(Published 11/12/13)
Though a sideshow throughout Obamacare’s passage and litigation, Medicaid’s pivotal role in President Obama’s health care reform effort has become apparent following the law’s October 1 implementation. In many states, Medicaid enrollment through the Healthcare.gov portal is dwarfing the number of “private” insurance plan purchases.
While this development represents a major financial threat to the survival of Obamacare, new regulations established by Obamacare to cover Medicaid enrollment have created a major threat to the United States’ ability to administrate that far larger benefit program.
Following is a summary of the problem:
- Non-citizens are eligible for Medicaid and CHIP (Children’s Health Insurance Program). This is not a new development. However, the documentation and verification process for such enrollments was significantly eased by regulations in the Affordable Care Act.
- Getting fraudulent applications for Medicaid or CHIP approved is now easier, and thus more likely.
- The risk is increased by the security concerns inherent in the Navigator/Assister program. (For background on these concerns, read: “DRAINING THE SWAMP: Top 40 Troubling Listings from the Obamacare Navigator/Assister Security Nightmare”, and “Identity Theft Russian Roulette: Healthcare.gov Refers Users to Uncertified Navigators and Assisters”.) Also watch James O’Keefe’s undercover sting, which reveals the inevitable results of creating such an unaccountable program.)
While troubling, final approval of fraudulent applications represents a lesser element of the problem regarding non-citizen enrollment. The greater concern is initial approval:
- Applicants attempting to register for Medicaid as non-citizens by using Healthcare.gov will have their identification checked in real-time by the SAVE (Systematic Alien Verification for Entitlements) database. But if SAVE verification fails, the applicant is not prevented from enrolling in Medicaid/CHIP.
- In fact, the opposite occurs: the applicant is likely enrolled in Medicaid immediately.
- The applicant is then given a 90-day period to clear up the identification problem.
- This “enroll first, confirm later” regulation, combined with the ACA’s easing of verification requirements, allows anyone, from a computer anywhere in the world, to successfully auto-enroll for 90 days of Medicaid by entering fraudulent information about being a certain category of legal alien living in the United States.
- There is no guarantee that state governments will take action to cancel these enrollments at the end of each application’s 90-day period if identification is never provided. The cancellation of unverified enrollments is left to each state’s available manpower and political will.
- At the end of the 90-day period, if states do indeed ask the applicant to produce identification or to have the enrollment canceled, the applicant is allowed to ask for an extension of the 90-day period. The applicant can get the period extended for significantly longer.
- Obamacare does not allow any information entered into Healthcare.gov to be used for legal action against illegal immigrants. Like “catch and release,” an applicant could attempt to fraudulently enroll repeatedly.
- Foreign entities looking to flood the Medicaid rolls with fraudulent auto-enrollments are, of course, beyond U.S. prosecution and able to cause such chaos.
- An organized effort by domestic or foreign entities to create countless numbers of these fraudulent enrollments could challenge Medicaid with an unsolvable administrative situation …