Audits and investigations into the effects of ObamaCare from congressional committees, government auditors, advocacy groups, and others.
House Republican committee chairmen on Wednesday subpoenaed Treasury Secretary Jack Lew for documents related to ObamaCare payments that Republicans say are unlawful.
House Energy and Commerce Chairman Fred Upton (R-Mich.) and House Ways and Means Committee Chairman Kevin Brady (R-Texas) issued the subpoena for Lew and three Internal Revenue Service officials to produce documents related to financial help for people under ObamaCare known as “cost sharing reductions.”
The lawmakers are issuing the subpoena after repeatedly requesting the information throughout 2015 but being rebuffed by the administration.
Judicial Watch today released over 1,000 pages of new documents that show federal health care officials knew that the Obamacare website, when it launched in 2013, did not have the required “authorization to operate” from agency information security officials. These documents, obtained from the U.S. Department of Health and Human Services, come in two productions of records: a 143-page production and an 886-page production. The email records reveal that HHS officials had significant concerns about the security of the Healthcare.gov site leading up to its October 1, 2013, launch.
The Obama administration wasn’t able to ensure that all tax-credit payments made to insurers under the health law in 2014 were on behalf of consumers who had paid their premiums, according to a federal oversight agency. The Health and Human Services’ Office of Inspector General released the report Wednesday. The findings raise questions about the oversight of tax-credit payments that went to insurers on behalf of consumers who qualified for financial assistance.
The Department of Health & Human Services’ Office of the Inspector General found that the Centers for Medicare & Medicaid Services (CMS):
• Did not have an effective process in place to ensure that advance premium tax credit (APTC) payments were made only for enrollees who had paid their monthly premiums; instead, CMS relied on each qualified health plan (QHP) issuer to verify that enrollees paid their monthly premiums and to attest that APTC payment information that the issuer reported on its template was accurate; and
• Had sole responsibility for ensuring that APTC payments were made only for confirmed enrollees and did not share these data for enrollees with the IRS when making payments.
The OIG determined that CMS’s processes limited its ability to ensure that APTC payments made to QHP issuers were only for enrollees who had made their premium payments.
Poor planning and a “lack of effective leadership” within the state Department of Human Services prevented the department’s $155 million computer system from meeting the goals of the federal Affordable Care Act, according to a report released today by the Hawaii State Auditor.
The system has not been able to meet federal goals of creating a simple, real-time process for enrolling and determining eligibility for coverage, according to the auditor.
The lone health insurance cooperative to make money last year on the ObamaCare insurance exchanges is now losing millions and suspending individual enrollment for 2016. Maine’s Community Health Options lost more than $17 million in the first nine months of this year, after making $10.9 million in the same period last year. A spokesman said higher-than-expected medical costs have hurt the co-op. An Associated Press review of financial statements from 10 of the 11 surviving co-ops shows that they lost, on average, more than $21 million in the first nine months of this year.
“Woefully sloppy and willfully ignorant” is how Chairman Tim Murphy (R-PA) described the oversight of the state-run health insurance exchanges at an Energy & Commerce oversight hearing Tuesday.
Andy Slavitt, Acting Administrator for the Centers for Medicare & Medicaid Services (CMS), testified before the subcommittee on the use of federal funds provided to establish state-based marketplaces under the Affordable Care Act.
CMS doled out more than $5.5 billion in grant money to construct exchanges in 17 states, but lawmakers now question whether this money has been used properly. Chairman Murphy noted that every single state exchange faces significant budget shortfalls. For example, $733 million was given to establish state exchanges in Hawaii, Nevada, New Mexico, and Oregon. All four exchanges failed to become self-sustaining and were forced to transition consumers to the federal marketplace. It is increasingly unclear whether or not the money will be recouped.
Congresswoman Marsha Blackburn (R-TN) questioned Slavitt about a recent report from the Government Accountability Office which revealed that some state exchanges’ information technology systems were still functioning improperly. The report found that CMS “did not always clearly document, define, or communicate its oversight roles and responsibilities to states as called for by best practices for project management.” State administrators say communication with CMS has been poor, which “adversely affected states’ deadlines, increased uncertainty, and required additional work.”
CMS is charged with reviewing states’ funding requests and conducting audits to ensure all money is being spent legally. After January 1, 2015, states were not allowed to spend grant money on operation expenses such as rent, utilities, telecommunications, or software maintenance. Chairman Murphy cited a report from the Office of Inspector General revealing that Washington state may have used its grant money for operational costs, contrary to law.
Slavitt contended all current state marketplaces are sustainable despite these compelling challenges. When asked by Congressman David McKinley (R-WV) whether anyone has lost their job for giving erroneous advice to the state exchanges, Slavitt was unable to provide a single name.
Tuesday’s hearing was the second Energy & Commerce oversight hearing to address the tumultuous problems within the state marketplaces in an effort to ensure that taxpayer dollars are being spent wisely and in accordance with the law.
Cassandra Gekas, operations director for Vermont Health Connect, said staff members are working on a problem in which hundreds of people who paid their monthly premiums on time were canceled for nonpayment. Apparently, the cancellations were related to a five- to seven-day period it takes for the system to process end of the month payments. Vermont Health Connect was plagued with technical glitches and security problems after its launch Oct. 1, 2013.
When Oregon Attorney General Ellen Rosenblum filed suit against Oracle last year, she claimed the contractor “repeatedly lied and defrauded the state” during the course of its work on the failed Cover Oregon health exchange. The defunct health exchange website cost $300 million in federal grants, which could mean that even if Oregon prevails in court and wins a judgment for the billions it is seeking, the state might not be able to keep any of it.
When consumer advocates tried to call the obstetrician-gynecologists in the online directory of insurers’ in-network providers on the Maryland state exchange, they found that only about 22% of the 1,493 practitioners were accepting new patients, performed well-patient visits and had appointments available within four weeks. More than a third weren’t available at all because they had left the networks, retired or were dead.