Will There Be Fraud With Obamacare’s Lack Of Income Verification?

Lipstick on a pigAs Obamacare’s startup date for the individual mandate approaches, the focus has become the lack of income verification for subsidies. Under new rules published by HHS federally operated exchanges still will verify such information beginning in 2014, but states operating their own exchanges can wait until 2015 to do so

Under the Affordable Care Act, individuals with annual incomes ranging between 100% and 400% of the federal poverty level who do not have access to affordable coverage through their employer are eligible for subsidized coverage through the exchanges.

Prior to the final rule, exchanges were expected to verify applicants’ income status and conduct random checks to determine their access to employer-sponsored coverage. But under the new rules it will not require the states running their own marketplaces to do this check until 2015.

Subsidies are based on income levels but in the initial year of operation the federal government will take an applicant’s word on their income. The federal government has decided that they will only sample a statistically significant number of these people with large income discrepancies, rather than the entire group.

Most applicants will supply honest information just as most do on their tax returns but the opportunity for “free money” will be too much for some people. Expect widespread abuses of the new Obamacare system. If Medicaid fraud is any indication of the government’s ability to police such a system then there may not be enough money to pay for this program.

Not all abuses will be venal. Many of the income problems will occur due to honest mistakes by uninformed applicants. The government’s definition and recipient’s definitions are often different. If HHS does not have clear definitions of income and communicate these to applicants expect big problems.

The really confusing thing about our new four-part health system is that the federal subsidies available to households earning the same income can vary dramatically, depending on which part of the health system you find yourself in.

As long as you are old or disabled, Medicare treats all comers roughly equally. The federal contribution to Medicaid varies from state to state, but the level of coverage tends to be pretty similar across recipients.

Subsidies for employer-sponsored insurance, meanwhile, are much higher for households earning high incomes, and thus paying high taxes, than for less affluent households, while subsidies for the new exchange policies are generous for low-earners and phase out for high-earners. The upshot is that subsidies for many low- and middle-income households are far more generous on the exchanges than they are for employer-sponsored insurance.

If the employer mandate and income verification are unworkable now, will they be workable in year? If the federal government never gets the employer mandate up and running, what will stop employers from dropping health insurance for lower paid workers?

Obamacare looked good to the liberals when it was jammed through the Congress on a purely partisan vote, but it seems that it is more than the government can handle. Anyway that the Obama administration describes this boondoggle, you just can’t put lipstick on this pig.


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Waste and Fraud at Planned Parenthood

Planned ParenthoodIf you’re wondering why we’re in such a financial hole, you’ll need to know that the Federal government subsidizes hundreds if not thousands of organizations and programs. Most are perfectly innocent and helpful to Americans in their everyday lives.

Some, however, strike a dissonant chord with segments of the American people. One such organization is Planned Parenthood. Since the Roe v Wade ruling that allowed abortions the organization has become a lightening rod for pro-choice and anti-abortion advocates.

Congressional Republicans have attempted to defund the organization since the 1980s. In 2011 the issue nearly led to a government shutdown.  Planned Parenthood claims that the federal money that they receive is not used to fund abortion services.

However, pro-life activists have argued that the funding frees up other resources which are, in turn, used to provide abortions.

Planned Parenthood is the largest single provider of abortions in the U.S. In 2009, Planned Parenthood performed 332,278 abortions (1.21 million abortions were performed in the US in 2008), from which it derives about $164,154,000, or 15% of its annual revenue as of their 2008-2009 calculations.

According to their own estimates, its contraceptive services prevent approximately 612,000 unintended pregnancies and 291,000 abortions annually.

Charges of fraud by Planned Parenthood have begun to pop up all over the country. The Alliance Defense Fund, in conjunction with the Susan B. Anthony List, released its summary report on publicly available federal and state audits that identify waste, abuse, and potential fraud by Planned Parenthood and state family planning programs and reveal systemic misuse of nearly $100 million taxpayer dollars.

Ten state audits of Planned Parenthood affiliates in California, New York State, Texas, and Washington reveal waste and abuse totaling nearly $8 million. Moreover, 38 federal audits of 19 states across the country uncovered $88-99 million of waste and abuse in “family planning” programs.

Two of these audits, in New York and New Jersey, specifically identified Planned Parenthood, and only Planned Parenthood, as a source of overbilling in the family planning programs; the combined waste in these two audits alone was over $1.5 million.

At the end of July news broke that Planned Parenthood would be settling with Texas, repaying $1.4 Million for “fraudulently overbilling” the state’s Medicaid program.

The Texas settlement is only a portion of a larger settlement with the state and federal governments and Karen Reynolds, a former Planned Parenthood Gulf Coast employee who blew the whistle on its fraudulent billing. Planned Parenthood will actually repay $4.3 million to U.S. and Texas taxpayers to settle the fraud claims and an unspecified amount for Reynolds’ attorneys’ fees.

In 2012, Planned Parenthood received a record amount in taxpayer support that totaled $542 million. This despite repeated attempts by Republicans to limit or completely defund the organization. The organization now receives about 45% of its budget from taxpayers.

When the report was released in January of this year, critics made their opinions known to the public. “Americans are sick and tired of underwriting the nation’s largest abortion business,” said Marjorie Dannenfelser, president of the Susan B. Anthony List. Republican Tennessee Rep. Diane Black said the report “underscores the pressing need to cut off all federal funding for Planned Parenthood.” 

Separate efforts at the state level to eliminate funding have been blocked by the courts. Mostly recently, a federal appeals court in October blocked Indiana from carrying out a law to cut Medicaid funding for Planned Parenthood.

Rather than separate their abortion clinics from the rest of their services, Planned Parenthood maintains that both sides of their business are important for women’s health. Perhaps it’s also the $164 million in revenue that abortions generate for the organization.

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Waste in the Joint POW-MIA Accounting Command

POW-MIA FlagThis is a sad tale of how the Pentagon has neglected the Congressional mandate for finding, recovering and identifying U.S. service members missing in action from past conflicts.

Three years ago the Congress mandated that the Pentagon identify 200 identifications of war remains per year by 2015. The United States currently has 83,000 troops missing from World War II, Korea and Vietnam. At this point they are only able to identify 70 to 80 per year.

The investigation was disclosed at a Senate hearing held in response to an Associated Press story revealing an internal Pentagon report that said the search for soldiers’ remains on foreign battlefields by the Joint POW-MIA Accounting Command was inept, mismanaged, wasteful and dysfunctional.

Shortly after the AP report July 7, the Government Accountability Office (GAO) issued a report saying the MIA accounting effort was hampered by weak leadership, infighting and a fragmented approach to planning. The report recommended a more streamlined chain of command and other organizational changes.

Brenda Farrell, who authored the GAO report, said the Pentagon lacked a “road map” for this mission and how many resources it deserved. “Right now it is not clear where this particular accounting mission does fall in terms of priorities with the (Pentagon),” she said.

The Pentagon is being besieged on all sides from the media, the GAO and the Congress, particularly Senator Claire McCaskill (D-MO) who expressed outrage at the statement that three years after Congress ordered the Pentagon to present a plan for achieving the 200-a-year target, the plan is still being “coordinated” inside the department. It’s actually “lost in a deep black hole at the Pentagon,” she said.

She told Pentagon officials to get it done, and she threatened that their budgets “will go away” if their agencies’ performance does not improve soon. The Senator is not one to be trifled with.

The officials at Arlington National Cemetery can attest to that after she forced several into retirement after it was revealed that a number of graves had the wrong bodies in them.

Meanwhile on the Republican side of the aisle, Senator Kelly Ayotte (R-NH) added her voice to the criticism of the Pentagon “This is an issue that needs a fire lit on it at the top,” Ayotte said, adding that she expects additional congressional committee hearings on the topic.

Noting that a 1993 Senate report said the MIA accounting effort was hobbled by internal disorder, Ayotte said the Congress is losing patience with assurances by senior Pentagon officials that they are looking for ways to improve.

“You’ve been looking and looking for 20 years,” she said. “We need to go beyond looking. We need results.” She said Hagel needs to set a deadline for action.


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Wasting Millions at the Veterans Administration

VA Hospital constructionThe Veterans Administration is in the midst of a large-scale building boom from coast to coast. The problem is that they don’t know what they’re doing. A number of the massive construction projects are not only behind schedule but hundreds of millions over budget.

The Government Accountability Office, the investigative and auditing arm of Congress, studied VA hospital construction projects in Denver, Las Vegas, New Orleans and Orlando, finding the average construction delay was 35 months and the average cost overrun was $366 million.

In New Orleans, local station wwltv.com reports that  the new VA hospital is 14 months behind schedule and $370 million over budget. The original estimate was $625 million with a completion date of December 2014.

However, the new hospital’s cost is approaching a cool billion dollars and the anticipated opening is slated for February 2016.

Looking for any excuse for the delays and the higher cost, the VA’s story (and they’re sticking to it) is that it was all Hurricane Katrina’s fault. Of course the hurricane, which hit the city in 2005, was to blame. Their convoluted story is that their original plan was to share a hospital with LSU’s new University Medical Center. Instead, the VA decided to operate its hospital as a stand-alone facility.

Then we have the construction of a new VA hospital in Aurora, Colorado. The hospital, which will serve veterans in multiple states, will replace an aging regional center in Denver. The project has ballooned over time from an original proposal for a $200 million joint venture with University of Colorado hospital, opening as early as 2008.

The latest cost estimate is pegged at $800 million with a disputed opening date. The VA says that the facility will open in the spring of 2015 while the builder says that it will be more like June 2016. Meanwhile, The VA and builder, Kiewit-Turner, are still debating tens of millions of dollars in change orders requested from construction completed so far.

U.S. Rep. Mike Coffman (R-CO) said, “I don’t have any confidence that it will be on time. And I have every confidence it will be over budget. There’s a pattern of mismanagement of projects by the VA.”

Coffman, chairman of the House Veterans’ Affairs subcommittee on oversight and investigations, added, “Not only is VA building facilities over budget and late, but it is also failing to pay the contractors for their work in a timely manner.”

The longest delay was in Las Vegas, where a hospital now expected to be done in June is taking more than 10 years to complete, 74 months behind schedule. Its price, now estimated at $585 million, is 80 percent over the initial estimate.

The VA hospital in Orlando was scheduled for completion in June 2013. That would put it 39 months behind schedule and 143 percent over cost. Most of the delays at the Orlando medical center result from disputes over changes.

Raymond Kelley of Veterans of Foreign Wars made some interesting observations that on their face seem logical. He advocates putting an architect in charge at the start of many medical construction projects, working with a construction contractor. Early agreement on design would reduce errors and give earlier warning about modifications that might be needed, he said.

Having medical equipment planners involved early in the process — something already done by the military and some other federal agencies — would reduce what he called inevitable delays to accommodate equipment.

The VA seems to be listening. The VA insists that the delays and cost increases reflect its changing needs in each of the markets, as well as unforeseen construction obstacles. It plans to add medical equipment planners on each project to work with architects, and then with contractors, to reduce inevitable delays.

Unfortunately, their change in building procedures has come at an estimated waste of $1.5 billion in taxpayer money!




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Lies Obama Told Us: Protecting Whistleblowers

Lies Obama Told UsThere was a famous Broadway play entitles “Lies My Mother Told Me“. We now have a more modern adaptation from Barack Obama entitled “Lies Obama Told Us.”

The current act in the so-far 4 1/2 year run concerns the once laudable goal of protecting whistleblowers that come forward in an attempt to shed light on government waste, fraud and abuse. That no longer seems to be the administration’s policy.

Sometime in early June, President Obama’s Change.gov campaign website underwent an unannounced change. The following statement regarding the protection of whistleblowers was removed.

Protect Whistleblowers: Often the best source of information about waste, fraud, and abuse in government is an existing government employee committed to public integrity and willing to speak out. Such acts of courage and patriotism, which can sometimes save lives and often save taxpayer dollars, should be encouraged rather than stifled. We need to empower federal employees as watchdogs of wrongdoing and partners in performance. Barack Obama will strengthen whistleblower laws to protect federal workers who expose waste, fraud, and abuse of authority in government. Obama will ensure that federal agencies expedite the process for reviewing whistleblower claims and whistleblowers have full access to courts and due process.

The administration is no longer advertising a policy of protecting whistleblowers. Why would they protect the likes of Edward Snowden who revealed the massive data collection programs of the National Security Agency?

Or why would they protect the State Department employees who were in Benghazi on 9/11/12 who could torpedo them in the court of public opinion?

Why would they want to protect all of those government employees who only want to do their jobs and refuse to turn their backs on flagrant waste, fraud and abuse?

Of course, they wouldn’t want to protect all of these people for the simple reason that the President is drowning in a sea of lies and scandals.

Of course, he’s latest set of talking points calls all of them ‘phony’ scandals. They’re attempting to play out the string by deliberate lies, obfuscations and outright stonewalling.

Let’s face it. Without the media pressing them on the IRS or Benghazi, we’ll never know the full extent of these travesties. The top IRS employees that were involved have all invoked their Fifth Amendment rights and clammed up.

The State and Defense Departments made their employees who were there sign non-disclosure agreements, agreements that the corrupt Department of Justice or the mainstream media will never challenge.

The conservative Media Research Center also calculates that on the Big Three network news channels — NBC, CBS, and ABC — the number of stories on the IRS scandal has plummeted.

Without sunlight illuminating the scandals and corruption within the Obama administration all of it will remain unknown. “If a tree falls in the forest and no one hears it, does it make a sound?”


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Big Brother Strikes Again: The Federal Data Services Hub

This is going to hurtWith a name as innocuous as the Federal Data Services Hub this intrusive NSA-like spying program has managed to fly under American’s radar up until now. But as we near the start of the individual mandate on October 1st it’s suddenly in the news.

A report from the Government Accountability Office says that it will provide “electronic, near real-time access to federal data” and “access to state and third party data sources needed to verify consumer-eligibility information.” 

The massive, centralized database will include comprehensive personal information such as income and financial data, family size, citizenship and immigration status, incarceration status, social security numbers, and private health information.

It will compile dossiers based on information obtained from the IRS, the Department of Homeland Security, the Department of Defense, the Veterans Administration, the Office of Personnel Management, the Social Security Administration, state Medicaid databases, and for some reason the Peace Corps.

The Data Hub will provide web-based, one-stop shopping for prying into people’s personal affairs. But it gets worse.

Access to all of this private information will be available to the so-called Navigators. According to the GAO are “community and consumer-focused nonprofit groups, to which exchanges award grants to provide fair and impartial public education” and “refer consumers as appropriate for further assistance.”

Rep. Diane Black, R-Tenn., complained that just months before ObamaCare officially starts, the Obama administration still hasn’t answered “even the most basic questions about the Data Hub,” such as who will have access to what information, or what training and clearances will be required.

On Capitol Hill last week, a top Obamacare official told GOP lawmakers that navigators will not be required to undergo background checks. Criminal records are not automatically disqualifying and that includes identity theft. The federal rule-makers will require online training of a mere 20 hours.

The Navigators smack of the discredited Acorn organizing group that has been closed for several years. The Navigators will be demographically tailored Democratic-party recruitment operatives, not objective, informed insurance experts.

In fact according to Health-care-regulations watchdog Betsy McCaughey navigators “don’t have to know math or insurance, but rules announced April 5 specify you have to match the race, ethnicity, and language preferences of the neighborhood that will be targeted.”

The potential for identity theft under these circumstances is off the charts. Obamacare will be boon to at least one sector of the economy: identity theft protection!

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The F-35 Strike Fighter: Eating the Pentagon’s Budget

F-35 Joint Strike FighterA weapons system that is consuming the Pentagon’s budget at an alarming rate, the F-35 Joint Strike Fighter will be the costliest weapons’ program that the Pentagon has ever had.

We’ve written about this military boondoggle before but the spending and problems with this plane rolls on like a juggernaut.

The Lockheed Martin F-35 Lightning II is a family of single-seat, single-engine, fifth generation multirole fighters under development to perform ground attack, reconnaissance, and air defense missions with stealth capability.

The F-35 has three main models; the F-35A is a conventional takeoff and landing variant, the F-35B is a short take-off and vertical-landing variant, and the F-35C is a carrier-based variant.

Sounds great, right? But at the current price of $120 million per copy the plane is eating the Pentagon’s budget in a time of fiscal austerity. The United States originally planned to buy 2,443 aircraft but Pentagon budget cuts could mean the U.S. will purchase as few as 1,200 aircraft.

How has the Pentagon been able to keep the program alive? Simple, parts for the plane are being manufactured in 45 states with over 130,000 jobs at stake. This translates into 90 votes in the U.S. Senate and no senator has the temerity to vote against such a large job creator.

The question has arisen: does the United States need such an expensive weapons system or are we wasting billions to satisfy the “fighter jock” cult of the military. After all who will we fight with such an advanced aircraft?

More importantly can we afford to trade hardware for maintenance costs and personnel? What are our priorities, bright shiny toys or basic military hardware? Up until now we have been able to afford both but we’re entering an age when we will need to make hard choices.

Yes, the F-35 is a superior weapons system but do we really need it? Is it just another want that has ballooned the Federal budget to an enormous cost? Who will we fight with these aircraft: Russia, China, Iran or North Korea.

The Pentagon has developed a terrible habit of trying to buy the most advanced weapons system that are available while basic military needs go unfulfilled.

Most combat infantrymen are still using the M-16, first put into service in 1963. From Vietnam until the present conflicts, over 8 million have been produced.

Recently, the Pentagon has introduced the XM25 Counter Defilade Target Engagement System, a high-tech rifle that can be programmed so that its 25-mm. ammunition detonates either in front of or behind a target. However, at $35,000 per copy the XM25 is much more expensive than the M-16.

Instead of buying basic weapons system, the military will invariably default to the bright shiny objects that cost billions. Isn’t it time for the politicians to exercise some budgetary oversight on these types of boondoggles?

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“Right to the Moon, Alice”

The MoonWhenever Ralph Kramden (Jackie Gleason) lost his temper with his wife, he threatened to send her with “One of this days Alice, right to the moon”. Alice may get there before Americans return to the Moon.

Yet, we have two Democrat representatives that have already decided to plan for a future national park on the moon. Yes, you read it right. You just can’t make this stuff up.

As reported in The Hill, Maryland Rep. Donna Edwards and Texas Rep. Eddie Bernice Johnson are seeking to create a national historical park on the surface of the moon, commemorating the Apollo lunar landing missions that took place between 1969 and 1972.

That’s right, two members of Barack Obama’s Democrat Party, have proposed a national park on the moon. Selfsame park would be administered by NASA and the Department of the Interior.

This is the same party that killed, first, the shuttle and then the Constellation, leaving America, once the premier space power to hitch rides to the International Space Station that was substantially paid for by American taxpayers. We paid $50 of the $100 billion cost for the station. That’s before you factor in the cost of the shuttle program.

“Establishing the Historical Park under this Act will expand and enhance the protection and preservation of the Apollo lunar landing sites and provide for greater recognition and public understanding of this singular achievement in American history,” reads H.R. 2617, a bill jointly submitted by the two representatives .

These two representatives are two of the more extreme members of the Congressional Black Caucus. You wonder what their ulterior motive for this bill could possibly be.


One reason could be that both Edwards and Bernice Johnson are members of the House Science, Space, and Technology Committee. Bernice Johnson is the panel’s ranking member. Both represent states that have serious facilities related to space.


Edwards, the ranking member on the House Space Subcommittee, also proposed legislation on Monday to reauthorize NASA for three years. That bill, H.R. 2616, authorizes spending of $18.1 billion in 2014 for NASA, which rises to $18.9 billion in 2016.

Unfortunately, the proposed bill is just that a not-to-serious proposal. Without a vehicle to get there any future missions to the Moon are questionable.


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The Waste, Fraud and Abuse of Obamaphone Continues

The Lifeline phone programThe Lifeline phone program, often referred to as Obamaphone continues with an ever-increasing cost. In four short years it has soared from $819 million to $2.2 billion.

The program was begun in 1984 to ensure that poor people aren’t cut off from jobs, families and emergency services due to inability to pay for phone service. It’s funded by charges that appear on the monthly bills of every landline and wireless-phone customer.

The Lifeline program was started during the Reagan administration with the best of intentions but over the years it has morphed into a full-blown entitlement program. It’s a classic example of the exponential growth of the Federal government. There are hundreds, if not thousands, of programs that have started small and mushroomed out of control.

Of course, we all remember this video:

According to a February 13, 2013 article in the Wall Street Journal the program is fraught with fraud. Last year, the Federal Communications Commission suspecting that many of the newer enrollees were ineligible tightened the rules last year and required carriers to verify that existing subscribers were eligible.

The agency estimated 15% of users would be weeded out, but far more were dropped. A survey of the five top providers of Lifeline conducted by the FCC showed that a staggering 41% of their more than six million subscribers either couldn’t demonstrate their eligibility or didn’t respond to requests for certification.

The program is administered by the nonprofit Universal Service Administrative Co. It pays carriers $9.25 a customer per month toward free or discounted wireless service. Meanwhile, Americans pay an average of $2.50 a month per household to fund a number of subsidized communications programs, including Lifeline.

Until last year the FCC did not require carriers to certify that subscribers were eligible. They were allowed to self-certify and in many states documentation wasn’t required.

Carriers said many of the disqualified subscribers simply didn’t reply when asked to prove their eligibility. They also said the FCC rules on self-certification, and the absence of a national database of participants, made it hard to keep ineligible people from signing up.

Until last year, the FCC allowed consumers to self-certify, without requiring documentation that they met federal poverty guidelines. Subscribers didn’t have to recertify once they were enrolled in the program, and there were few checks on whether households signed up for more than one cellphone. It was an open invitation to fraud and abuse.

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Bring Out Your Dead

Bring Out Your DeadThe cry of “Bring out your dead” was heard throughout the cities of Europe in the Middle Ages during the various deadly plagues. The surviving residents brought out dead relatives and friends to special carts that carried them to areas for burial.

Fast forward to modern times and the phrase may soon be popular again. A new report from the Social Security Administration revealed that they have been issuing checks to the dead, some for decades.

According to a June 21 audit by the Inspector General for the Social Security Administration, 2,475 beneficiaries had a recorded date of death in Social Security’s own database.  The IG determined that “at least” 1,546 of these individuals were in fact dead and still receiving benefits, totaling $30,956,695 through May 2012.

Some of these dead recipients had been receiving benefits for up to 20 years. “SSA continued issuing benefit payments to these beneficiaries for 2 to 237 months after recording the beneficiaries’ dates of death and death certificate information on the Numident [Numerical Identification System],” the report said.  237 months equals 19.75 years.

The average length of time that individuals continued to receive benefits was 20 months  after their death, racking up $20,023 each in payments.

This problem is not new. In the IG’s last audit in 2009 it was reported that 6,733 dead recipients received $40.3 million in benefit payments. An astonishing 91 dead people were still receiving benefits according to the 2012 audit.

The audits point out the sloppy system that the Social Security Administration uses to record the dead’s date of death. In the case of one individual who died in 2000 his relatives continued to receive benefit checks  for 12 years.

“In February 2001, SSA recorded the beneficiary’s date of death and New York death certificate number on the Numident,” the report said. “However, SSA did not record the death entry on the beneficiary’s payment record and continued issuing monthly benefit payments.” Over the course of 12 years, Social Security issued checks for $158,000.

According to the latest audit the alert system that was designed to notify Social Security workers of a beneficiary’s death failed an astounding 80 percent of the time.

“In all 2,475 cases, once the death reports were processed, DACUS [Death Alert, Control, and Update System] should have generated alerts to notify the appropriate field office to take action and resolve the discrepancies,” the report said.

Field office employees are then required to address death notices within 30 days.

“However, SSA Office of Systems staff informed us that DACUS issued alerts in only about 20 percent of cases reviewed,” the IG said.

This is just the tip of the iceberg of waste, fraud and abuse at the Federal level. In 2011 Senator Tom Coburn (R-OK) said that “the federal government had paid nearly $1 billion to at least 250,000 dead people since 2000.”

That same month, a watchdog reported that the Obama administration’s economic stimulus program had made 89,000 payments of $250 each to dead or incarcerated people.

According to a report by the Office of Personnel Management and reported in Ed O’Keefe’s “The Federal Eye” column in the Washington Post, our government has been sending checks to dead people. “In the last five years,” O’Keefe writes, “the Office of Personnel Management has made more than $601 million in payments to dead federal retirees, according to the agency’s inspector general. Total annual payouts range between $100 million and $150 million.”


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