No one spends a dollar better than the person who earned it. That adage reveals the crux of massive fraud and improper payments that plague federal health insurance programs and drive up costs for taxpayers. According to a report from the Government Accountability Office, more than 95% of the fictitious applications the GAO created and attempted to enroll in Obamacare were approved and enrolled, with insurance companies receiving thousands of taxpayers’ dollars per month on behalf of those fake enrollees.  The details of the GAO report reveal the utter negligence and perverse incentives that result when the federal government puts taxpayers’ money up for grabs to people who didn’t earn it. That includes the agents and brokers who receive commissions from insurance companies when they enroll individuals—real or fake—into federal marketplace health plans. Most Obamacare enrollments are assisted by an agent or broker. And it includes the insurance companies that can receive upward of $10,000 per year of taxpayers’ money for every individual—real or fake—enrolled in their plans. For instance, out of four fake applicants GAO sought to enroll in 2024, two were initially flagged by the system’s automatic identity checks, but later cleared after submitting fictitious identification documents, including fake citizenship documents. In the other two cases, in which GAO worked with brokers to enroll fake applicants, the system the brokers used initially flagged the applicants’ Social Security numbers as unverified. But after the GAO’s fake applicants authorized their brokers to work toward enrollment on their behalf, “Both brokers worked with the Marketplace Call Center—without the applicants—to successfully submit the applications with invalid SSNs.” The GAO noted of its false enrollment attempts that, “We either were not requested to provide the federal Marketplace with documentation or generally did not provide what was requested, yet our four fictitious applicants received subsidized coverage …” Sometimes, Obamacare’s fraud detection systems not only failed to detect fraud but manufactured false verifications. As the GAO noted, “In one case, we received a notice from the federal Marketplace that it confirmed the applicant’s estimated income based on documentation we submitted. However, we did not submit documentation to confirm the applicant’s income.” In other cases, the most basic checks are ignored. Social Security numbers provide a unique identifier, both to prevent fake enrollment through stolen Social Security numbers, and to ensure the accuracy of Obamacare payments based on income that is linked to Social Security numbers. Yet, when GAO examined the reconciliation of income data from tax records to Social Security numbers, it could not identify evidence of such reconciliation for 32%, or $21 billion of all tax credits paid in 2023. Moreover, while an applicant’s Social Security number should serve as a basic check to make sure that the same individual—or fake Social Security number or stolen identity—isn’t enrolled more than once, the GAO nevertheless found more than 29,000 Social Security numbers that received more than 365 days of plan coverage in 2023 and more than 66,000 Social Security numbers that were similarly enrolled more than once in 2024. In the most egregious example, one Social Security number “was used to receive subsidized insurance coverage for over 26,000 days (over 71 years of coverage) across over 125 insurance policies” in a single year. The GAO also identified over 7,000 instances in which the Social Security numbers of individuals enrolled in Obamacare in 2023 were for individuals who were identified in the Social Security Administration’s death files with reported death dates prior to their enrollment applications. Payments were nevertheless made to brokers and health insurance companies for these dead Obamacare enrollees. In addition to fake and fraudulent enrollments, the GAO report also noted that brokers often act illegally to make changes to an individual’s insurance plan—typically changes that will result in payment from an insurance company to the broker—without their consent. The GAO identified at least 160,000 applicants (1.5% of relevant applicants) that likely had unauthorized changes made to their plans in 2024. This aligns with a CMS statement noting that it received more than 90,000 complaints in the first eight months of 2024 from individuals who had their Obamacare plans changed without their consent. Unfortunately, fraud, abuse, and improper payments are not contained to Obamacare—they are rampant across the federal government and have been growing exponentially alongside the massive expansion in federal spending. Last year alone, the federal government identified $162 billion in improper payments among the programs that it examined. But that’s a massive understatement as the government often fails to properly audit programs. For example, Brian Blase and I found that Medicaid’s reported improper payments are half their more realistic total of $1.1 trillion over the past decade. There is plenty that lawmakers can and should do to protect the integrity of taxpayer spending. That includes not extending what were supposed to be temporary COVID subsidies that have exploded in costs and further subsidized insurance companies’ profits. And it ultimately requires right-sizing the federal government because the more opportunities fraudsters have to steal taxpayers’ money, the more they will take. The post Fraught With Fraud: Undercover GAO Investigation Reveals 95% of Its Fake Enrollees Received Obamacare Subsidies appeared first on The Daily Signal.

House Republican leadership is hoping to pass a health care plan this week. But it could hit some major speed bumps along the way. Going into the last week in session before Christmas break, House Republicans are in a rush to pass premium-slashing legislation to counter Democrat-led efforts to extend enhanced premium tax credit levels set in place under President Joe Biden. Republicans, arguing that these tax credits are expensive, prone to fraud, and inflationary, are now trying to advance their policy alternative as the credits are set to expire at the end of the year. What’s in and What’s out? The Republican bill is not a highly ambitious repeal, reform, or restructuring of Obamacare. Rather, it is a bundle of focused tweaks to the health insurance system that aims to lower health care costs, instead of the government’s current strategy, which has been to have government subsidize an increasingly unaffordable health care system. The bill’s lack of highly controversial provisions is by design, as Republicans will need to rally their narrow majority in the House and pick up least seven Democrat votes in the Senate to have any chance of the bill reaching the president’s desk before the credit expiration date. Many of the Republican proposals debated in recent weeks have involved setting up flexible health savings accounts as a replacement for the enhanced premium tax credits. The House bill left those flexible health savings accounts out, however. A House Republican leadership aide told The Daily Signal that they remain open to this idea in the future, but that their “bills right now, I think, have a real strong consensus, and again, lower premiums for all Americans.” The biggest change in bill is the appropriation of Treasury funding toward cost-sharing reductions (CSRs), a part of Obamacare. In theory, CSRs involve insurers being required to offer cheaper copays and deductibles to consumers for out-of-pocket expenses, for which the federal government reimburses them. Under Obama, funding for CSRs was originally provided directly from the executive branch to insurers, without explicit Congressional approval. This practice faced a Republican-backed court challenge before finally being cut off in 2017 during President Donald Trump’s first term. This change led to what is called “silver loading,” as insurers increased premiums on the Obamacare silver-level plan in order to make up for no longer being reimbursed for offering the legally mandated cheaper copays and deductibles. Proponents say that renewing funding for CSRs is that it will effectively end silver loading, thereby lowering premiums substantially. Additionally, although counter-intuitive, funding CSRs is likely to reduce the federal deficit, per the Congressional Budget Office (CBO), a nonpartisan budgetary analysis office funded by Congress. This is due to the fact that higher premiums from silver loading have automatically increased the deficit costs from premium tax credits, which cover a set percentage of premiums for each income level. Thus, despite the fact that the bill’s most important provision is a subsidization of a tenet of Obamacare, its deficit-cutting effect could prevent it from upsetting House fiscal hawks, many of whom entered politics as crusaders against Obamacare and the national debt. Mountain-High Procedural Hurdles The bill does not include any extension of the enhanced premium tax credits—possibly a disappointment to moderate House Republicans in swing districts, who have been calling for a short-term extension. Some moderate Republicans have signed on to efforts to extend the tax credits that Democrats shut the government down over in October. Now, moderates are expected to put on somewhat of a political show. Republican moderates will likely be allowed to propose an amendment to extend the credits in some form, but the House’s “Cut-As-You-Go” rule prohibits the adoption of amendments whose mandatory spending are expected to produce a net increase in deficits over either a six or 11-year fiscal period. Thus, any proposed amendment would likely have to include massive offsetting provisions reducing mandatory spending to make up for projected lost revenue from extending the credits. Before a bill comes to the House floor, it makes a stop at the House Rules Committee, where committee members set the terms for debate of the measure.  On Tuesday, moderates are expected to bring forth their amendment in rules committee, but it is unclear how they might tweak it to make it viable. Rep. Brian Fitzpatrick, R-Pa. (Bill Clark/CQ-Roll Call, Inc/Getty Images) The question facing House leadership is whether or not GOP moderates stay on board with the bill if they do not extend the credits. The big danger for Republicans is that more Republican members will get behind discharge petitions looking to force a vote on extending the credits. Separate discharge petitions from Rep. Brian Fitzpatrick, R-Pa., and Rep. Josh Gottheimer, D-N.J., would force votes on a two-year extension. House Minority Leader Hakeem Jeffries, D-N.Y., has his own petition for a three-year extension. The success of any one of these petitions would be a setback for the Republican effort to counter Democrats on the premium affordability issue. And if Republicans lose this political battle, the midterms could be messy. The post Will the House GOP Health Care Plan Survive the Week? appeared first on The Daily Signal.

Day One of Judge Dugan's Trial

We’ve got a new interactive series called Worst Media Take of the Week, where you — our loyal NewsBusters visitors and MRC supporters — get to vote on which leftist journalist or celebrity had the worst media take of the week.   Much appreciation to all who voted last week via NewsBusters and the MRC’s various social media sites (Facebook, Instagram and X.com).   The results of the Worst Media Take of the Week are in and the winner is… Jennifer Welch! The co-host of the I’ve Had It podcast and former Bravo reality show host won with 60 percent of the vote. Welch took first place for her disgusting attack on Erika Kirk. ABC’s The View co-host Sunny Hostin came in second place with 28 percent. Finishing last was former CBS Late Show host David Letterman at 12 percent. The following is a montage of all the nominees:      WINNER (60 percent of the vote)   Jennifer Welch: Erika Kirk Is a “Grifter” Just like Trump and Her “Unrepentant, Racist, Homophobic Husband” “She [Erika Kirk] is a grifter. And just look at the costume changes. Look at the costume changes. Look at the affect and how she does that. It’s wild. This woman should be kicked to the curb. She is an absolute grifter. Just like Donald Trump and just like her unrepentant, racist, homophobic husband was.”— Co-host Jennifer Welch on the I’ve Had It podcast, December 7.   SECOND PLACE (28 percent of the vote)   Sunny Hostin Attacks Trump’s “Xenophobia” and “Racism” Language That Leads to “White Supremacy” Taking Over a Country “I think everyone should be offended at the blatant xenophobia and racism that comes from the highest office in the United States - and the misogyny. And so now he’s just openly embracing these words like garbage, like filth….and vermin….Where have we heard that language, Whoopi? We have heard that language in places, fascist places where white supremacy has taken over the country.”— Co-host Sunny Hostin on ABC’s The View, December 10.     THIRD PLACE (12 percent of the vote)   David Letterman Sucks Up to Anti-Trump Host Jimmy Kimmel: “You Are the Leader of the Resistance” “People are aware of the fact that you are the leader of the resistance?...I’m gonna suck up to you because I feel like if I kind of tag along with you, I’ll be glorified in retrospect….If the leader of the free world is a fool, the leader of the free world then should expect and examine every bit of ridicule he receives.”— Former CBS Late Show host David Letterman to Jimmy Kimmel on ABC’s Jimmy Kimmel Live!, December 9.   Thanks again to all who participated!    Funded by James P. Jimirro

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