Report: Obamacare Exchanges Fraud Costs Taxpayers Millions

It seems an incredible waste to put tens of millions, if not hundreds of millions, of taxpayer dollars at risk through fraud on federal exchanges.

Christopher Jacobs reports: What do Obamacare and Haley Joel Osment have in common? They both see dead people.

On Tuesday, the Government Accountability Office (GAO) released another report into eligibility verification checks on the federally run Obamacare insurance exchange used by more than three dozen states. As with prior studies, GAO concluded that regulators still need to improve integrity efforts to ensure the federal government spends taxpayer funds wisely.

[Read the full story here, at thefederalist.com]

Among the report’s most noteworthy conclusions: A total of 17,000 federally subsidized insurance policies studied during the 2015 plan year—the most recent for which GAO had complete data at the time of its investigation—began or continued after the applicant’s reported date of death. In 1,000 of those cases, coverage began after the applicant’s reported date of death. In a further 2,000, the application was submitted after the applicant’s reported date of death—in most cases because the exchange automatically re-enrolled applicants without checking to determine that they remained alive.

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GAO previously recommended that the federal exchange verify eligibility periodically, checking changes in circumstances that would affect the status of federal subsidies, such as death. However, to the best of auditors’ knowledge, the Centers for Medicare and Medicaid Services (CMS) has not implemented this recommendation, one of 18 relating to exchange integrity that remain open (i.e., not completed) from two prior GAO reports. Read the rest of this entry »


The Great Recession Enabled ObamaCare. Now the Law’s Failure Makes Reform Possible

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The Four Legs of a New Health-Care System

James C. Carpetta and Scott Gottlieb write: Donald Trump announced this week that he had chosen Rep. Tom Price (R., Ga.), a leader in the efforts to replace ObamaCare, to be his secretary of Health and Human Services. This is a consequential choice. Mr. Trump’s election, and the political realignment it represents, offers a generational opportunity to pursue a new direction for American health care. Mr. Price will now be leading the charge.

The new system should be fully consumer driven, empowering individuals to be the surveyors and purchasers of their care. Past reforms in this direction became stilted and ultimately incomplete, but the current moment offers a chance to truly rebuild from the ground up. If Messrs. Trump and Price want to make the most of this short window, they should keep four central reforms in mind.

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1. Provide a path to catastrophic health insurance for all Americans. There’s ample evidence that enrollment in insurance doesn’t always lead to improvements in health—but access to health insurance is important nonetheless. A 2012 study from the National Bureau of Economic Research found higher insurance enrollment from reforms in Massachusetts led to better results in several measures of physical and mental health.

[Read the full text here, at WSJ]

Health insurance is also important for financial security. The ObamaCare replacement should make it possible for all people to get health insurance that provides coverage for basic prevention, like vaccines, and expensive medical care that exceeds, perhaps, $5,000 for individuals.

Those Americans who don’t get health insurance through employers, or Medicare and Medicaid, should be eligible for a refundable tax credit that can be used to enroll in a health-insurance plan. The credit would be set at a level comparable to the tax benefits available to individuals with employer-sponsored insurance plans. The subsidy would be enough to make a basic level of catastrophic coverage easily affordable for all Americans.

2. Accommodate people with pre-existing health conditions. The price of insurance naturally reflects added risk. That’s why beach houses cost more to insure than a typical suburban home. Yet there is a reasonable social consensus that people should not be penalized financially for health problems that are largely outside of their control.

So as long as someone remains insured, he should be allowed to move from employer coverage to the individual market without facing exclusions or higher premiums based on his health status. If someone chooses voluntarily not to get coverage, state regulation could allow for an assessment of the risk when the person returns to the market. Read the rest of this entry »


Daniel F. Craviotto: A Doctor’s Declaration of Independence

It’s time to defy health-care mandates issued by bureaucrats not in the healing profession.

daniel-f-craviotto-jr-md-pro-phDaniel F. Craviotto Jr. writes: In my 23 years as a practicing physician, I’ve learned that the only thing that matters is the doctor-patient relationship. How we interact and treat our patientsis the practice of medicine. I acknowledge that there is a problem with the rising cost of health care, but there is also a problem when the individual physician in the trenches does not have a voice in the debate and is being told what to do and how to do it.

As a group, the nearly 880,000 licensed physicians in the U.S. are, for the most part, well-intentioned. We strive to do our best even while we sometimes contend with unrealistic expectations. The demands are great, and many of our families pay a huge price for our not being around. We do the things we do because it is right and our patients expect us to.

So when do we say damn the mandates and requirements from bureaucrats who are not in the healing profession? When do we stand up and say we are not going to take it any more?

The Centers for Medicare and Medicaid Services dictates that we must use an electronic health record (EHR) or be penalized with lower reimbursements in the future. There are “meaningful use” criteria whereby the Centers for Medicare and Medicaid Services tells us as physicians what we need to include in the electronic health record or we will not be subsidized the cost of converting to the electronic system and we will be penalized by lower reimbursements. Across the country, doctors waste precious time filling in unnecessary electronic-record fields just to satisfy a regulatory measure. I personally spend two hours a day dictating and documenting electronic health records just so I can be paid and not face a government audit. Is that the best use of time for a highly trained surgical specialist? Read the rest of this entry »


Where Did Your Tax Dollars Go?

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The Hipster Libertarian


[VIDEO] Obamacare’s Trio of Doom

Guy Benson has the video. Edited by Guy Benson and his associate Sarah Jean Seman, it captures the essence of the the president’s trilogy of rotting, stinking, dead promises.

From TownHall:  In light of President Obama’s dramatic goalpost shifting on his ironclad “keep your doctor” pledge, we decided to highlight what’s become of three core promises made by Democrats during their frenetic Obamacare sales pitch:

(1) If you like your doctor, you can keep your doctor.

(2) If you like your plan, you can keep your plan.

(3) Everyone’s premiums will go down, with the average family saving $2,500. Americans were also assured that the law wouldn’t add to deficits, would bend the government’s healthcare spending “cost curve” down, and wouldn’t negatively impact Medicare — none of which have been borne out by reality…

obama-promises Read the rest of this entry »


The Hammer: Debating CBO’s Obamacare Findings …

 “If you have a part-time job and you’re getting a big subsidy, and you’re offered a better job, you do the calculation…”

Charles Krauthammer pushed back against National Journal’s Ron Fournier’s belief that the recent Congressional Budget Office’s report on Obamacarewas being manipulated to score partisan points…

“…It’s a huge incentive not to take that job — it’s irrefutable”

Read the rest of this entry »


SOTU Survey

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After five State of the Union addresses, all Obama’s delivered is a series of broken promises on jobs, debt, health care, government and accountability.

What is the biggest disappointment in the current state of our union under Obama?

  • Jobs: Under Obama, over 20 million Americans are still struggling to find work, despite billions of dollars in binge government spending and empty promises.
  • Debt: Obama promised to tackle our debt and entitlement problems. But on his watch, the national debt has gone up $6.6 trillion, and Medicare and Social Security are still on a path to bankruptcy.
  • Health Care: ObamaCare was the liberals’ dream solution to our health care problems. But since Obama took office, insurance costs for families have gone up by $3,671 and 5 million Americans have received cancellation notices for their health plans.
  • Benghazi: Obama promised swift justice for the Benghazi attackers, but what we got was a political scandal. None of the Benghazi suspects have been brought to trial for their connection with the attack on our consulate and the murder of one of our Ambassadors.
  • Government: Obama has let the federal government run wild: the IRS targeted conservative organizations, Obama’s agencies threw lavish taxpayer-funded parties, and lobbyists continue to pass through the revolving door at the Obama White House.

One Cheer for Our Unproductive Congress

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When so much of what government does makes matters worse, inactivity is a blessing

Michael Tanner writes:  As this session of the 113th Congress draws to a merciful close, much of the punditry has picked up on the refrain that this is the “most unproductive Congress in history.” Indeed, this Congress has passed just 28 bills, easily eclipsing the previous record for inactivity set by Congress in 2012, when it passed just 68 new laws. But why, we might ask, is this such a bad thing?

Sure, there are things we might have wished Congress had accomplished. Something to address immigration or entitlement reform springs to mind. And it certainly would have produced less chaos if Congress had actually managed to pass annual appropriations bills instead of cramming all spending into the usual last-minute continuing resolution.

But there is a presumption behind such handwringing that we really need Congress to be even more involved in our lives than it is. Consider the laundry list of new programs that President Obama introduced in his State of the Union address back in January: early-childhood education, green energy, more economic stimulus, a higher minimum wage, and so on. Would we really have been better off if those things had passed?

Read the rest of this entry »


OBAMA’S CARNIVAL OF CASCADING CATASTROPHE

Image source: Mad Magazine

Image source: Mad Magazine

Obamacare: So, what could go wrong next? 

David Nather writes:  Busted website, canceled policies, lousy early enrollment numbers. And that could be just the warmup.

Because the lesson of the last six weeks is that when it comes to the Obamacare rollout, if it can go wrong, it probably will.

 ‘It’s going to get worse’  –Bob Woodward  

The stumble-filled debut of President Barack Obama’s health care law is drawing new attention to the other risks that have been on the radar screen of health care wonks for months. Think health insurance plans sinking under the weight of sick customers, newly insured people being stunned that they still have to spend on health care, and possibly another wave of canceled policies — right before the 2014 elections.

They’re mostly worst-case scenarios, and an Obamacare recovery in the next few months could still prevent some of the biggest ones from ever happening. But health care experts are taking all of them a lot more seriously now — because at this point, why wouldn’t they?

A complete list of possibilities could be overwhelming, but here are the main ones to watch:

Death spiral

This was always the worst of the worst-case scenarios: Only sick people enroll in the Obamacare health insurance plans, healthy people stay away, and everyone’s premiums rise out of control because there are no healthy people to cover the sick people’s costs.

Read the rest of this entry »


Why We Have Federal Deficits

6a00d8341c3e3953ef0167661243ea970b-320wiCharles Blahous writes: Today the Mercatus Center is releasing a study I completed earlier this year that comprehensively analyzes the policy decisions underlying federal deficits.  Too often partisan advocates focus on a limited time period to purposely throw blame on a targeted political figure.  Instead I dissected the entire budget, identifying deficit-driving policies regardless of when they were enacted.  The study was a mammoth undertaking; it required the digestion of practically every Congressional Budget Office (CBO) and Office of Management and Budget (OMB) budget report published over the past forty years.

The striking finding is that more than three-quarters of our long-term fiscal problem derives from a set of policy decisions made over a period of just seven years, 1965 to 1972.  1965 saw the establishment of Medicare and Medicaid, advocated for and signed by President Lyndon B. Johnson.  Both of these programs were later expanded in 1972 during the Nixon administration, as was Social Security.  Nothing done by any recent President or Congress carries long-term fiscal consequences as daunting as those arising from these 1965-72 decisions. Read the rest of this entry »


PEA Party: The ‘Punished Enough Already’ Young Middle Class

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In 2011 Salon made a weak-tea effort to coin Pea Party, but it vanished. (the lightweight Salon is also fond of the juvenile smear ‘neo-Confederate’ to demonize middle class folks they disagree with, so it’s easy to dismiss ’em as irrelevant)  punditfromanotherplanet is adopting the ‘punished-enough-already’ young middle class as the new Pea Party, to introduce Fleischer’s essay. Take it away Matthew.

LA Times guest blogger Matthew Fleischer writes: The Obama administration came out with a report Monday arguing that 1 million single adults between the ages of 18 and 35 will be eligible for an Obamacare insurance plan costing less than $50 a month.

That’s news to me.

I’m a healthy 34-year-old with a taxable income hovering right around the Obamacare subsidy level who, for the last several years, has purchased a relatively inexpensive catastrophic health insurance plan from Blue Shield. I get to see the doctor four times a year for a $30 co-pay, and I won’t have to spend the rest of my life working off the debt if I get hit by a bus.

Read the rest of this entry »


It Pays to be Dead: Medicare Paid Millions to Dead People, Illegal Immigrants

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New reports from the Department of Health and Human Services Office of Inspector General reveal that Medicare wrongly paid out millions of dollars in benefits to dead patients, illegal immigrants and dead doctors.

rockybonesAccording to the reports in 2011 Medicare paid $23 million in services for dead patients, spent $25 million on dead doctors between 2009-2011, and provided $29 million in prescription drugs for illegal immigrants from 2009-2011.

Under federal law, none of these categories of people are eligible for Medicare benefits or payments.

The IG reports that from 2009-2011, more than 4,100 illegal immigrants were able to make drug benefit claims, because while the agency does have controls in place to prevent illegal immigrants from making Medicare claims, it did not have policies for prescription drug coverage. CMS agreed to put controls in place to prevent illegal immigrants from receiving benefits.

CMS also agreed to work to prevent and recover benefits provided to dead beneficiaries.     Read the rest of this entry »


What’s Next For Health Care Policy?

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Ben Domenech writes:  Over the past few days we’ve seen an ever-increasing number of voices on the Left, most of whom laughed at the prospects of Obamacare as a train wreck a few months ago, gradually opening up about their concerns on the future of the law.  They aren’t saying it’s going to fail now, mind you – but they are gaming out a future where things just don’t work out as they had intended, where the combination of implementation failures and unfixable policy come together to make a real mess of things. It raises the possibility of the post-Obamacare era, with policy writers on the left finally recognizing that there will be another round of health care reform in the near future.

What might post-Obamacare health care policy look like?

Read the rest of this entry »


The Transformation of the USA: Introducing America 3.0

laborAge

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The recent political deadlock and government shutdown, and the disastrous rollout of ObamaCare, show that something is seriously wrong in Washington, D.C.

What’s going on?

America is going through a transformation, on a scale that few people now realize. The last such fundamental change was from the rural and agrarian society of the Founding era (America 1.0) to the urban and industrial society which is now coming to an end (America 2.0).

That transition was disruptive and painful, but ultimately led to a better America.

We are now making a similar transition to a post-industrial, networked, decentralized, immensely productive America, with a more individualistic, voluntarist, anti-bureaucratic culture (America 3.0).

Today’s political regime is like legacy software, built for an earlier world.

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Institutions of the 20th Century welfare state that once looked permanent are crumbling. The old operating system has been kludged so many times it won’t work much longer. It has to be replaced.

The time-worn liberal-progressive wisdom is simple: See a problem, create a government program to fix it.

ObamaCare proves this approach no longer works.

Read the rest of this entry »


Report: U.S. Digs Giant Hole, Fills it with Money, Pours Gasoline, Lights Match

Daniel Halper writes:  New research from the Republicans on the Senate Budget Committee shows that over the last 5 years, the U.S. has spent about $3.7 trillion on welfare. Here’s a chart, showing that spending versus transportation, education, and NASA spending:

U.S. Has Spent $3.7 Trillion On Welfare Over Past 5 Years.preview

“We have just concluded the 5th fiscal year since President Obama took office. During those five years, the federal government has spent a total $3.7 trillion on approximately 80 different means-tested poverty and welfare programs. Read the rest of this entry »


It’s Official: Obamacare is Coughing Up Blood

Ten Things to Expect from Obamacare

Obama's Promise Fulfilled: A Great Leap Forward to the Best of Modern Health Care

Obama’s Promise Fulfilled: A Great Leap Forward to the Best of Modern Health Care

By Elizabeth Lee Vliet, M.D.

1. The expansion of Medicaid, with increased cost burden for taxpayers.

Medicaid is a combined state-federal program initially designed to help the neediest among us. But it has burgeoned to cover medical costs for about one in every five people. Today, Medicaid pays for two of every five babies born in the United States, and three of every five people in long-term care facilities in the US.

Obamacare will add another 20 million new Medicaid dependents. According to the Kasier Family Foundation, that Medicaid expansion will add an average of 13% to state budgets in costs for 2014 alone.

Even though Medicaid was designed to help the poor, studies have consistently shown that Medicaid recipients receive worse medical care than people withoutany health insurance at all! Medicaid patients have longer waits to see a doctor, fewer specialists to choose from, and poorer medical outcomes overall. A particularly morbid piece of evidence is that on average, Medicaid patients die sooner after surgery than people who have no medical insurance.

Essentially, Obamacare is forcing 20 million more Americans into second-class medical care with Medicaid.

2. “Sticker shock” as the reality of higher health insurance premiums hits home.

The majority of Americans, especially those who are young and healthy and therefore have paid low premiums in the past, are seeing their health insurance premiums rise between 50% and 150%. Further, employers are cutting full-time workers back to part-time by reducing employees’ hours per week from 40 to 29 or less, to avoid having to provide those employees with expensive, Obamacare-compliant coverage.

The “Affordable Care Act” has become anything but affordable for most people.

Read the rest of this entry »


Toxic Overreach: Obama Would Be a Fool to Pursue Immigration Next

Immigration reform next? Bad idea, writes David Frum—it’s a path littered with the same obstacles that nearly brought down Obamacare.

Thousands of immigrants marched on the US capital Washington to demand immigration reform on October 8, 2013. (Anadolu Agency/Getty)

Thousands of immigrants marched on the US capital Washington to demand immigration reform on October 8, 2013. (Anadolu Agency/Getty)

Overreach: nobody’s immune to it. Republicans overreached in the debt ceiling fight. Now, by some reports, President Obama is tempted to do the same.

Those reports state that Obama intends to proceed from the debt battle to the immigration issue, taking up again his plan to regularize the status of millions of people illegally present in the United States. Let’s leave aside for the moment the policy merits of the president’s immigration proposals. (I think they’re dreadful, but your mileage may vary.) Consider instead the politics of advancing this measure in a polarized Congress and a recession-battered country.

Why is the debate over the Affordable Care Act—Obamacare—so bitter? Yes, it’s a big and expensive new entitlement. But so was Medicare Part D back in 2004, and that program provoked nothing like the controversy of the ACA.

Read the rest of this entry »


Goodbye to Health Care Jobs

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The medical industry’s employment growth disappears. 

Kevin D. Williamson writes: In another bit of grim news for the long-term prosperity of these United States, hospitals, medical practices, and related businesses are shedding jobs: 8,000 of them since April, more than in any other sector. For the year, there have been more than 41,000 layoffs at health-care firms. As Paul Davidson and Barbara Hansen of USA Today report, those are mostly hospital staffing reductions in response to reduced reimbursement rates for Medicare patients under the sequester and cuts for some providers under the Affordable Care Act. Private insurers, who are starting to experience a burning sensation after having gone to bed with the devil on Obamacare, are reducing payments, too.

The sequester, unfortunately, is likely to be repealed at some point, but the Independent Payments Advisory Board (IPAB) is required by the ACA to reduce the growth of Medicare spending. The American Medical Association sees the writing on the wall and assumes that the bulk of any savings will come in the form of reduced payments to providers — which it more or less has to, since the ACA forbids IPAB from raising Medicare premiums or rationing care. (We are going to ration care regardless of what the law says.) The more serious long-term problem is that the aging of our population means that more and more health care will be paid at Medicare rates in the coming years, putting more financial strain on hospitals.

So hospitals are cutting back.

Read the rest of this entry »


ObamaCare: It’s unsustainable; better to scrap it and start anew

Confirming the disconnect between the empty-promise pretenses on which ObamaCare was sold and its real-world effects in practice is a new report from Medicare actuaries that says health spending in ObamaCare’s first 10 years will be about $621 billion higher than it would be without that train wreck of a law.

That’s $7,450 more in health spending per family of four through 2022, according to Duke University health-policy expert Chris Conover, writing for The Apothecary, a Forbes blog. And that figure’s contrast with candidate Barack Obama’s 2008 promise that he’d lower such families’ premiums “by up to $2,500” — during his first term! — is both grim and stark.

The Medicare actuaries’ report is consistent with their prior reports showing ObamaCare would increase, not decrease, health spending. It’s the latest evidence that Mr. Obama made America the “absurd promise” that Mr. Conover says it is. Read the rest of this entry »


51% Favor Government Shutdown Until Congress Cuts Health Care Funding

President Obama yesterday criticized congressional Republicans for insisting on spending cuts in any budget deal that continues government operations past October 1, saying they risk “economic chaos.” Most voters agree a federal government shutdown would be bad for the economy, but they’re willing to risk one until Democrats and Republicans in Congress agree on ways to cut the budget, including cuts in funding for the new national health care law. Read the rest of this entry »


(OMG. WHO KNEW?) Subsidies for Electronic Medical Records Leads to Higher Medicare Bills

Government subsidies often produce unintended consequences

The latest example comes from the New York Times, which reports that federal subsidizes to encourage doctors and hospitals to use electronic billing and recording records are leading to larger Medicare bills.

That means that taxpayers are taking a double hit even though policymakers claimed that electronic record-keeping would make health care delivery more efficient, and thus less costly…

More >> via  Cato @ Liberty