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Preventing Fraud in the Health Care Law


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This week, the health care law's state-based insurance exchanges began their open enrollment period, and unfortunately people are still unsure what the government takeover of our healthcare system will mean for them and their families. Obamacare is so large and so convoluted that the administration is struggling to implement it. Crain's Chicago Business reported that the uncertainty surrounding the law is "vexing business owners" and many individuals are "frustrated they can't plan ahead for their families' health care costs in 2014." Meanwhile, the White House has been speeding up the rollout process, cutting corners and delaying key parts of their signature health care law in order to preserve the façade that everything is just fine. Unfortunately, this haphazard implementation is putting Americans at risk and making it easier for fraudsters to game the system.

Over the July 4 weekend, the Obama administration announced 606 pages of final Obamacare regulations. Buried in this release was the announcement that the government would no longer check an individual's eligibility for federal health care insurance subsidies. You read that right: the Administration is removing the process to verify that the millions of Americans applying for federal subsidies are actually eligible, instead relying on the "honor system" when people apply. And while the White House characterizes this waiver is a "slight technical correction," it actually signals a free for all for fraudsters that the Wall Street Journal reported could lead to as much as $250 billion taxpayer dollars wrongly getting paid out.

In September, the House of Representatives passed a bill that stops the federal government from doling out these subsidies until there is a system in place to prevent fraud. This commonsense measure makes sure procedures are in place to keep crooks from abusing the system for their personal financial gain. Whatever your views on the health care law, we can all agree that requiring documentation and verification helps stop the fraud and abuse of taxpayer dollars.

On top of removing anti-fraud checks, the many delays in Obamacare's implementation have made the program even more confusing for individuals who just want to comply with the law. In a blog post last July, the administration announced a one-year delay of the employer mandate, but they still require individuals to buy insurance or be fined. This lopsided delay could result in individuals getting lost in the marketplace without good information. It's easy to envision a scenario in which someone trying to comply with the law applies for insurance and receives subsidies in the state-run exchanges thinking they are eligible for them. However, come tax season, if that individual is found to have been ineligible for the subsidy, the IRS can "claw back" the benefit, potentially resulting in thousands of dollars in fines.

By giving big businesses a reprieve from the devastating impacts of Obamacare, the Administration admitted that their health care law is not ready for prime time. What's worse, the delay of the employer mandate will likely leave many confused about where they are going to get their health insurance next year. A one-year delay for businesses but not for ordinary, hardworking Americans is unacceptable. That's why the House acted this summer to ease the burden for both businesses and individuals. Everyone should get relief from this unworkable law, not just the select few carved out by the White House.

The Obama Administration's health care law was ill-conceived and it is being poorly implemented, leaving people at risk and their tax dollars susceptible to fraud. The American people deserve better than a costly, complex government takeover of health care. In the House, we are working to protect Americans from the destructive effects of Obamacare, safeguard their tax dollars from fraud and move targeted reforms that put the patient-doctor relationship first and promote quality, affordable care through a market-based approach.

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