Obamacare Could Be a Fraudsters’ Free-For-All.

Have any idea where to find a health insurance exchange? Up to speed on what a healthcare “navigator” is? Know whether you’ll need a new government-issued ID card to qualify for Obamacare when it goes live on October 1?

Scam artists hope you’re as clueless as possible, because they’re counting on widespread confusion about the Affordable Care Act to tap fresh opportunities for milking the unwary. Regulators expect a stream of complaints about Obamacare fraud to swell to a gusher this fall, as people begin to explore new insurance options. So far, scams seem to be a variation on familiar themes, such as somebody claiming to be from Medicare calling seniors and warning of scary-sounding changes in the law that require them to provide sensitive info. The Federal Trade Commission logged more than 1,000 complaints about such calls earlier this year. Some of the calls originate from overseas.

The startup of state-run health-insurance exchanges under Obamacare on October 1 gives scammers a plausible basis for claiming the law is changing and ordinary people need to make some changes themselves to remain in good standing with the government. On a typical call, an authoritative-sounding person says the Affordable Care Act now requires a new ID card or else doctors can’t provide treatment. The government will send the ID out right away as long as you provide a valid Social Security, bank account or credit-card number to confirm your identity. The card never arrives, of course, but you do discover some unfamiliar new charges in your name.

Rich opportunities

Scams are nothing new, but three factors make the Affordable Care Act a uniquely rich opportunity. First, the law affects nearly every American in some way, since it requires most people to have health care coverage. Second, it won’t be standardized nationwide, the way Medicare and Social Security are, since states have the freedom to administer the law in different ways. Third, the law is brutally complex, which has sown confusion even among health care experts. The result is a sweeping new law that’s shrouded in confusion and varies based on where you live, which is an invitation for abuse.

The proper response to fraudulent marketing, of course, is to hang up, delete or slam the door and then contact the FTC. But Obamacare comes with a few wrinkles that make it a bit harder to tell who’s legit and who’s bogus. The law, for instance, requires each health-insurance exchange to develop a network of “navigators” whose role is “to educate the public about qualified health plans, distribute information on enrollment and tax credits, facilitate enrollment, and provide referrals on grievances, complaints, or questions.” Among other things, navigators will make sure people know they need insurance, and help enroll them in Obamacare if necessary.

Navigators will be chosen from a list of designated community groups such as United Way, Planned Parenthood and a variety of local agencies. But there are also private operators who claim to be navigators. The website onlinenavigator.org, for instance, offers to help consumers sort through the rate and coverage options offered on federal or state exchanges. A disclaimer points out that the site isn’t affiliated with any government program. Right next to that, however, is an icon labeled Healthcare.gov, which is the federal government’s official site for info related to the ACA. Clicking on it doesn’t lead to the government site, though, but to a page that urges people to “schedule pre-paid navigator help” for a $40 fee.

On a related site, freedombenefits.net, clicking on a similar Healthcare.gov icon leads to a form users are urged to fill out to apply for a personal health insurance navigator. It asks for name, address, date of birth and Social Security number.

Tony Novak, a Philadelphia-area accountant who operates both sites, says he has been involved with private health-insurance exchanges for 25 years and is using the sites as part of a consulting business. Using the government logo, he acknowledges, is a “mistake” going back several months, when his site did link to the federal site. He changed the links, he says, when the government itself changed some of its procedures for helping people find insurance.

“So much has happened so fast,” Novak says of Obamacare. “I’m learning the same as everybody else.” Novak says he plans to change the links and hasn’t been subject to any regulatory inquiries.

Misleading sites

Regulators have shut down some sites deemed misleading. Over the summer, a site popped upclaiming to be the Pennsylvania Health Exchange, with an image of the state’s seal at the top of the site. The site was run by a private insurance broker, however, and after questions from news organizations and state regulators, the logo disappeared from the site. Then the entire site went dark.

To protect themselves, consumers looking for info on the Affordable Care Act and the exchange in their state should start at the government’s official online portal—the real one. That site asks users to answer a few basic questions about their age, income bracket and insurance status, but doesn’t ask for anything that can be used to identify individuals. Once you provide the basic info, the site suggests insurance options that might be appropriate for you. It also links to the insurance exchange in the state where you reside.

Navigators who work for the exchanges are supposed to provide some kind of credentials that prove their legitimacy, but that could be delayed as many states try to figure out what the right criteria should be. Some Republican governors are complicating the matter even further by withholding support for Obamacare implementation, including things such as training navigators.

As a rule of thumb for consumers, government healthcare agencies rarely call or email people unless it’s in response to an inquiry or a complaint. Navigators might be more aggressive in some areas, so people should cross-check navigators’ credentials with the exchange in their state.

Consumers should also be suspicious if somebody offers free medicine or other benefits you didn’t ask for. (Even under Obamacare, if it seems too good to be true, it probably is.) If you’re suspicious about a call, note the number on your caller ID and report it to the FTC or to the insurance commissioner in your state. If a call comes from overseas or anything seems fishy, get off the phone.

Consumers should also be prepared to prove their own legitimacy, since regulators expect a lot of scam artists posing as ordinary people to attempt to defraud the government under the ACA. Enrollees in Obamacare will have to provide personal information once they’ve selected an insurance company, just as they do now. And anybody applying for subsidies to help them pay for care may have to prove their income falls below various thresholds for eligibility. If you get that far, maybe you won’t need a navigator after all.

Rick Newman’s latest book is Rebounders: How Winners Pivot From Setback To Success. Follow him on Twitter: @rickjnewman.

Texas State Health Insurance

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210.822.9950 Office

210.930.3410 Fax

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How many pages of regulations for ‘Obamacare’?

“Obamacare is fully implemented January 1st, even though the regulations haven’t been written yet. And Brian, we’ve got 33,000 pages of regulations that they’ve already written. If we stacked it up here, it would be seven feet tall.”

— Rep. Richard Hudson (R-N.C.), speaking on “Fox and Friends,” May 13, 2013

“Implementation has also become a bureaucratic nightmare, with some 159 new government agencies, boards and programs busily enforcing the roughly 20,000 pages of rules and regulations already associated with this law.”

— Sen. Mitch McConnell (R-Ky.), on the third anniversary of the law’s passage, March 22, 2013

This column has been updated

Rep. Richard Hudson this week offered such an astonishing figure — 33,000 pages of “Obamacare” regulations! — that we immediately wanted to know more.

But it turns out that Hudson got a little bit ahead of himself. An aide said that he misspoke and meant to say 13,000 pages. “Whether it is 13,000, 22,000 or 33,000, it is too many,” the aide added.

But then it turns out that Senate Minority Leader Mitch McConnell (R-Ky.) has actually tweeted a photograph of this stack of paper. By his math, the Obama administration has issued 20,000 pages of regulations “associated” with the new law.

The Facts

 

The process the McConnell folks used is fairly simple. They went to the Web site for the Federal Registerand searched for “Affordable Care Act,” the official name for the health-care law. That turned up 897 documents.

On the Web site, there’s a button that will download the documents to an Excel spreadsheet (CVS/excel). Then you use the sum feature on Excel to add up the pages and presto, you end with 20,202 pages. These were then printed out and duly stacked in a pile.

“Some of these may only relate to ‘Obamacare’ (rather than being entirely on ‘Obamacare’), but since they’re related, they’re part of the regulatory structure,” said Don Stewart, McConnell’s spokesman.

Regular readers know that we frown on such page-counting exercises, since we’re not sure what it really tells you. In the case of the health-care law, businesses actually have been seeking detailed regulations so they know exactly what to expect. And using the same methods used by the McConnell team, we found tens of thousands of pages of regulations for Medicare Advantage and the prescription drug plan (Medicare Part D), which were pushed by Republicans.

Stewart countered that it would be fairer to count only the regs issued 1,148 days after the Medicare Modernization Act of 2003 was enacted, since it’s exactly that long since the Affordable Care Act became law. By his count, that yields about 5,000 pages of regulations, or roughly one-quarter of the number for Obamacare.

There’s another wrinkle, too. The documents that turn up are both final rules and proposed rules, as well as “notices” (such as for new funding or committee meetings) and “presidential documents” (mostly news releases). But the proposed rules are often similar to the final rules, except that the final rules include pages of public comments. Looking just at rules, you end up with just 9,625 pages, while proposed rules amount to 7,432 pages.

One could argue that this amounts to double counting, since the final regulations, not the proposed rules, are what matters to business. Stewart begs to differ: “If you’re affected by the regulations, you have to know and understand the proposed rule so you can comment on it, and you have to know the actual rule because you have to try and live with it.”

In any case, note how McConnell referred to “rules and regulations already associated with this law.” In this way, he neatly sidesteps the question of whether he is referring just to the final regulations.

Moreover, all of these rules, proposed rules, notices and the like are listed on the administration’s Health Reform page on the Federal Register Web site.

Stewart pointed out that McConnell’s office counted only Federal Register pages, which are typed in such tiny type that each page is worth almost four pages with regular, double-spaced type. By that logic, 10,000 pages of final rules could be labeled as 40,000 pages. “So if anything, we’re undercounting,” he said.

An administration official said most of the rules related to the implementation of the law are complete but there are still rules that have not been finalized or issued. “We will continue to issue guidance and rules from time to time to respond to stakeholder questions or respond to guidance,” the official said.

 

 

The Pinocchio Test

 

We realize this is a bit of muddle. At the very least, one can point to 10,000 pages of tiny regulatory type regarding the implementation of the Affordable Care Act. Frankly, this is to be expected in any large and complex governmental undertaking. Depending on your perspective, the visual of a seven-foot-high pile of documents may be meaningful — or not. That’s a matter of opinion.

At this point, we can’t rule this claim as absolutely accurate or as worthy of Pinocchio. McConnell used careful phrasing. Hudson’s staff says the congressman misspoke, and his corrected answer is relatively close to 10,000.

Update: A reader asked about our criteria for giving a politician a break for misspeaking. Here’s an explanation:

We don’t like to play gotcha at The Fact Checker. We understand people can make mistakes, especially on live television, and we are more interested in helping explain the facts behind a statement. So an admission of an error, rather than some lame defense, generally earns some credit.

Secondly, we look at the underlying facts of the issue. We have two good recent examples of where, even with clarification, the assertion did not hold up under scrutiny.

Sen. Tom Coburn (R-Okla.) claimed violence had gone down 85 percent in national parks since guns were permitted, and his staff said he meant to say 20 percent. But there is no evidence that violence had gone down because of guns; in fact, depending on how you looked at the numbers you could say violence went up.

Similarly, Sen. Debbie Stabenow (D-Mich.) asserted (in a floor speech) that the Democrats had passed a “balanced budget,” which an aide also said was a mistake. She apparently was trying to say it was balanced in terms of values, though she also said it was balanced in terms of numbers. In this case, the use of the word “balance” is designed to mislead on a document that predicts huges deficits for years to come.

So both Coburn and Stabenow earned Three Pinocchios, for what might have been Four Pinocchio rulings. Hudson, however, made an understandable slip–33 rather than 13–and his “13,000” is in the realm of possibility when you look at the data. So that’s why he avoided Pinocchios.

Texas State Health Insurance

1250 N.E. Loop 410, Suite 330

San Antonio, TX, 78209

210.822.9950 Office

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Is ‘Obamacare’ really that long?

By Tom Giffey Leader-Telegram staff | 0 comments

The U.S. Supreme Court’s recent ruling to uphold the Affordable Care Act has led to a new round of condemnation for the law, which critics usually call “Obamacare.” In addition to challenging the law’s constitutionality (a question which, presumably, has been answered by the high court), they criticize its cost, its scope, and in many cases its very length.

More than two years after it was passed by Congress and signed into law by President Barack Obama, critics still frequently note that Obamacare is 2,400 (sometimes it’s stated as 2,700) pages long — the implication being that it’s overly complex and that lawmakers could not possibly have read it (and therefore understood it) before they voted on it. The 2,400 figure is included often in letters to the editor, blogs, newspaper articles and even on the website of Mitt Romney, President Barack Obama’s Republican challenger.

Two-thousand, four-hundred pages. Wow! That’s a lot of paper! It’s a good thing that, thanks to the Internet, I don’t have to track down or print out a hard copy of the bill to double-check the claims made about it. All I had to do was Google “Affordable Care Act” to learn that the document is official known as Public Law 111-148. A visit to the U.S. Government Printing Office website (gpo.gov) yields a page with PDF and text versions of the law. A quick click on the PDF link opens up all 2,400 pages of the law on my computer.

Oops! Make that all 906 pages of the law. You read that correctly: The law, as enacted, is 906 pages long. (Click here to check it out.) That’s still really, really long, but it brings the law down from insanely large to sometime almost manageable. It’s hard to imagine anyone reading a 2,400-page document, but 906 pages puts the law in the realm of some of Stephen King’s longer novels. (And, for Republicans, “Obamacare” is just as frightening.)

To double-check the 906-page figure, I visited the Obama administration’s website for the law,HealthCare.gov. Clicking on the “Full Text of the Affordable Care Act” link yields a 974-page PDF. The 68-page discrepancy puzzled me, until I read the full title at the top of the document, which noted that it included “Health-Related Portions Of The Health Care And Education Reconciliation Act Of 2010.” As you may recall, the Democrats’ loss of a supermajority in the Senate in early 2010 led to parliamentary gymnastics to pass an amended version of the bill in a way that avoided a Republican filibuster; this was done through the so-called “reconciliation” process, which limits debate on spending bills. As far as I can tell, including this reconciliation act makes the document a bit longer.

So where did the 2,400-page number come from? The Affordable Care Act, as you’ll recall, was the subject of much debate and alternation in Congress during Obama’s first year in office. One early version of the bill (that’s the bill, not the law) — known as House Resolution 3590, as amended by the Senate — ran to 2,076 pages. A subsequent version of this bill, passed by the U.S. Senate Dec. 24, 2009, was2,409 pages long. Voila! That’s where the elusive, often-cited figure comes from. So, while it’s not accurate to call the “Obamacare” law 2,400 pages, it is correct to call one version of the bill 2,400 pages. Confusing, I know.

So why the roughly 1,500-page difference between the bill and the final law? Some of it, I suspect, was because of amendments that deleted parts of the original bill. A lot, however, lies in the kind of tricks known to anyone who has ever tried to make a college essay look longer (or shorter): altering margins, font sizes, etc. I arbitrarily picked a page of the bill’s text and found it contained 202 words; an arbitrary page of the law’s text included 396 words.

I was curious to know how the length of the Affordable Care Act compared with other major pieces of legislation. Take, for example, the Wisconsin state budget (officially known as Act 32) signed into law last July by Gov. Scott Walker. The PDF of the budget, as approved, is 532 pages long. I cut and pasted the text into my word processor, and learned the budget ran to 409,629 words (give or take — the figure includes some page headers and other extraneous verbiage). How long is the Affordable Care Act? By my count, it’s 418,779 words (again, that’s approximate).

In other words (pardon the pun), a law refashioning one of the major sectors of the U.S. economy is only slightly longer than a law setting the two-year budget for one of the 50 states.

So, ultimately, how long is 906 pages? Yes, it’s really, really long. But is it unreasonably long, considering the issue involved? That’s up to readers — and voters — to decide for themselves.

Giffey is the Leader-Telegram’s editorial page editor.

Texas State Health Insurance

1250 N.E. Loop 410, Suite 330

San Antonio, TX, 78209

210.822.9950 Office

210.930.3410 Fax

www.txstatehealth.com

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