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For a former prosecutor and Calif. Atty. Gen. Kamala Harris sure seems to have a laissez-faire attitude toward fraud.
In the race to enroll as many Americans as possible in Medicaid and in Obamacare exchange plans, the Biden-Harris administration has looked the other way as millions of Americans receive publicly subsidized coverage they aren't legally entitled to.
It's hard to imagine that, if Harris is elected president, such widespread misuse of public healthcare dollars will get any better.
Consider recent enrollment trends in Medicaid.
Obamacare expanded eligibility to adults earning up to 138% of the federal poverty level --- just under $20,800 for an individual this year. To entice states to go along with this expansion,
Obamacare directed that the federal government cover 90% of the cost of insuring this newly eligible population.
Forty states and the District of Columbia have expanded Medicaid in this way.
As of September 2023, 18.6 million people were newly enrolled because of Obamacare's expansion of the program, according to a March 2024 report from the U.S. Department of Health and Human Services (HHS).
One might imagine that, as responsible stewards of public money, the federal government would make it difficult for ineligible patients to sign up for the program.
But not under the Biden-Harris administration. Some of the largest gains in Medicaid enrollment in recent years have been among patients who earn more than 200% of the poverty level.
By contrast, enrollment among those earning below 138% of the poverty level — that is, people for whom the program is intended — has remained fairly constant in recent years.
Much of this trend can be explained by COVID-19-era reforms to the program.
Early in the pandemic, the federal government suspended Medicaid's routine eligibility audits and paused automatic disenrollments for people who were ineligible.
Those policies expired in April 2023.
But the Biden administration has urged many states to take their time kicking ineligible patients out of the program. The Centers for Medicare and Medicaid Services informally collaborated with states to put Medicaid disenrollments on hold.
This suited state governments just fine.
They were happy to collect nine dollars from the federal government for every one they spent on Medicaid coverage for the expansion population.
Taxpayers, of course, were the losers in this fraudulent arrangement.
Obamacare's exchanges have also become hotbeds of dishonesty and graft — largely because of the more generous premium tax credits signed into law by President Biden as part of the American Rescue Plan Act of 2021 and the Inflation Reduction Action of 2022.
Specifically, these Biden-era tax credits have helped encourage patients to report earning between 100% and 150% of the federal poverty level, as this income range qualifies them for premium-free coverage.
According to research by the Paragon Health Institute's Brian Blase, there are nine states in which the total number of exchange enrollees claiming to make between 100% and 150% of poverty is higher than the actual number of people in that income range.
In other words, patients are lying about their earnings, in order to get free health insurance — and at a cost to taxpayers of $20 billion a year, Blase estimates.
Improperly enrolling people in fully subsidized plans is lucrative business for insurers, too. They're the ones who collect the tax credits from the U.S. Treasury.
And individuals have to payback improperly claimed subsidies — not insurers.
Further, all these subsidies make consumers insensitive to the price of insurance.
So insurers have more leeway to raise premiums.
And higher premiums actually mean more subsidies!
The Biden-Harris administration has helped initiate this new era of rampant healthcare fraud — one in which stealing taxpayer money by gaming the health insurance market has never been easier.
Rather than crack down on this misbehavior, Democrats have largely encouraged it.
Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is "False Premise, False Promise: The Disastrous Reality of Medicare for All," (Encounter Books 2020). Follow her on Twitter @sallypipes. Read Sally Pipes' Reports — More Here.