Undercover Obamacare shoppers were at the center of heated disputes at a House hearing Wednesday on the insurance marketplaces set up under President Obama’s healthcare law.
The “secret shoppers,” used by a government watchdog to test oversight in the marketplaces, were largely able to enroll in federally subsidized plans even though they used fraudulent information about personal identity and tax status.
Republicans on the House Energy and Commerce Committee pointed to that investigation, and several others carried out by the Government Accountability Office and the Inspector General for the Department of Health and Human Services, to argue that the federal government has wasted massive sums of money on failed state marketplaces and failed to sufficiently oversee the federal healthcare.gov marketplace.
“We now have three years of undercover testing, and results have not improved,” Rep. Joe Pitts, health subcommittee chairman, told Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services.
All 10 of the fictitious applications submitted by the GAO in 2015 were approved. When the agency repeated the exercise this year, all 15 of its applications were approved. The findings suggest the marketplaces are vulnerable to fraud by people trying to collect taxpayer subsidies for which they’re not eligible, the watchdog agency wrote.
The Obamacare marketplaces are an especially charged topic now, with a month and a half remaining until they open for their fourth enrollment season. As some insurers have left the marketplaces and raised premiums, Republicans have sought to portray the law as fraught with problems that are leaving consumers without affordable options.
Slavitt said the administration has implemented the GAO’s recommendations for improving oversight. The Department of Health and Human Services responded Wednesday by saying it has put in place 43 suggestions and submitted almost 100 more for review.
“The marketplace takes seriously the responsibility to protect taxpayer funds, while making coverage available to eligible people,” HHS spokesman Matt Inzeo said.
But Democrats attacked the GAO’s methods, saying the secret shoppers don’t reflect how Americans would behave in real life.
The top Democrat on the Energy and Commerce Committee, Rep. Frank Pallone of New Jersey, called the report “ridiculous” and a “farce.” Rep. Diana DeGette, D-Colo., asked Slavitt whether he knows of any actual cases of people who intentionally misrepresented themselves to get insurance subsidies.
“I’m unclear why someone would try to do this in real life,” DeGette said. “Do you know of any actual cases of real people who did this?”
“I do not,” Slavitt responded.
Reports released Tuesday by Energy and Commerce Republicans looked at federal spending on the marketplaces, including the taxpayer-funded co-ops that have largely failed, and how the government is managing the programs.
Lawmakers spent much of Wednesday’s hearing presenting contradictory views of how the marketplaces have fared.
Republicans pointed to rising premiums and plans canceled by insurers exiting due to heavy losses. Democrats noted Obamacare’s significant coverage expansions and protections for those with pre-existing conditions and accused the GOP of refusing to fix the law’s problems.
“It’s a little bit broken, but it can be fixed,” said Rep. Eliot Engel, D-N.Y.
“If you’re looking for perfection in any piece of legislation, you don’t come to Congress,” said Rep. Gene Green, D-Texas. “I would love to see a plan that would actually help expand coverage more than we’ve done.”
