WASHINGTON – With a nasty showdown looming, congressional Republicans are broadening their assault on Obamacare, offering up their own less costly plan as an alternative while insisting the massive healthcare program championed by the White House presents a golden opportunity for scammers.
Implementation of critical aspects of the Affordable Health Care Act are slated to occur on Oct. 1, the beginning of the federal fiscal year, and GOP lawmakers are pulling out all the stops in a last-ditch effort to see that it never happens.
House Speaker John Boehner (R-Ohio), who consistently maintained it would be a mistake for Republicans to initiate a confrontation that could force a shutdown of the federal government, has acquiesced to House conservatives and will now move ahead with a plan to defund the broad healthcare reform program as a part of negotiations over a continuing resolution to fund the entire government.
Several committees controlled by the GOP are now contributing to that defunding effort.
– The House Oversight & Government Reform Committee released a report asserting that the opportunities for fraud in a significant part of the AHCA dealing with navigators are rampant. Navigators, also known as assisters, are those individuals hired to encourage and facilitate enrollment in health insurance exchanges.
– The Republican Study Committee, a conservative caucus composed of House Republicans, released a competing healthcare measure — the American Health Care Reform Act — that would attempt to expand health insurance coverage through tax deductions and a program to provide federal assistance for those with pre-existing conditions.
– The House Subcommittee on Regulatory Reform, Commercial and Antitrust Law held a hearing on the anti-trust issues involving Obamacare, with several witnesses maintaining that the ACHA will worsen the already problematic issue of monopolies within the healthcare market place, thus permitting costs to rise.
Rep. Elijah Cummings (D-Md.), ranking member of the House Oversight & Government Reform Committee, said recent GOP efforts are not “designed to improve implementation of the law at all, but rather to bring it down. Worse, this appears to be part of a broader, coordinated campaign by House Republicans to take the unprecedented step of shutting down the federal government unless the Affordable Care Act is completely defunded through the continuing resolution.”
“We will not be complicit in efforts to throw sand in the gears of this program as part of a broader campaign to take away health insurance coverage for tens of millions of Americans,” Cummings said.
But Boehner counters that the American public “continues to adamantly oppose the healthcare law,” citing several recent surveys showing disapproval at a record high. With Obamacare’s implementation set to begin in just two weeks, Boehner said, families and small-business owners are right to be concerned.
“We’re going to continue to do everything we can to repeal the president’s failed healthcare law,” Boehner said.
On the fraud front, the House Oversight & Government Reform Committee contends in its report that the navigator and assister programs lack basic safeguards against fraud and abuse.
The navigator program was created by Obamacare as an outreach program to encourage and facilitate enrollment in health insurance exchanges. Navigators were intended to be funded through the operating funds of state exchanges but several states objected, leading the Obama administration to create a twin program — the In-Person Assistance Program — which fulfills the same function but uses federal monies and identifies its representatives as assisters.
The report notes that neither navigators nor assisters are required to undergo background checks and/or be fingerprinted, meaning those utilizing the program have no basis to determine if they are seeking help from a trained and certified personnel or a scam artist.
It also reports that in some states navigators and assisters are paid based on the number of persons they enroll, creating a conflict of interest.
“With this kind of pay structure, navigators and assisters have a financial incentive to persuade people to enroll,” the report said.
In conclusion, the report said, “Given the stories about how scammers are gearing up to take advantage of the tremendous confusion caused by Obamacare, Americans are at an increased risk of being the victim of fraud and identity theft because of the administration’s poor development of its outreach program.”
Meanwhile, the Republican Study Committee released its AHCA alternative, according to Rep. Steve Scalise (R-La.), the panel chairman, because “it is also important to lay out the reforms we stand behind and support.”
“American families and businesses deserve and demand real solutions to the serious problems that exist in our healthcare system,” he said. “The RSC’s American Health Care Reform Act is a common-sense bill that will lower costs using conservative, free-market solutions which give American families more choices without the unworkable mandates and billions in taxes included in President Obama’s healthcare law.”
The 200-page bill offers $20,000 in tax deductions to families and a $7,500 deduction to individuals to purchase insurance from vendors in any state — thus, supporters say, allowing people to save money by selecting lower-cost providers.
The measure also offers altered proposals to some of the more popular aspects of Obamacare – creation of a $25 billion fund to lower costs for those afflicted with pre-existing conditions, permitting people to carry their insurance from job to job and permitting coverage for adult children up to age 26.
“By allowing people to buy health insurance across state lines and pool together so small businesses and families can get the same buying power as large corporations, we can lower costs and increase choices while removing Washington bureaucrats from your healthcare decisions,” Scalise said.
Supporters maintain the cost of the program will be paid through “savings.”
And testifying before the House Judiciary Committee, Thomas P. Miller, resident fellow in Health Policy Studies at the American Enterprise Institute, noted that healthcare providers with market power enjoy more pricing freedom than monopolists in other markets – providing them with the ability to sometimes charge a lot of money for relatively inexpensive goods and services.
Traditional antitrust enforcement has done little to halt consolidation in local hospital markets over the last two decades. ACHA, Miller said, does little to address the monopoly problem and may even worsen it by favoring entrenched interests, thus hindering innovative start-ups and encouraging additional consolidation to increase market share.
“Heavily regulated healthcare providers and insurers increasingly will have to focus more on dealing with the mandates, rules, and payment incentives of their main customers — government administrators, and less on the needs and wants of their patients and other private payers,” Miller said.