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The real Obamacare swindle

By Suzy Khimm

NPR has a good story about how swindlers are already trying to take advantage of the confusion over the Affordable Care Act to run health-care scams:

Days after President Obama signed the $938 billion bill into law, a cable television advertisement exhorted viewers to call an 800-number so they wouldn't miss a "limited enrollment" period to obtain coverage available "now that historic health-care legislation has passed."

And there have already been reports of door-to-door salespeople peddling "Obamacare" insurance policies.

There is, of course, no limited enrollment period for any coverage, and no such thing as a new federal insurance policy named after the president.

As NPR notes, the "bitter and divisive" debate over health reform has been a boon for the scam market, which has sought to exploit the public misconceptions about the bill. Given how quickly the "death panel" meme caught on -- and how long such fabrications have persisted in the political discourse -- the idea of purchasing an "Obamacare" insurance policy might not seem so far-fetched.

The new health law does commit millions of dollars to beefing up anti-fraud enforcement and oversight, as insurance fraud has a long history of plaguing the health-care system, and the system's upcoming expansion will create new opportunities for exploitation. In the Medicare and Medicaid programs, for example, fraudsters have long perpetrated billing scams that prey upon the elderly and the poor -- and their schemes have become increasingly complex, as I explained in the New Republic last year. The biggest scam artists aren't going to be door-to-door hucksters, but sophisticated white-collar criminals who are likely to try to exploit new changes like the conversion to electronic health records to defraud the system on a large scale. And these schemes make dispelling the myths about the new health law -- and
clarifying the real changes that are afoot -- all the more important.

— Suzy Khimm is a journalist who covered health-care reform at the New Republic and is now a political reporter at Mother Jones.

By Washington Post editor  |  April 2, 2010; 3:24 PM ET
Categories:  Explaining health-care reform  
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Next: Reconciliation

Comments

Can you please not call the health care law "Obamacare"? That's the right-wing's invention.

Posted by: Vaughan1 | April 2, 2010 7:10 PM | Report abuse

Can you please not call the health care law "Obamacare"? That's the right-wing's invention.
Posted by: Vaughan1 | April 2, 2010 7:10 PM

==========================

Oh, I see...you prefer the futurespeak title of "Affordable Health Care Act". Peddle that agitprop...the LAST thing Obamacare is, is "affordable". Obamacare is a perfectly acceptable title, especially as it will make it harder for him to run away from it.

Posted by: JohnR22 | April 2, 2010 7:39 PM | Report abuse

Suzy Khimm has certainly made a distinguished appearance here. Having said that...

Both the PPACA (aka "Obamacare") and Medicaid suffer from fraud and abuse; however, the Obama administration favors -- rather than opposes -- such fraud and abuse. As discussed on this thread almost a year ago, the addiction effect enhances the Progressive meme: by allowing fraud and abuse, the federal Progressive Party Administration both taps state fiscs and enlarges a greedy population, ready to vote for anyone who gives them the next "fix." A similar behavior was noted after the 1965 Medicaid legislation and (as documents in the Johnson Library reveal) a President may attempt (without success) to use the addictive effect to his own advantage.

Posted by: rmgregory | April 2, 2010 8:10 PM | Report abuse

I'd like to purchase an Obamacare insurance policy - I'm hoping I can get insurance against the idiotic policies of Obama and his thugs.

Posted by: annie321 | April 2, 2010 10:09 PM | Report abuse

A local orthopedist reports patients demanding immediate hip replacements, even though they aren't yet necessary. These folks are convinced that when reform takes effect, transplants will no longer be available.

Posted by: DaveoftheCoonties | April 3, 2010 12:54 AM | Report abuse

"the addiction effect enhances the Progressive meme: by allowing fraud and abuse, the federal Progressive Party Administration both taps state fiscs and enlarges a greedy population, ready to vote for anyone who gives them the next "fix." A similar behavior was noted after the 1965 Medicaid legislation and (as documents in the Johnson Library reveal) a President may attempt (without success) to use the addictive effect to his own advantage."


It is sad to hear you think that the American "population" is "greedy" and addicted. My guess is that you did not think of the American people that way during the ultra-pork-fueled-deficit Bush years.


"I'd like to purchase an Obamacare insurance policy - I'm hoping I can get insurance against the idiotic policies of Obama and his thugs."


Obama and his thugs just rescued the the private health care insurance system in America, using a model developed by socialist thugs like Bob Dole and Mitt Romney. Grow up and invent yourself a new bogie man, because this sort of pathetic anti-health care snark is so completely exhausted now, annie321.


Posted by: Patrick_M | April 3, 2010 1:28 AM | Report abuse

"A local orthopedist reports patients demanding immediate hip replacements, even though they aren't yet necessary. These folks are convinced that when reform takes effect, transplants will no longer be available."


Very sad, and a sick tribute to the disinformation campaign of the Republican party, and the xenophobia that such propaganda exploits among the most underinformed segments of our society.

Posted by: Patrick_M | April 3, 2010 1:36 AM | Report abuse

what does xenophobia have to do with anything? do you know what that word means?

unfortunately for obama, even if everything republicans sad about what this bill will do to health care in america is true (and 80% of it is) the basic fact is that we cant afford to spend $900 billion dollars and try to make it seem fiscally responsible by project savings of barely 1/10 of that amount. every dime in new taxes and spending needs to go towards reducing the debt and balancing the budget.

we will have run up more debt in that last two years that in bush's entire two terms in office. i dont even care whose fault it is, the money isnt there for obama to spend like he has.

Posted by: dummypants | April 3, 2010 4:06 AM | Report abuse

also lets be real: the most underinformed segments of society are the people who though obama was going to pay off their mortgage out of his "stash". there are many clips on youtube of obama supporters saying such things.

Posted by: dummypants | April 3, 2010 4:08 AM | Report abuse

"The biggest scam artists aren't going to be door-to-door hucksters, but sophisticated white-collar criminals who are likely to try to exploit new changes like the conversion to electronic health records to defraud the system on a large scale."

Sorry, but the biggest scam artist is out stumping in Maine and Massachusetts. He travels by 747 and goes by "Barack" ....

Posted by: mabarnes66 | April 3, 2010 10:46 AM | Report abuse

"what does xenophobia have to do with anything? do you know what that word means?"

Yes. It means a fear of something that is not known or understood.

So for people who do not understand the content of the ACA, the Republican crazy talk of "Armegeddon" and "Death Panels" and "A Government Takeover" of medicine creates fear, and that fear makes it rather easy to understand how swindlers are exploiting propaganda and ignorance, dummypants.

Posted by: Patrick_M | April 3, 2010 1:00 PM | Report abuse

People who vote for Republicans are angry right now. The Republican Party has been fooling people into voting for them for decades despite their inability to deliver policies or laws that parallel the wishes of the majority of the constituency. If you are rich people then it makes sense that you would vote for Republicans because they will at any cost fight for the lowering of taxes for rich people, but aside from rich people Republicans do very little to improve the lives of average Americans.

How is it that Republicans get elected at all? What kind of fools would vote for somebody that cares so little for governing?

It seems every cultural position a Republican takes in public is meant to simply intensify and manipulate the emotions of people, despite their already having lost the battles in debate when it comes to meaningful constructs of public policy and law. They seem willing and able to find and exploit Americans who still think battles long lost are still being waged.

Republicans of today are master manipulators of information and, they unfortunately for America, have powerful media corporations and lobbyist behind their cynical displays of misinformation and false hopes of resurrecting battles long lost to reasonable public policy and law. Republicans don’t make public policy to improve the lives of average Americans, they gain government positions to improve the situations of those who give them the most money and they gain positions of power by simply creating and manipulating public opinion facilitated by monies received.

People often discount our political system as broken but I believe this disputatious. There are huge differences between the Democrats and Republicans. I believe any American given the facts will come to find that Republicans of today have very little in mind when it comes to protecting liberty and justice for the majority in our country despite them using those words more than anybody.

I’m not going to let Republicans sell my country to the highest bidder. Democrats get my vote for years to come. I believe that Democrats are made up of the people who believe in liberty and justice for all Americans.

Posted by: ApostasyUSA | April 3, 2010 3:44 PM | Report abuse

@ ApostacyUSA,

If Republicans are only supported by the rich, as you suppose, it would follow that their goal would be to create as much wealth as possible, thereby ensuring even more of the electorate support them.
Conversely, if the Democrats are only supported by those seeking assistance from Uncle Sam, then they likely seek to create conditions under which more of the electorate must do so.
Which goal do you feel is more in tune with our country?

Posted by: OttoDog | April 3, 2010 5:00 PM | Report abuse

OttoDog,

You apparently were unable to comprehend ApostasyUSA's point, which was not that "Republicans are only supported by the rich."

His point was that Republicans engineer majorities to support them by "fooling people" into vote against their own self-interest. Once in office, they tend to enact policies which benefit the rich, and which do benefit the majority of the voters.

Hence during the Bush years, the wealthy enjoyed a huge tax cut, and the country at large got to pay for it with an enormous budget deficit, along with such wonders as the colllapse of the economy, and a trillion dollar invasion and occupation of a country with no WMD.

As for your straw man that "Democrats are only supported by those seeking assistance from Uncle Sam" ... well, no, Democrats are supported by those believe the government should protect the interests of all of the people, not just corporations and wealthy individuals. Democrats seek to enlarge a prosperous middle class, not to enlarge the numbers of people receiving public assistance.

The Bush stewardship of the economy did more to enlarge the number of people that have been forced to receive unemployment, food stamps, and other forms of public assistance than anything which transpired under Bill Clinton or Barack Obama.

Posted by: Patrick_M | April 3, 2010 5:16 PM | Report abuse

The real swindle is Obamacare itself. Trillions of dollars in new spending, stacked on top of the trillions in entitlements that we already can't afford, and all scored by the CBO to be deficit neutral in the most phony piece of accounting this side of Bernie Madoff, and rammed down the throats of the American people through bribes, threats, and coercion, in the most bitterly partisan manner possible.

And yes, Virginia, there WILL be death panels - in Obamacare, they are referred to as the "Comparative Effectiveness Research Panel". Time to repeal this bill and every politician who voted for it.

Posted by: pijacobsen | April 3, 2010 6:35 PM | Report abuse

pijacobsen, you did not get the latest talking points. Even the Republican leadership has now backed away from the pledge to repeal the ACA.

Otherwise, a really great job of parroting the party line cliches...you're just a few days out of date.

Posted by: Patrick_M | April 3, 2010 7:54 PM | Report abuse

The U.S. has a lot of issues, but the inability to read and interpret a simple paragraph is probably the most frightening. The American population, on average, reads, writes and comprehends at an 8th grade level. The Republican leadership knows that they are dealing with of a bunch of 14 year olds and so do the Insurance Companies. Most people are right in their assessment that the “Tea-baggers” marched merrily to the Bush Administrations’ tune. He started two “unfunded” wars while giving his “Rich & Corporate Base” humongous tax cuts, with a few pennies thrown in for the masses. The CBO stated many times that the upper 6% would benefit the most, yet these “Tea-baggers” went along with the program anyway. (Oh, and by the way, the tax cut was passed through “Reconciliation”).

America needs to get a clue and quit being a bunch of buffoons. We’re not even ‘human’ anymore if we’re just a bunch of consumers and that’s all we’re good for … consuming and making little consumers. Here we are, ranked 37th in the world on health care coverage yet we spend far more per person than many other countries including Australia, Austria, Belgium, Canada, Denmark, France, Germany, Iceland, Italy, and Japan. They cover everyone while we mostly cover citizens only if they’re fully employed. Thousands of Americans die each year as a result of unaffordable health insurance and/or denial of claims. Yet we have “tea parties” and town halls where racism has to compete with claims of fascism, socialism and the general drop in IQs over the last 10 years.

As for paying for this health plan, nothing provided by the Government is free. You and I pay for it with our tax dollars. Our tax dollars pay for farm subsidies to ADM, Cotton Growers, Corn Growers, BIG Tobacco and for the wars in Iraq & Afghanistan. Our tax dollars also pay for the “Billions & Billions” of dollars in aid to Israel each year, but I don’t see people jumping up and down and carrying loaded AR-15s and screaming about “THAT MONEY”. If America doesn’t wake up soon, we’ll be well on our way to becoming a third-world nation. (Personally, I think we’re already there)

At last count, 37 states plan to either put forward amendments to their state Constitutions to void this Health Care bill or to file suit in federal court to prohibit its enactment. (Once 2/3rds – or 34 – of the states pass such a law, does it then become an amendment to the U.S. Constitution?) What a wonderful example we set to the whole world. People in all the different sections of Iraq are probably thinking – hey, the Kurds can have their own niche, the Sunnis their own, and the Shiites too. We can all still be a country and divided at the same time. What a special idea! We can argue and rant and demonstrate and file law suits and protest and call each other really bad names – and we don’t even have to blow up bombs any more.

Posted by: ppsikogios | April 3, 2010 9:38 PM | Report abuse

Posted by: Patrick_M | April 3, 2010 7:54 PM

"Even the Republican leadership has now backed away from the pledge to repeal the ACA."

You wish, you kool-aid sotted Obama Zombie. We may have to wait for your Messiah to be booted out at the next opportunity, but repeal is still the goal.

"Otherwise, a really great job of parroting the party line cliches...you're just a few days out of date."

If anyone parrots cliches, it's you. I notice how you don't dare address any of the substantive points in my post, because you can't. Get a life somewhere off these boards, and get a brain too while you're at it.

Posted by: pijacobsen | April 3, 2010 9:57 PM | Report abuse

pijacobsen: "...but repeal is still the goal."

"Speaking to a Louisville audience, Mitch McConnell said he is hopeful for GOP gains in the fall election, based partly on recent poll results. “Will that make full repeal possible? It might not,” McConnell said."

"It may not be total repeal at the end of the day," North Carolina Sen. Richard Burr, who's up for reelection, said in a recent interview."

"Tennessee Sen. Bob Corker was less subtle. Talking about repeal efforts on Wednesday, Corker said, "The fact is that's not going to happen, OK?"

Posted by: Patrick_M | April 3, 2010 11:21 PM | Report abuse

"Just days ago, Rep. Jack Kingston (R-GA) was condemning the “government takeover” of health care, cheering on Tea Party protesters, and denouncing the law’s “special deals” on the floor of the House and on news shows across the country. Kingston joined the Republican effort to repeal the law in Congress and co-sponsored two separate bills to “repeal and replace” the bill. But yesterday, during a town hall at College of Coastal Georgia in Brunswik, Kingston did what’s quickly becoming a popular trend for Republicans. He walked back from his repeal rhetoric and highlighted some of the benefits of the new law."


"GOP leaders are advising their candidates to tread lightly on the “repeal the law’ strategy and focus instead on jobs and the economy. “The number one concern of the public is jobs and people losing their homes,” Sen. John Cornyn, chairman of the National Republican Senatorial Committee told the Associated Press. Cronyn added that candidates should look at how the health care bill plays at home before going out of a limb on repeal."

Posted by: Patrick_M | April 4, 2010 12:47 AM | Report abuse

how weird. why is "patrick_m" responding to nearly every post as if he's still trying to sell the bill. Obama, is that you? Oh wait, there is a 5,000 word limit on here.

Posted by: KateWilson | April 4, 2010 7:22 AM | Report abuse

"Obama, is that you?"

Yes. My "hopey changey thing" is doing very well lately. And it is nice to see YOU again, "former half-term governor of Alaska" Sarah Palin.

Posted by: Patrick_M | April 4, 2010 11:20 AM | Report abuse

Actually, selling Obamacare Insurance door to door and selling Obamacare Insurance is a lot more honest than the real HC bill. At least the buyer gets a chance to say no. And if he refuses, he won't have to worry about a penalty or an IRS audit!

I'd rather the salesman than our actual President on this one. At least the salesman believes in free enterprise.

Posted by: dmarney | April 5, 2010 8:03 AM | Report abuse

@Apostasy: "I’m not going to let Republicans sell my country to the highest bidder. Democrats get my vote for years to come. I believe that Democrats are made up of the people who believe in liberty and justice for all Americans"

I feel the same way, only in reverse.

Except for that last part. I think that the Republicans are made up of cynical and self-aggrandizing politicians, except for maybe a few well-meaning folks, but that their policies (when they advance them, and not partisan attacks) are better and more conducive to the actual experience of "liberty and justice for All Americans" than the often well-meaning (but not always) tax-and-spend-and-regulate-and-nationalize policies of the Democrats.

But that's why it's my job to vote against the Democrats. BTW, I agree completely with Patrick_M on repealing HCR. It will be modified at the fringes (and perhaps substantially), but it's never going away. At most, it will be replaced with something that spends more (all deficit spending) and purports to be something way totally better than Obamacare. But is a political maneuver, meant to try and take the issue away from the Democrats.

Posted by: Kevin_Willis | April 5, 2010 8:04 AM | Report abuse

anyone that would vote "for years to come" on style rather than substance should have their voting privliges revoked.

Oh and one question on healthcare. Do they factor in the small employer tax credits when factoring in the cost? I can't believe how many client/small employers that I work with have heard already and want their money. I'm guessing that the answer is no and that its another unfunded entitlement (this time for small business). But if CBO doesn't score it, I'm guessing it doesn't exist for Washington??

Short sighted again.

Posted by: visionbrkr | April 5, 2010 10:20 AM | Report abuse

It begins.

Endemic (and inevitable) healthcare fraud will consume 10% of all newspaper inches from this moment forth.

All you have to do is look across the pond: that's our gray socialist future.

Posted by: happyacres | April 5, 2010 11:57 AM | Report abuse

visionbrkr says:

"Oh and one question on healthcare. Do they factor in the small employer tax credits when factoring in the cost? I can't believe how many client/small employers that I work with have heard already and want their money. I'm guessing that the answer is no and that its another unfunded entitlement (this time for small business). But if CBO doesn't score it, I'm guessing it doesn't exist for Washington??"


CBO most definitely did include the tax credits in calculating the effect on the deficit. Why in the world would you assume otherwise? Based on your comments since the passage of the ACA, many would never realize that you were a supporter of the Senate bill. Kind of a "for it before you were against it" thing going on here, my friend.

Kevin_Willis says:

"At most, it will be replaced with something that spends more (all deficit spending) and purports to be something way totally better than Obamacare. But is a political maneuver, meant to try and take the issue away from the Democrats."

Yes. If you look carefully at much of the Republican commentary since passage, they seem to indicate that the "good parts" of HCR are the popular insurance reforms that improve access to care (no pre-ex, no recission, no caps) and that the "bad parts" are collection of the revenues to subsidize the new enrollees that make the good parts possible. So it would not surprise me at all if Republican changes involve turning the bill into a completely unfunded mandate, in keeping with their handiwork with Medicare Part D.

Posted by: Patrick_M | April 5, 2010 2:20 PM | Report abuse

Patrick,

Its amazing that you can see inside my mind. How do you do that? As I've said many times before we need cost controls and there's very little of that here. How do you get that I'm against this? I just want the truth that's all. And I'm stating a fact that since passage i've had calls from at least a dozen clients that have asked how much their credit is and several that have postponed planned reductions in benefits because they now know that the government will be picking up their cost increase in premium.

Please stop putting words in my mouth Patrick. it makes you look as bad as the right wing nuts like msoja etc.

i'm 100% for the senate bill but wish there were more cost controls on all players including insurers.

I'll try not to judge you even though you don't extend me that same courtesy.

Posted by: visionbrkr | April 5, 2010 2:40 PM | Report abuse

and please feel free to inform me with a link to CBO that shows they factor in lesser tax revenues received due to the payout of the tax credits.

If I'm wrong, I'll gladly admit I'm wrong or I'll say that I think they underestimate its affect or over-estimate its affect.

Posted by: visionbrkr | April 5, 2010 2:47 PM | Report abuse

visionbrkr,

Here's a summary of CBO scoring:

http://news.avancehealth.com/2009/10/cbo-scores-does-health-reform-win.html

This analysis is of the original Senate Finance Committee bill, but it serves an example of the analysis done for all the iterations of HCR, including the final ACA with the sidecar changes.

Note that gross costs include not only forecasts for payouts for the subsidies and for the additional contributions to Medicaid and SCHIP, but they also take into account the cost in reduced revenue due to small employer tax credits.

Revenue changes from tax credits are an obvious element that the CBO must (and does) take into account when scoring a package like the ACA for its impact on the federal budget deficit.

Posted by: Patrick_M | April 5, 2010 4:21 PM | Report abuse

"Please stop putting words in my mouth Patrick. it makes you look as bad as the right wing nuts like msoja etc.

i'm 100% for the senate bill but wish there were more cost controls on all players including insurers.

I'll try not to judge you even though you don't extend me that same courtesy."


visionbrkr,

I was not trying to "judge" you, I just think it is helpful to mention that you supported the passage of the law (as you do in this quote) when questioning the math and describing the process of its passage as "short-sighted."

I also wish the bill did more to lower costs, and I expect we will inevitably see additional reforms in the years ahead that will be targeted at doing just that. I don't think anybody on the right or the left thinks the law is perfect, but I am glad you and I still agree that it is an improvement on the status quo, and that it won't be "Armegeddon" for America and the end of freedom.

Posted by: Patrick_M | April 5, 2010 4:28 PM | Report abuse

Patrick,

thanks for the link. $23 billion huh? We'll see if that is all that it ends up being. I think if the administration was smart they'd talk this up more and fully explain it until they're blue in the face. I doubt they will knowing how far behind on the messaging they've been. I'll be making sure all my clients know about it and how to access it once the regs come out.

IMO you were judging me by your "you were before it before you were against it remark"

I was never against it. I just don't know how the numbers compute. I don't think they'll be as low as they are personally. I'm going to look up to try to find the small group national market figures to see what premiums cost last year but to my understanding they'll be reimbursing small employers (2-50 employees) between 35-50% of their premium. Is that just the employer funded portion? If not then there's no way that $23 billion is enough IMO.


Again i'm all for it but i'm just for all honesty in numbers. It'll be easy enough to see by 2014 if the credits amounted to more than $23 billion.

Posted by: visionbrkr | April 5, 2010 4:42 PM | Report abuse

visionbrkr:

To see the CBO scoring breakdown for the final bill with the reconciliation sidecar (student loan reform and all), follow this link:

http://www.cbo.gov/doc.cfm?index=11379

and then click on " pdf "

See Table 2 and the annual year-by year (2010 through 2019) forecasts for federal revenue reduction due to the Small Employer Tax Credit.

You may choose to disagree with the estimate, but you can't argue that CBO did not include a forecast of the impact of the credits as part of the scoring of the overal impact of the law.

Posted by: Patrick_M | April 5, 2010 4:49 PM | Report abuse

Patrick,

thanks for the link. And i was wrong to say, "I'm guessing the answer is no" and as I think more about it there's no way they'd be able to sneak that through even if they wanted to.

its not unfunded but I do believe its underfunded. I emailed KFF to see if they have data on the small employer market and the amount of premiums paid there annually. Time will tell who is right.

Posted by: visionbrkr | April 5, 2010 4:58 PM | Report abuse

The following collection of CBO "Director's Blog" log entries on the CBO's PPACA models may also be of interest to anyone interested in the scoring:

http://cboblog.cbo.gov/?cat=5

Posted by: Patrick_M | April 5, 2010 5:02 PM | Report abuse

so basically from the PDF they're saying that the small business tax credit will only cost $2 billion in 2010 in lost revenue, then $4 billion in 2011, $5 billion in 2012, $6 billion in 2013 etc.

Sorry I think those figures are low based upon my understanding of what premiums are.

Posted by: visionbrkr | April 5, 2010 5:04 PM | Report abuse

visionbrkr -

"And i was wrong to say, "I'm guessing the answer is no" and as I think more about it there's no way they'd be able to sneak that through even if they wanted to."

Thanks. Yes, I thought that was a strange assumption about CBO toward which to leap. I guess that's what prompted my editorial comment, for which I apologize, since it came off to you as judgemental.

Posted by: Patrick_M | April 5, 2010 5:06 PM | Report abuse

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