 PM

Thousands were bounced by healthcare.gov to Medicaid based on income reporting only. This doesn’t work since many states have strict asset limits for qualification. HHS will probably offer states a $$$ workaround for those people as well.
MaxBC on June 16, 2014 at 1:39 PM

Wasn’t that called the Medicaid expansion, which was ruled unconstitutional, insofar as how 404care wanted to implement it?

Newtie and the Beauty on June 16, 2014 at 1:45 PM

So besides a shaky start to the web site, everything seems to have gone okay….

Axeman on June 16, 2014 at 5:28 PM

See, this is the reason I’m never, ever going to trust government-run health care. They’ll give it away to whoever shows up in order to make their numbers look good, and then after that’s taken care of, they’ll crunch the numbers and insist that a bunch of people who thought they were getting subsidized pay up some extra to make up for their self-engineered shortfall. If you trust these people with your healthcare, you will end up being their slaves. They’ll lure you in with the promise of an entitlement, then reneg on the subsidies until you’re paying more money for less care than you would ever have tolerated from a private business. Their goal is NOT to provide you with health insurance, it’s to find new ways to pick your pocket while convincing you that if you dump them, they you’ll be adrift and helpless. People need to stop tolerating this massive rip off.

dkmonroe on June 16, 2014 at 11:22 PM