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Jordan Candler / December 21, 2016

The Government’s Fictitious Fraud Prevention

The GAO discovers more problems with ObamaCare enrollment.

The Government Accountability Office continues to find that ObamaCare employees are grossly ineffective at preventing fraud. A recent GAO report revealed that “[t]he federal and selected state-based marketplaces approved health-insurance coverage and subsidies for 9 of 12 of GAO’s fictitious applications made during a 2016 SEP [Special Enrollment Period].” An SEP is defined as “an opportunity period to allow an individual to apply for health coverage after events such as losing minimum essential coverage or getting married.”

“For these 9 applications,” the report elucidates, “we were approved for APTC [advance premium tax credit] subsidies, which totaled about $1,580 on a monthly basis, or about $18,960 annually. These 9 applicants also each were approved for CSR [cost-sharing reduction] subsidies, putting them in a position to further benefit if they used medical services.” This is a never-ending saga. According to John Sexton, “A report in 2014 found 11 of 12 fictitious applicants were able to get insurance. In October 2015 17 of 18 were approved. So the exchanges do seem to have improved slightly at fraud detection, though a 25% success rate several years into the program is really nothing to brag about.”

The TSA has similar misfortunes. In 2015, clandestine DHS workers were sent to examine the nation’s airport screening process. A total of 70 tests were conducted, but only three were successful in stopping weapons from getting past security. And that’s not to mention the myriad other problems that plague the systems. With ObamaCare, for example, co-ops are falling left and right. Whether it’s the TSA or the government’s insurance takeover, the authors’ ambitions were fictitious and the outcomes predictable. Let’s just hope the incoming president and new Congress weren’t speaking fiction when they promised to do something about it.

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