To say that the ‘Affordable Care Act,’ more commonly known by the people of the United States as Obamacare, was mismanaged would be a misstatement. The law, forced through during the beginning of the Barack Obama administration, did very little of what it claimed it would do, and perhaps worst of all, it increased the cost of health insurance for most people.
Now, according to a report, it turns out that the wastefulness of the program also included sending out $434 million in improper payments. To make matters worse, that was just how much money was sent out incorrectly in the first year that the payments were made, all due to an inaccurate ‘mistake’ of policy.
On Monday, they released a report concerning improperly-made payments during the first year that Obamacare was in operation.
The HHS OIG reviewed 140 insurance policies that were sold in 2014, the first year that such payments were made, and found that Centers for Medicare and Medicaid Services improperly paid out financial assistance payments for 26 of those policies.
For another five policies, the CMS authorized assistance to insurers who didn’t provide the appropriate documentation.
This means that the financial assistance provided to those insurers was possibly improper.
At the time, the Centers for Medicare and Medicaid Services were using an interim process to approve financial assistance payments, although they moved to an automated system two years later, in 2016.
The payments that were made improperly, or that might have been made improperly, included income-based tax credits and cost-sharing reductions.
The tax credits were paid to customers in order to lower the premiums, while the cost-sharing reductions were paid to insurers to lower the out-of-pocket costs for customers below certain income levels.
The interim process that improperly approves these expenses worked by having insurance companies that were participating in ‘Obamacare’ submit a monthly template.
This template outlined reimbursement based on the number of enrollees who had paid for at least the first month’s premium of their insurance plan.
However, the government did not have an accurate way, or an effective process, to ensure that the payments got to the enrollees who paid their premiums.
Instead, they relied on various insurers to verify that the information they reported on their templates was accurate.
The HHS Office of the Inspector General estimated that, according to the sample they looked at, the CMS authorized payments improperly for 461,127 policies, which adds up to $434 million.
They also estimated that the government authorized ‘potentially’ improper assistance payments of $504 million for 183,983 policies.
Combined, that amounts to as much as $938 million dollars in improper payments over the first year that Affordable Care Act was making such payments, while Obama‘s appointees were in charge of HHS.
The watchdog within the Department of Health and Human Services said that the Department of the Treasury needs to collect the improper payments, and that the agency should work to figure out whether the other payments were made improperly.
However, CMS said that it would not require Obamacare insurers to return improper money.
Instead, they attacked the methodology employed to come to the total of money misallocated, which comes to nearly a billion dollars, and said that they did not believe it could be extrapolated like that.
They also said that the inspector general for the Department of Health and Human Services did not take into account the ‘guidance’ used at the time, as it pertained to financial consideration.
The worst part is not that they disagree with the methodology, the way that the estimate was arrived at, the worst part is that the government agency, which may have given away as much as $938 million dollars of American taxpayer money improperly, doesn’t seem very interested in getting that money back.
That money isn’t theirs to misplace nonchalantly. That’s money, taken forcibly from the American taxpayer, and it sounds like the group that was designed to pay out money did a horrific job.
Now that a report has suggested that there was malfeasance in how the American people’s money was spent, the group doesn’t seem to care.
When Obamacare was first passed, many on the political right suggested that this sort of thing would happen (among other predictions, many of which came true).
Another interesting question, still unresolved, is how many millions of dollars were misspent in 2015, as the automated system did not come into use until 2016.
For that matter, was the automated system any better, any more accurate? Could there not be funds misspent on subsequent years?
Perhaps the United States government needs to take a better look at how those funds were spent, and where that money went, and even actually attempt to recover the money. Surely, that $900 million-plus dollars could be better spent elsewhere.