Category: Investigations

The federal contractor that operates ObamaCare call centers was accused of wage theft totaling more than $100 million over five years in complaints filed Monday.

The Communications Workers of America (CWA) brought the complaints with the Department of Labor, alleging that the contractor, General Dynamics Information Technology (GDIT), has been underpaying its workers.

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California is indeed the Golden State where Medicaid is concerned. The HHS Office of Inspector General (OIG) has found that, by exploiting Obamacare’s expansion of the program, California has enrolled hundreds of thousands of ineligible adults in Medicaid. Consequently, the state has bilked the federal government out of more than $1 billion in funding to which the state was not entitled. Indeed, these figures probably understate the amount of money that California officials have fraudulently extracted from the taxpayers. The OIG sampled a mere six-month period, from October 1, 2014 through March 31, 2015, to arrive at its damning assessment.

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California signed up an estimated 450,000 people under Medicaid expansion who may not have been eligible for coverage, according to a report by the U.S. Health and Human Services’ chief watchdog.

In a Feb. 21 report, the HHS’ inspector general estimated that California spent $738.2 million on 366,078 expansion beneficiaries who were ineligible. It spent an additional $416.5 million for 79,055 expansion enrollees who were “potentially” ineligible, auditors found.

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The federal government owes health insurer Molina $52 million for payments it was supposed to receive involving losses under Obamacare, the U.S. Court of Federal Claims ruled Friday.

The payments, called “risk corridors,” were diminished as part of a spending bill advanced by Republicans, who referred to them as a “bailout” for the insurance industry. Withholding them contributed to losses for insurers and to the shutdown of nonprofit insurance co-ops created under the law.

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More than a dozen states and the District of Columbia filed a motion on Thursday to intervene in the appeal of a lawsuit targeting the ACA’s cost-sharing reduction (CSR) subsidies. The lawsuit was originally brought by the U.S. House of Representatives against the Obama administration, which the Trump administration must now deal with. The Kaiser Family Foundation has estimated that the average premiums for silver plans sold on the ACA exchanges would increase by about 19% to compensate for insurers’ lack of funding without the CSR payments. The Trump administration and the House are set to update the court on Monday on how they plan to proceed with the case.

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Judicial Watch today released 944 pages of Department of Health and Human Services (HHS) records showing that the Obamacare website was launched despite serious concerns by its security testing contractor, Mitre Corporation, as well as internal executive-level apprehension about security.

The documents reveal that Mitre recommended a “Denial Authorization to Operate” in the month prior to Obamacare’s launch, noting that it could not adequately test the confidentiality and integrity of the system. It said that complete end-to-end testing of the system never occurred. Miter found that 11 “moderate” security findings and eight “low” findings remained open as September 19, 2013 – 12 days before the launch.

And an unsigned “Authorization to Operate” prepared just five days before Obamacare’s launch, indicates that the site’s “validation contractor” was “unable to adequately test the confidentiality and integrity of the [Federally Facilitated Marketplace] system in full.” That contractor, Blue Canopy, noted that they were able to access data “that should not be publically accessible.”

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Fewer than 12 months ago, some people—aka, yours truly—raised a warning about Obamacare’s cost-sharing reductions. The text of the law nowhere provided an appropriation for them, meaning that, as I wrote last May, the next President could shut them off unilaterally. At the time, I contacted several reporters, pointing out that such a move could have major implications for the health care law. None showed any interest in writing on the topic, and to the best of my knowledge, few if any reporters did.

Having now under-reacted regarding the issue during most of 2016, the media are compensating by over-reacting now. Since the House failed to pass “repeal-and-replace” legislation, breathless articles in multiple publications have examined the issue, whether the Trump Administration will cut off the subsidies, and whether insurers will bail on the Exchanges en masse as a result.

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The Trump administration says it is willing to continue paying subsidies to health insurance companies under the Affordable Care Act even though House Republicans say the payments are illegal because Congress never authorized them. The statement sends a small but potentially significant signal to insurers, encouraging them to stay in the market. The future of the payments has been in doubt because of a lawsuit filed in 2014 by House Republicans, who said the Obama administration was paying the subsidies illegally.

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The Trump administration indicated that it plans to continue the Affordable Care Act’s cost-sharing subsidies while they are part of ongoing litigation, one administration official said Monday, in what may be the clearest statement on the issue so far.

The precedent that the cost-sharing subdues would be funded while the lawsuit is being litigated remains the policy of the current administration, according to the official, who spoke on conditions of anonymity.

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The shaky case for the individual mandate is based on mistaken premises, faulty economic analysis, short-sighted politics, and flawed health policy. Opponents have found the mandate to be administratively challenging, politically unsustainable, economically unnecessary, beyond the proper role of government, and constitutionally questionable. Arguments in favor of the individual mandate usually present it as a necessary, though far less popular, means to more laudable ends.

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