Report Shows Obamacare Fraud Is Worse Than You Think:
The improper enrollment outlined in last week’s report argues against spending another $350 billion-plus to extend enhanced Obamacare subsidies.
Following the expiration of the Covid-era enhanced Obamacare subsidies at the end of last year, the corporate media have remained focused on how much Exchange enrollment might decline this year. But a new report issued by the Department of Health and Human Services (HHS) provides another perspective on the issue.
Official reports by the Congressional Budget Office and Government Accountability Office have previously examined how applicants misstate their income to qualify for subsidies and how Exchanges permitted enrollment of fictitious applicants. But the data HHS analyzed gives additional context and granular details surrounding improper enrollments into Exchange coverage. It provides yet another reminder that “success” should not merely consist of the number of people (real or otherwise) enrolled in government programs — and that Congress and the administration should take additional action to guard against fraud.
Individuals Removed
The report shows two facets of the same story: groups of individuals who have been disenrolled over the past year and additional groups still enrolled who show signs of questionable activity. The report reveals how the Centers for Medicare and Medicaid Services (CMS) removed enrollees over the second half of last year due to various program integrity efforts.
As the graphic below shows, two rounds of Medicaid periodic data matching (PDM in the chart) — i.e., removing people enrolled simultaneously in Medicaid and Exchange subsidies — culled the rolls by about 550,000. Likewise, CMS also removed approximately 665,000 enrollees who did not file federal taxes to reconcile the subsidies they received in prior years (which are based on projected income) with the subsidy amounts they should have received based on actual income (i.e., failure to reconcile, or FTR in the chart).
Additionally, the report notes that “27.8 percent of individuals in a plan where they pay no premiums whatsoever have canceled their plans through May 2026.” It would ordinarily make no sense for someone receiving “free” health coverage to disenroll from it — unless of course they were enrolled without their consent or are concerned about having to repay subsidies they do not qualify for.
The corporate media have focused on the 4 million decline in enrollment — i.e., the difference between the 23.1 million people who selected a plan during open enrollment (which ended in January) and the 19.2 million that the report says are paying premiums and currently enrolled. But if large percentages of people are canceling “free” coverage, that is a separate story in and of itself.
Continued Questionable Conduct --->READ MORE HERE
Trump admin cracks down on estimated $10 billion in Obamacare fraud, boots millions from rolls:
Stronger verification protocols have been restored after alleged scammers took advantage of the program on Biden's watch:
As part of an anti-fraud crackdown that spans the entirety of the federal government, the Trump administration's Department of Health and Human Services (HHS) uncovered millions of alleged fraudsters on the Affordable Care Act rolls, according to a report obtained by Fox News Digital.
A Biden-era spike in Obamacare enrollments led to a probe into the veracity of millions of claims, a Trump administration official confirmed. At the beginning of Biden's term, there were 10 million people enrolled in the government's healthcare program, but that number drastically skyrocketed to 22 million at its 2024 peak.
Now, the Trump administration has removed nearly three million of the fraudulent enrollees, with a planned 2.6 million left to go.
The administration official said the program's massive abuse equates to about $10 billion swindled annually from the American taxpayer between 2021 and 2024.The Biden administration relaxed eligibility checks and income verification requirements while also allowing more year-round enrollment in the program, according to the report. Furthermore, the report claims that fraudsters intentionally misstated their income levels in order to qualify and that insurance brokers signed people up for Obamacare without their knowledge, which are called "phantom enrollments." Some people also received subsidies they were not eligible for.
"By our estimate, improper, phantom, and fraudulent enrollment peaked at 5.6 million people in 2025," the report says. "We estimate 2.6 million improper and phantom enrollments remain, including over 1 million enrollments without a social security number."
The Trump administration has since restored income verification, ended some special enrollment opportunities, checked for duplicate Medicaid enrollment, investigated so-called "phantom" enrollments by scamming brokers and ended some special enrollment periods.
Right now, about 19.2 million people remain on the Obamacare rolls. --->READ MORE HERE
If you like what you see, please "Like" and/or Follow us on FACEBOOK
here, GETTR
here, and TWITTER
here.
No comments:
Post a Comment