Presumptive Duplicity with Obamacare

By James R. Edwards, Jr. on August 5, 2014

Have you heard about President Obama's illegal immigration scandal?

Not the one where Central Americans are surging over the border with the administration's tacit approval. The scandal I'm referring to is the wholesale enrollment of illegal aliens in Obamacare. You may recall the president averring before a joint meeting of Congress in 2009 that this would never happen.

A recent HHS Inspector General investigation found that up to 1.3 million of the eight million who got health coverage through Obamacare exchanges could be illegal aliens. Yet many may have obtained health coverage through a qualified health plan or Medicaid, based on the illegal aliens' attesting to (lying about?) their citizenship or immigration status. This means that thousands of illegal aliens could receive a taxpayer subsidy for their health premiums.

Officials are supposed to verify the information applicants give, not only about their immigration status, but also income levels. However, the "enroll-first-ask-questions-later" design has – predictably – resulted in lots of questionable outcomes, if not fraud and abuse. If officials cannot readily verify someone's information, the 90-day "inconsistency period" may be extended.

The IG report noted:

If an applicant is unable to resolve an inconsistency because the documentation does not exist or is not reasonably available, then the marketplace may, on a case-by-case basis, accept an applicant's attestation along with an explanation of why the documentation is not available. The marketplace cannot accept an applicant's attestation for citizenship or immigration status if it is unable to resolve this inconsistency. (Emphasis added.)

Thus, the honor system of Obamacare enrollment is supposed to stop short of taking their word that someone is lawfully in the country. But the left hand of HHS has instituted presumptive eligibility. Enrollment first, sort out "inconsistencies" later. Those are the marching orders from HHS to health insurers, navigators, et al.

The IG found that the federal exchange couldn't resolve the inconsistencies in self-reported information 89 percent of the time. That's 2.6 million out of 2.9 million cases of inconsistencies. It remains unclear when officials pull the plug on the health coverage of those newly enrolled who have sketchy stories and spotty documentation.

Some 1,295,571 of the inconsistencies in enrollee self-attestations that HHS couldn't resolve involved citizenship or lawful residence claims. That represents 44 percent of the inconsistencies. Unresolved income matters represented one-third of total inconsistencies. The IG found similar causes of inconsistencies for the state-run exchanges. The IG discovered variations as to when different states start the 90-day clock running, and couldn't determine how many cases the federal exchange had given extensions:

[B]ecause of the federal marketplace's inability to resolve most inconsistencies, we were unable to determine the number of applicants who may have exceeded the 90-day inconsistency period or for whom the inconsistency period was extended by the federal marketplace because the applicant demonstrated a good-faith effort in obtaining satisfactory documentation.

Part of the problem, the IG said, is the federal data hub, which is supposed to connect the various databases from DHS, HHS, the IRS, etc. It amounts to a major malfunction. If all the horror stories last year about the Obamacare website fouling up expose the front-end, consumer-side problems, the data hub represents the back-end, government user-side problems.

This isn't just some radical open-borders bureaucrats acting on their own in the nooks and crannies of Obamacare. No, President Obama himself assured Telemundo and Univision viewers that Obamacare information won't be shared with immigration enforcers. He said:

It's true that the undocumented are not eligible [for Obamacare], that's how the law was written, but if you are a U.S. citizen or you have a legal presence in this country, you are eligible. And none of the information that is provided in order for you to obtain health insurance is in any way transferred to immigration services. So that's something we've been very clear about. If you live in a mixed status family, then the son who could potentially be eligible for the children's health insurance program or some other mechanism to get health insurance, he needs to be signed up.

This gets real interesting if you think about the implications. Obviously, the lawfully resident child in this example doesn't have an income, so his eligibility for taxpayer-funded health care is determined based on household income. The illegal alien, who earns too little to pay for private health coverage for the members of her household, derives an indirect public benefit despite her unlawful immigration status. Meanwhile, this illegal alien parent competes in the U.S. job market with Americans who can't find a full-time job, drives down American wages by helping to flood the labor force with cheap foreign workers who displace American workers, and may now have no fear of removal — that is, being held accountable for her lawbreaking. Is this a great country, or what!

So-called navigators, who assist potential Obamacare enrollees, have conducted outreach events not just in Latino and other minority communities, but at Mexican consulates. Senior administration officials have embraced such questionable venues. Obama Small Business Administrator Yolanda Garcia Olivarez, for example, made an appearance at an event at the Brownsville, Texas, Mexican consulate. Similar Obamacare enrollment has occurred at Mexican consulates in Chicago and Las Vegas. And remember, some navigators have been exposed as being illegal aliens themselves.

A navigator organizer had this to say about staging enrollment at foreign consulates:

"Whether they're Mexican nationals or whether they're United States citizens or whether they're in transition — and if they're there it is our responsibility within all of America to educate on the Affordable Care Act," Enroll America Field Organizer Jose Medrano told Breitbart News

Add to this mess the fact that the Deferred Action for Childhood Arrivals administrative amnesty further expands the pool of illegal aliens who can get health care on taxpayers' backs, at least in California. About 125,000 DACA recipients in California make less than $15,850 and thus qualify for Medi-Cal, the Golden State's Medicaid program.

All of this shows that, despite several Supreme Court rulings against some of health reform's excesses, this law treats illegal aliens better than it does U.S. citizens. Presumptive eligibility, enrollment events that cross the line, the willful ignorance of complicit navigators, and outright solicitation by high-ranking officials add up to a raw deal for the American people.

Topics: Health Care