The White House and the Centers for Medicaid Services illegally diverted billions of federal dollars to reimburse insurance companies at the expense of the American taxpayer, as well as that of the Treasury.
That is the finding from the Government Accountability Office, an independent government watchdog group, after Republicans asked repeatedly for the program be investigated.
Thursday’s ruling supports ongoing allegations that the Obama administration bent the law as it saw fit, as problems arose in carrying out complex provisions in the Affordable Care Act. The findings may complicate efforts to stabilize premiums in the law’s insurance marketplaces, from which about 11 million people get coverage, the Associated Press reported Thursday.
The administration, of course, continues to deny any wrongdoing and disagrees with the findings.
At issue is how the administration handled “transitional reinsurance,” a program put in place for the first three years of the ACA that collects fees from employer and other private health insurance plans. It then channels the money to health plans “struggling” with losses due to large claims for treating patients with catastrophic medical problems.
The law specified the fee would collect $25 billion from 2014 to 2016, and $5 billion of that would go directly to the Treasury. But when fee collections fell short, the Health and Human Services Department failed to allocate a share of the money to the Treasury — saying it would do so later as more money came in.
Republicans, accusing the Obama administration of short-changing the Treasury to “bail out” insurers, asked the GAO to examine the issue. Finally, the ruling came down: HHS may not use amounts collected for the Treasury to make reinsurance payments.
“HHS may not use amounts collected for the Treasury to make reinsurance payments.”
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“[W]e conclude that HHS lacks authority to ignore the statute’s directive to deposit amounts from collections under the transitional reinsurance program to the Treasury and instead make deposits in the Treasury only if its collections reach the amounts for reinsurance payments specified in section 1341,” the GAO said in its findings.
“The agency is not authorized to prioritize collections in this manner. The agency must give effect to the extent possible to all of section 1341, and, to do so, is required to collect and deposit amounts for the Treasury, regardless of whether its collections fall short of the amounts specified in statute for reinsurance payments. HHS may not use amounts collected for the Treasury to make reinsurance payments,” the report further stated.
“Today, the comptroller general of the United States ruled that the Obama administration can no longer take money from taxpayers to bail out Obamacare,” Sen. John Barrasso (R-Wyo.) said in a statement. “This is a major victory for the American people who are suffering with higher premiums and fewer choices because of this failed law. The administration should end this illegal scheme immediately, and focus on providing relief from the burdens of this law.”
Yet the Obama administration doesn’t appear to care — it responded with a comment that the program was implemented “lawfully and in a transparent manner” and “helps to reduce premiums for consumers.”
The GAO has no enforcement power over its ruling, but congressional opponents of the health law could use the finding to write legislation that forces HHS to pay the Treasury. Generally, lawmakers of both parties respect GAO’s rulings on federal budget issues. So what changes — and are taxpayers even paying attention?
The ACA continues to appear unaffordable, especially for insurers, as they back out of the marketplace due to less-than-promised support from a different government stabilization program. Insurers also say they’ve been swamped by higher-than-expected claims and by customers who sign up for coverage, use it for expensive care — and then stop paying premiums.
But the claims come at a time of astounding growth for top health care executives’ salaries. “Salaries and bonuses were up across the board last year for top leaders at Health Care Service Corp., the Blue Cross and Blue Shield insurer in five states,” Modern Healthcare reported in an article this week. “The top 10 executives cumulatively earned $56.7 million in 2015 — the same year in which HCSC suffered substantial losses in the Affordable Care Act exchange markets.”
The same 10 executives earned $36.1 million in 2014.
“This is about fairness and respect for the rule of law clearly anchored in the Constitution,” the lawmakers who requested the GAO inquiry said in a statement. “The facts are simple — the Constitution is on our side. This new opinion from the government’s top watchdog confirms that the Obama administration is not above the law. The administration needs to put an end to the Great Obamacare Heist immediately.”