The federal government may be incorrectly paying people twice to help them obtain health coverage under the Affordable Care Act, according to a report from the Government Accountability Office.
The report, commissioned by Republicans on Capitol Hill, also found the government may be paying more than its fair share of the cost and allowing gaps in coverage.
Democrats on the House Energy and Commerce Committee's subcommittee on health, which commissioned the report, immediately blasted the findings as a partisan attack on the law. “I do not believe that today's hearing is about program integrity,” said Rep. Frank Pallone, Jr. (D-N.J.) at a committee meeting Friday. “It is another example of Republicans' relentless and tone-deaf war on the Affordable Care Act.”
Democrats on the committee also complained they had not receiving the report in enough time to adequately prepare for the hearing. Pallone in his opening remarks questioned the GAO's motives and said he does not think those who qualify for Medicaid would have the desire, time, money or expertise to try to commit fraud against the ACA.
Rep. Marsha Blackburn (R-Tenn.) countered the administration has gotten too lax while trying to encourage enrollment in the ACA. “They've really thrown the door open for fraud,” she said.
The GAO noted that the number of consumers being paid twice is “relatively small” but said it could increase as more people enroll in exchanges or if more states expand Medicaid.
The report also found that states with federal exchanges have a limited ability to ensure that state expenditures are properly matched the federal funds.
GAO recommended that the Centers for Medicare and Medicaid Services monitor the timeliness of account transfers in states, periodically check for duplicative coverage and then monitor those checks for effectiveness.
This is the second GAO investigation to find flaws in eligibility determination under the ACA. A report released in July found that investigators were able to get coverage for 11 of 18 fake identities, including some through two enrollment periods.
This week's GAO report found that the federal government is not ensuring near real time transfer of records with states that have a federally-operated exchange. This can lead to a consumer continuing to receive a subsidy for private insurance while also being newly enrolled in Medicaid.
The opposite could also occur, with the consumer experiencing a gap in coverage and possibly forgoing medical care.
The partisan sniping about possible fraud in the program comes about a week before the ACA's third open-enrollment period begins.
