Ease of fake O-Care sign-ups worries GOP

Republicans say the Government Accountability Office (GAO) has shown it's too easy for fake applicants to sign-up for health insurance through the federal exchange, but the agency counters it’s too early to draw conclusions.

The House Ways and Means Oversight subcommittee held a hearing Wednesday about an undercover investigation by the GAO that found it was able to sign up 11 out of 12 fake applicants using false citizenship/immigration and income documents.


“The initial findings are deeply troubling to me,” said subcommittee Chairman Charles BoustanyCharles William BoustanyFormer lawmakers call on leadership to focus on unity Partial disengagement based on democratic characteristics: A new era of US-China economic relations Lobbying world MORE (R-La.). “We’re in an area, where tax credits are being utilized to undermine the program. … These kinds of situations are intolerable, whether you are a Republican or a Democratic.”

However, Seto Bagdoyan, acting director of the GAO’s investigative services, said the investigation is too small to draw conclusions that people might be using fake documents to sign up for health insurance and receive federal subsidies.

“I would emphasize the narrowness and smallness of our sample,” he said. “The intent of this sample was not to project in any way — it’s too small for that — it was to identify issues.”

Bagdoyan said the agency is using what it learned from the sting to expand its investigation, but he couldn’t provide any more details since the probe is ongoing. He says the GAO will provide an updated report in a few months to expand on the controls that are in place to stop people from signing up using false information.

Democrats argued the hearing was just another political attempt by Republicans to smear the Affordable Care Act.

“Fifty-two times my colleagues on the other side of the aisle have tried to repeal the act … so it’s interesting to hear their concern,” Rep. Joseph Crowley (D-N.Y.) said. “Frankly, this hearing is premature.”

The GAO investigation initially tried to sign up fake applicants using HealthCare.gov but were denied because of the control measures. They were then instructed to apply via phone through a third-party contractor and found more success.
The Centers for Medicare and Medicaid Services argues it has back-end controls in place to verify information on insurance applications.
However, several reports have found problems with the agency’s verification system, and the agency has admitted it is unable to verify many of the applications.
“While the Marketplace has several layers of safeguards in place to verify consumer data, including requiring consumers to submit accurate information to qualify for health coverage, we are examining this report carefully and will work with GAO to identify additional strategies to strengthen our verification processes,” said Aaron Albright, a CMS spokesman.