GAO Launched an Obamacare Sting Operation—and Almost All Fake Insurance Applications Were Approved
Report suggests the health care law’s eligibility verification system isn't working.
An undercover operation found that the majority of fake Obamacare applications submitted were approved by the health law's enrollment system.
Fake applicants were able to get subsidized insurance coverage in 11 of 18 attempts, according to a report from the nonpartisan Government Accountability Office. The agency conducted the sting operation to test the strength of the Affordable Care Act's eligibility-verification system.
The findings will be discussed at a House Ways and Means hearing Wednesday. They were revealed in an advance copy of the testimony from Seto Bagdoyan, head of GAO's Forensic Audits and Investigative Service, provided to the Associated Press.
The undercover investigators created fake identities by inventing Social Security numbers, income, and citizenship, and by counterfeiting documents.
Eleven of 12 fake online or telephone applications were approved, according to Bagdoyan. Five of six phone applications were successful, with the exception of one caller who declined to give a Social Security number. Six online applications were initially blocked by the verification system, but the investigators were able to find a workaround by going through the call center.
"The total amount of these credits for the 11 approved applications is about $2,500 monthly or about $30,000 annually," Bagdoyan said, according to a report from NBC. "We also obtained cost-sharing reduction subsidies, according to marketplace representatives, in at least nine of the 11 cases."
The investigators did not have the same luck with in-person assistors: They were unable to get help in five of six cases, and the last was told by the assistor that the income reported was too high for subsidized coverage.
The accuracy of the health law's eligibility verification system has been an ongoing concern among lawmakers and officials, and Republicans have repeatedly pointed to it as evidence that the law leaves the government vulnerable to fraud.
The GAO investigation was requested by several Republican senators and representatives before the insurance exchanges launched in the fall, according to The Washington Post.
The administration, meanwhile, maintains that it is working to improve the process.
"We are examining this report carefully and will work with GAO to identify additional strategies to strengthen our verification processes," said administration spokesman Aaron Albright.
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