Dive Brief:
- The health insurance marketplaces created under the Affordable Care Act remain vulnerable to fraud, the Government Accountability Office reported, more than a year since it first reported the issue.
- The investigation found fraudulent applications continued to get approved using false Social Security numbers and immigration information, and also received subsidies under the false pretenses.
- The investigators say some people are being approved despite having Medicaid or private coverage, while some others are being wrongfully denied coverage. They also showed people can get insurance through multiple markeplaces at the same time.
Dive Insight:
While the GAO findings are troubling, critics suggest they do not indicate likely scenarios.
"It seems unlikely that many uninsured Americans, many of whom have less than $100 in savings, would choose to commit perjury in order to pay the premiums and deductibles for two insurance policies or to pay premiums for marketplace insurance when eligible for Medicaid," HHS spokeswoman Meaghan Smith told the media.
"In addition," she noted, "the Affordable Care Act's design reduces the incentive for individuals to lie on their application because financial assistance is paid directly to the issuer, so an individual cannot directly profit."
Federal officials said they would examine the risks posed by people obtaining multiple forms of health coverage.