US health insurance exchanges are exposed to fraud

hacked phone federal health insurance exchange

GAO report highlights the fraud problems that many exchanges have to deal with

A new report from the Government Accountability Office has found that health insurance exchanges set up through the Affordable Care Act are still exposed to fraud. Exchanges have long had a problem with fraudulent applications, with fake Social Security Numbers and falsified immigration details being applied to these applications in order for people to acquire insurance coverage. These issues were first discovered more than a year ago, but efforts to curb fraud have had limited impact.

Many consumers were mistakenly uncovered due to issues with insurance exchanges

The report also found that many people were “double-covered” by private insurers and Medicaid coverage. Others that had applied for coverage and believed that they had insurance policies in effect were also mistaken. These people had gone without insurance coverage without realizing it. This may have left many exposed to tax penalties from the federal government, which apply to all those that do not have health insurance coverage. This issues will need attention from both the federal and state governments in order to avoid any serious problems in the coming year.

Persistent problems with fraud may become a costly problem

hacked phone federal health insurance exchangeThe Government Accountability Office believes that exchanges, especially those operated by the federal government, are highly susceptible to fraud. The agency’s report suggests that this could have significant financial consequences, as the majority of fraudulent applicants looking for coverage through exchanges were also eligible for subsidies. These subsidies are meant to make insurance coverage less expensive and more accessible to consumers. For private insurers, whom provide coverage through exchanges, fraud can lead to higher premiums, which would affect honest consumers.

Fraud issues could generate controversy for insurance exchanges

Health insurance exchanges have been the subject of criticism for some time. When these exchanges first launched, they were wrought with technical faults that made it impossible for many people to acquire coverage. Many of these issues had been fixed, but the exchanges are still exposed to fraud, which may spell disaster for the Affordable Care Act, as a whole, in the upcoming presidential election of 2016.

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