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Democrats decry undercover probe of HealthCare.gov, but investigator says it exposed concerns

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WASHINGTON — Senior Democrats pushed back Thursday against an undercover government probe of President Barack Obama's health care law, saying it didn't uncover any real fraud.

Investigators for the nonpartisan Government Accountability Office signed up 11 bogus beneficiaries for 2014 coverage then got HealthCare.gov to continue benefits this year for all but one.

Sen. Ron Wyden, D-Ore., said these were "fictitious cases" and the GAO investigators themselves admit the findings can't be translated to the 10 million people getting subsidized coverage through the law's health insurance markets. Wyden spoke at a Finance Committee hearing on the investigation.

But GAO's audits chief Seto Bagdoyan said the investigation exposed real concerns. He said it was relatively easy for GAO's fictitious characters to get and keep coverage, even to get reinstated after HealthCare.gov terminated them. HealthCare.gov seems to put a higher priority on getting people covered than on verifying they are legally entitled to benefits, Bagdoyan said.

Democrats have no tolerance for fraud, but "the report up for discussion today is not about any real-world fraud," Wyden said. "Not one of them was a real person who filed taxes or got medical services. No fast-buck fraudster got a government check sent to their bank account."

Bagdoyan said GAO is continuing its work on the strength of HealthCare.gov's antifraud controls, but his preliminary conclusion is that the administration's main focus is to get as many people signed up as possible. "As of now, the balance would probably favor access over program integrity," he said.

For example, the investigation found that HealthCare.gov's document-processing contractor is not charged with deterring fraud beyond looking for papers that appear to have been altered. "They are not tasked to look for fraud," Bagdoyan said, adding: "We do have concerns about the flags we've detected."

The law's subsidies for premiums get paid directly to insurers, not individual policyholders. But health insurance is a valuable product in and of itself, with the cost of employer-sponsored family coverage averaging close to $17,000 a year.

Opponents of Obama's health care law don't need much prodding to recite its flaws, real or imagined. But GAO's findings aren't pure make-believe, said Sen. Dan Coats, R-Ind.

"Sure it's fictitious," Coats said. "But if this isn't an alarm bell ... I don't know what is."

GAO is the investigative agency of Congress.

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Video:
PHOTO: Phony applicants that investigators signed up last year under President Barack Obama's health care law got automatically re-enrolled for 2015. Some received even bigger taxpayer subsidies a congressional probe found. (July 16)
Phony applicants that investigators signed up last year under President Barack Obama's health care law got automatically re-enrolled for 2015. Some received even bigger taxpayer subsidies a congressional probe found. (July 16)

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