Hearing of the Senate Finance Committee - Examining HealthCare.gov Enrollment Controls

Hearing

Let me begin my remarks by saying that on this side of the aisle, we don't take a back seat to anybody in
fighting fraud and protecting taxpayer dollars. One dollar ripped off is one dollar too many. But let's be
perfectly clear about one thing: The report up for discussion today is not about any real-world fraud.

This study looks at a dozen fictitious cases -- and not one of them was a real person who filed taxes or
got medical services. No fast-buck fraudster got a government check sent to their bank account.
Moreover, the government auditors acknowledge today that their work, quote, "cannot be generalized
to the full population of applicants or enrollees."

None of the fictitious characters in this study stepped foot in a hospital or a doctor's office. And the fact
is, when you actually show up for medical services, it's a lot harder to fake your way into receiving
taxpayer-subsidized care. Often before any services are delivered, providers ask for a photo I.D. with an
insurance card. And if you've stolen an identity, there's probably a medical history belonging to
somebody else that should set off alarm bells.

If you're a real person signing up in the insurance marketplace, you have to attest under penalty of
perjury that the information you provide is correct. And if you falsify the application, you face the
prospect of a fine of up to $250,000.

Another big anti-fraud check went untested in this study. That is, squaring up tax returns with the
information from your insurance application. The GAO's testimony today calls it a, quote, "key element
of back-end controls." If your tax return and personal info don't match, the gambit's up. But the study
before us today ignores that anti-fraud check. It looks at only part of the picture when it comes to
stopping fraud.

As I said at the beginning, there are always methods of strengthening any program and rooting out
fraudsters and rip-off artists. Part of any smart, ferocious strategy against fraud, on one hand, is drawing
a distinction between aggressively going after scammers, and on the other, not harming a law-abiding
American who's made an honest, often technical mistake.

A retiree nearing Medicare age shouldn't get kicked to the curb because she accidentally submitted an
incorrect document. A transgender American shouldn't lose health coverage after a name change
because some forms don't match. I can't imagine the Congress wants a system that nixes the health
insurance coverage of Americans because of simple issues like those.

A recent Gallup report stated that the rate of Americans without health insurance is the lowest they've
ever measured. This is the first Finance Committee hearing on health care since the Supreme Court's
landmark decision upholding the law that made that possible. The fact is, the Affordable Care Act has
extended health care coverage to more than 16 million real people who use their insurance to see real
doctors. At some point down the road, GAO is expected to complete their report. At that time, let's
work responsibly to draw conclusions on a bipartisan basis about how the committee can work to
improve American health care.

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