Obamacare Rigged to Fleece Taxpayers


June 11, 2014
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Never doubt the cleverness of Big Health. Obamacare does not redistribute wealth to the poor. Instead, the law’s various requirements redistribute wealth and wages to Obama’s partner in crime: large health plans. These corporations are then by law allowed to keep the cash and shortchange the care under “medical necessity” guidelines, demonstrating again that coverage is not care.

New evidence shows how one Obamacare tactic, called “risk adjustment” (RA), will be used to redistribute premium dollars from one health plan to another health plan. In short, the health plans with the sickest (riskiest) patients on paper win.
Under RA, enrollees in non-grandfathered individual plans (3.5 million people) and small group plans (18-24 million people), in and outside of the government exchanges, are assigned “individualized risk scores.” These scores are used to generate an “average risk score” for each plan, ostensibly representing the plan’s predicted expenses.
Wealth redistribution begins here. Plans that create the highest-risk scores win. As explained by the Kaiser Family Foundation:
“Under risk adjustment, plans with a relatively low average risk score will make payments into the system, while plans with relatively high average risk scores will receive payments.”
HHS collects the dollars from one set of plans and hands it over to the other set. This means your premium dollars could end up in another health plan’s pockets. It also means health plans that make their enrollees look the sickest can bleed their competition dry. To grab more of the RA dollars without necessarily providing more care, health plans are now conducting home visits to gather data on their enrollees.
Health plans are already using RA to defraud taxpayers.
Last week, the Center for Public Integrity revealed that auditors looking into Medicare Advantage (Medicare HMOs) have “concluded that all six health plans they visited couldn’t justify the money they took in for 40 percent or more of their patients.” Federal payments to Medicare Advantage health plans have been determined by risk adjustment since 2004. The overpayments for the six plans were estimated at $650 million in 2007 alone. In 200 counties, the cost of Medicare Advantage was 25% higher than traditional non-managed care Medicare.
Nothing was done about these overpayments. Instead, in 2013, the HHS inspector general under Obama decided to scrap future audits, blaming a budget cut, but ignoring the obvious: How many audits could be conducted with an extra $650 million a year?
The Center accurately states, “When risk scores overstate a patient’s illness, the plans make more money from Medicare.” Or better said, from you the taxpayer.
Obamacare moves most Americans into this public-fleecing scheme. Watch the gaming of the risk adjustment system begin as large health plans use sophisticated data systems to syphon millions -- or billions -- of dollars from premium-paying taxpayers.
Help us put an end to Obamacare. Your donation of $35, $75 or more today will help us secure the $28,000 we need to implement another round of our popular “Obamacare Games” billboards, which tell Millennials to stay away from Obamacare and its fraud-enabling schemes!
Telling the truth about Obamacare,
Twila Brase, RN, PHN
President and Co-founder