Obamacare

California Insurance Commissioner on Obamacare Enrollment Counselors: "We can have a real disaster on our hands."

|

credit: brianwallace / Foter / CC BY-NC

The announcement earlier this month that state-run health exchanges under Obamacare will not be required to independently verify an individual's income or insurance status has already opened up the health law to the risk of fraud and improper subsidy payments.

And now insurance officials in California see another fraud risk associated with enrollment in the law in the lack of controls on the enrollment counselors the state is planning to hire. The AP reports that the state's insurance commissioner is warning that the lax requirements for would-be sign-up assisters could open the door to identity theft and fraud:

The exchange, known as Covered California, recently adopted rules for a network of more than 21,000 enrollment counselors who will provide consumers with in-person assistance as part of the federal Affordable Care Act. In some cases, they will have access to personal and financial information, from ID cards to medical histories.

But the state insurance commissioner and anti-fraud groups say the exchange is falling short in ensuring that the people hired as counselors are adequately screened and monitored.

Insurance Commissioner Dave Jones also said the exchange does not have a plan for investigating any complaints that might arise once the counselors start work. That means consumers who might fall prey to bogus health care products, identity theft and other abuses will have a hard time seeking justice if unscrupulous counselors get ahold of their Social Security number, bank accounts, health records or other private information, he said.

"We can have a real disaster on our hands," Jones, a Democrat, said in an interview.

To some extent, this is just an industry turf war. Health insurance agents and brokers are worried about enrollment counselors moving into their space, and would prefer for navigators to face greater scrutiny. But the fraud concerns are not completely without merit. Because Obamacare's legions of enrollment assisters will be tasked with helping people sign up for insurance under the law, they will in many cases have to be able to access sensitive personal information—income, medical records, perhaps even Social Security numbers. That creates the potential for abuse by people who are being paid by the government to help boost Obamacare's enrollment.

There's a bigger related issue here, though, and that's whether it is legal to pay for these enrollment counselors using federal exchange grants, as California is doing. 

Obamacare sets up a "navigator" program that employs people to help assist with enrolling in the law. But the law also says that states running their own exchanges—like California—can't use federal exchange grants to pay for navigators. But that's what California wanted to do, so the state and the Obama administration agreed on a neat little trick: They decided not to call the folks working for their enrollment assistance program "navigators." But it's pretty clearly a navigator program in all but name, and California is using federal exchange grant money to fund it.

Congressional Republicans have raised questions about this, to little effect. It's potentially a big issue, though, given the cost (California has received $910 million in federal exchange funding) and the importance of enrollment, especially in California, to the overall Obamacare scheme It's also another example of how the administration has taken to ignoring the parts of the law that it finds inconvenient. 

NEXT: Rep. Justin Amash Wants to Defund NSA Surveillance Via Defense Bill

Editor's Note: We invite comments and request that they be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of Reason.com or Reason Foundation. We reserve the right to delete any comment for any reason at any time. Report abuses.

  1. If these 21,000 enrollment counselors are paid on commission, I would guess that fraud is going to be a HUGE problem…

    1. I doubt they will have commissions. I’m certain these jobs will be ultimately unionized, salaried, and gold-plated.

      1. SEIU, baby!

        1. Here is a link to the Covered California enrollment counselors page.
          http://www.cahba.com/covered-c…..isters.htm

          Looks like a counselor has to be associated with a state certified group including:
          American Indian Tribe or Tribal Organizations
          Chambers of Commerce
          City Government Agency
          Community Clinics
          Community Colleges and Universities
          Faith-Based Organizations
          Labor Unions
          Non-Profit Community Organizations
          Ranching and farming organizations
          Resource partners of Small Businesses
          School Districts
          Tax Preparers
          Trade, industry, and professional organizations

          Most of those entities are government sponsored/subsidied. So, yeah, more union jobs in California! Oh, and when one of these counselors does steal your ID, good luck fighting them in criminal/civil court. Because their collective bargaining agreement will have a provision where grievances are handled by a grievance committee, comprised of union members, and a few political appointees.

          This is going to work out real well.

          1. Well, the people who are actual government employees, ie the city governments and school systems, will have qualified immunity from lawsuits.

            Those non-govt employees may have qualified immunity if they are working on a govt grant. Anyone know this?

            As for the rest, it’s a pretty inclusive list, everyone but the garden club, seems like, so yeah much potential for infiltration, identity theft and general mischief.

          2. “and when one of these counselors does steal your ID, good luck fighting them in criminal/civil court.”

            From the article linked over in 24/7:
            “counselors who will provide consumers with in-person assistance as part of the federal Affordable Care Act. In some cases, they will have access to personal and financial information, from ID cards to medical histories.

            But the state insurance commissioner and anti-fraud groups say the exchange is falling short in ensuring that the people hired as counselors are adequately screened and monitored.”

            Yeah, I’m sure the folks will be every bit as helpful and professional as, oh, the DMV clerks!

    2. And 21,000 positions that have access to SSN and identity information for millions of people. That will never attract the attention of identity theft rings.

  2. Hello, yes this is Yuri Topanov and I will be your counselor throughout your enrollment period. Let’s start with a few things about you.

    1. “…this is Peggy…..”

      /Yuri voiced guy

    2. That name doesn’t sound like Nigerian royalty. How do I know that I can trust you?

      1. I am quite the trustworthy. My family comes from long line of Ukrainian turd farmers.

        1. “Fine crop of shit this year, Alexi.”

          1. And we needed it, last year’s crop was pretty shitty.

            Wait …..

      2. AlmightyJB| 7.15.13 @ 3:35PM |#
        “That name doesn’t sound like Nigerian royalty. How do I know that I can trust you?”

        Anybody else gotten calls, heavy Indian accent,; ‘I’m with windows tech support and you haven’t updated your computer. Please go to…’
        You bet! Why that turnip truck was realy comfortable…

        1. I did! I found they were quite helpful. I had 4,863 registry errors and they fixed them all! I can’t believe how much faster my computer is now!

          1. So, Scruffy, what’s the take per hit?

        2. I would love to get one of these, especially since I only run linux. I could have some fun with that.

        3. I sure had fun with the caller until she found out she was talking to an IT savvy guy and she was never getting my credit card….

          She did tell me however what she was wearing on her feet and if she had bathed recently, so I think in the information exchange battle the perv won…

  3. This is shaping up to be the biggest clusterfuck in the history of clusterfucks.

    I fucking love it.

    1. Well it’s clearly the fault of the Republicans…

      /shreeky

      1. ROMNEY PROPOSED IT FIRST! /buttplug

    2. This is shaping up to be the biggest clusterfuck in the history of clusterfucks.

      Really? Passing an infinity-paged law without ANYONE reading it first leads to clusterfuck? Who could have seen that coming?

      And just because:

      Foreseeable consequences arent unintended.

      1. RACIALIST!

      2. The idea that any delicately balanced social engineering scheme, such as those favored by Hillary! and other DNC types, can survive its various components being written by different interest groups, subjected to the legislative process, and them implemented by at least 50 different governmental organizations of varying degrees of confidence in the legislation, is moronic.

        The delicate balance that our Top Men Plus Hillary! are seeking to strike can never survive the political process necessary for its approval and implementation. Even if you convince the left that people respond to incentives more so than intentions, it still will never work out the way they intend.

    3. “This is shaping up to be the biggest clusterfuck in the history of clusterfucks.

      I fucking love it.”

      I’m torn between cheering at such failure and worrying about the follow-up but I’m popping some popcorn regardless.

  4. Passing an infinity-paged law

    Technically, passing an infinity-paged first draft of a law…..

    1. Wait, where’d Johnny go? What was that plorping sound?

  5. not to smash my old noggin into the concrete again and again, but what’s up with these massive multi-page bills?

    why not a simple bill… see how it impacts, adjust, improve, as you get data back.

    Or am I thinking too much like a programmer? Obamacare (and the latest “Comprehensive Immigration” bill) is like making a complicated program – something at the SAP level – and just throwing it out there and see what happens.

    1. They have a cost plus contract.

    2. why not a simple bill..

      Because such bills offer little or no opportunity for graft and corruption.

      1. “Because such bills offer little or no opportunity for graft and corruption.”

        You can’t pay off your contributors a nickle at a time.

    3. why not a simple bill… see how it impacts, adjust, improve, as you get data back.

      How about eliminating two regs for every new one? Don’t we have enough already?

      1. 2 regs enter 1 reg leaves?

    4. why not a simple bill…

      Haha. Wait, that wasn’t sarcasm?

      1. just misguided stupidity… (on my part)

        1. And here I was wondering what your angle asking somethign that crazy really was….

  6. Labor union leaders unhappy with PPACA.

    Last Thursday, representatives of three of the nation’s largest unions fired off a letter to Harry Reid and Nancy Pelosi, warning that Obamacare would “shatter not only our hard-earned health benefits, but destroy the foundation of the 40 hour work week that is the backbone of the American middle class.”

    http://www.forbes.com/sites/th…..r=yahootix

    1. Well, this really doesn’t disprove rob’s law. The idiots who passed it (including the union guys ‘helping’) are dumb enough that they didn’t see this coming.

    2. This is why the “free” stuff was implemented first, while the penaltaxes and the cadillac taxes and the rest keep getting postponed.

      Meanwhile, NBCNews website is celebrating the “free” breast pumps and surrogate breast feeders that insurers are now required to include in their coverage. And if you ask why premiums are rising across the board, and suggest a link to all the “free” stuff people are getting, you will get a blank stare and a condemnation of evil corporations and their evil profits.

    3. ….warning that Obamacare would “shatter not only our hard-earned health benefits, but destroy the foundation of the 40 hour work week that is the backbone of the American middle class.”

      Too late you fucking idiot…..you were already bought and sold.

    4. I don’t suppose there’s something like a shareholder lawsuit for unions, is there?

  7. In-N-Out is crap. There, I said it.

    1. Nothing wrong with a little of the old in-and-out, eh?

    2. I was told it was great, so I tried 4 times, 3 different locations.
      Micky D’s is gourmet by comparison…

    3. Their popularity on the West Coast is due to sentimentality more than anything I think, just like Whataburger in Texas. Every town in America has a little burger place or two that puts both of them to shame. Although of the two, I’ll take Whataburger.

  8. Looks like I pickedthe wrong week to quit sniffing glue.

    1. Heroin fuels my apathy in incredible ways.

Please to post comments

Comments are closed.