ObamaCare/Covered California Subsidies Will Allow Limited Access to Providers, Ripe For Fraud

Obamacare Covered CA Subsidy

What could possibly go wrong with 35 year old parents of three, earning $90,000 annually and receiving a $210 ObamaCare/Covered California subsidy?

Just about everything.

Many middle class Americans will be harmed by the design of ObamaCare’s cost-sharing subsidies for lower income enrollees reports The Heritage Foundation, though relatively little attention has been given to this feature, understanding it is crucial  to accurately projecting the results of its implementation.

Heritage Foundation Senior Fellow Ed Haislmaier has studied this feature of the bill and found that its effects will be unattractive for many people.

ObamaCare’s cost sharing subsidies pay insurers to offer coverage to lower income exchange enrollees with no deductibles and only nominal patient co-pays. As a result, Medicaid/MediCal managed care insurers are participating the the exchange and many insurers are offering exchange plans with ‘narrow networks’ that limit coverage to providers willing to accept low reimbursement.

Haislmaier points out: “ObamaCare’s complicated income based design of premium and cost-sharing subsidies will result in the exchange market offering something like Medicaid managed care for the middle-class.

Ripe for Fraud: In a new audit from the Treasury Dept Inspector General for Tax Administration dated 27 September, the Tigta report found that the IRS responsible for administrating ObamaCare subsidies, has not put in place a fraud strategy for its ObamaCare system development, initial deployment or long term operations.

Marguerite Bowling, writing in The Foundry on the 03 December explained “The IRS doesn’t have the necessary systems in place to effectively root out ObamaCare subsidy applicants who report an income lower than their true income so they can qualify for a higher subsidy. They’ll have unfairly high subsidies on the back of the American people who follow the rules.”

Making matters even worse is when ObamaCare Navigators, tasked with helping Americans to sign-up for health care insurance, have been providing people misinformation and in some cases, actively encouraging some people to commit fraud in order to raise their subsidy, according to a new report obtained by Breitbart News scheduled to be released today by the House Oversight and Govt Reform Committee.

Skyrocketing Deductibles and the Affordable Unaffordable Care Act: On the 09 December, I wrote here ObamaCare high deductibles are fueling new worries–many people with modest incomes are encountering a troubling element of the health care law, deductibles so steep, they may be unable to afford the portion of medical expenses that insurers won’t cover, subverting one of ObamaCare’s stated goals to ensure more people receive needed health care.

Stanford Economics Professor Michael J Boskin writing in The Wall Street Journal Sunday further explains, “The ‘sticker shock’ that many buyers of new ACA compliant health plans have experienced–with premiums 30% higher or more than their previous coverage has only begun. The costs borne by individuals will even be more obvious next year as more people start having to pay higher deductibles and co-pays.”

“The next shock will come next year, when scores of millions outside the individual market–people who are covered by employers, in union plans or on Medicare and Medicaid, experience the downsides of ObamaCare. There will be longer waits for hospital visits, doctors appointments and specialists’ treatment as more people crowd fewer providers.”

Already with 70% of California physicians reportedly boycotting and refusing to participate in ObamaCare/Covered California how much longer will it be before problems grow exponentially and become totally unmanageable?

Related: ObamaCare Chaos in California –Breitbart News

Former DNC Chair Howard Dean: ACA Subsidies Will Drive Up Spending

Ewww: Creepy Covered Calif Touched More Than 21 Million Americans

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