Think Tank Ignores Potential Fraud To Smear Trump Budget Bill

The left is ignoring potential fraud to pursue its own ideological objectives.

That’s the shorter version of a series of analyses regarding the House-passed reconciliation bill released in recent days by the Kaiser Family Foundation. The organization, and other leftist groups like it, fixate solely on the number of individuals with health insurance coverage — regardless of whether those individuals engage in fraud, or even whether those individuals belong in this country.

The Kaiser analyses create state-by-state breakdowns of projected changes in insurance coverage, based on national estimates from the Congressional Budget Office (CBO). These specialized estimates push greater propaganda than information because Kaiser and affiliated groups pitch scary headlines to the local press in each state: “Republicans’ legislation will mean X thousand people will lose health insurance — right here in this state!”

If that all sounds too cynical, consider what Kaiser had to say about an enrollment study conducted last year by the Paragon Health Institute, a right-leaning think tank. (Disclosure: While I have previously done work for Paragon, I had no involvement in the enrollment study last year.)

The Paragon study examined Exchange enrollment based on reported income and compared those enrollments to Census Bureau estimates of population based on income. In some states, particularly those that have not expanded Medicaid, the number of Exchange enrollees reporting the lowest income — who qualify for the richest subsidies — exceeds the number of people the Census Bureau indicates exist in that state. For instance, Florida reported more than 460,000 enrollees with incomes below 150 percent of the poverty level. The Census Bureau data, however, suggests that only about 175,000 eligible individuals earn that income without another source of health coverage.

Because so many more people have enrolled than those who are potentially eligible to enroll, the data from the Paragon study reveals that many individuals are lying about their income, for one of two reasons. In states like Florida that have not expanded Medicaid, individuals may inflate their income because people with income below the poverty level do not qualify for Exchange subsidies (a de facto work requirement in those states). In other cases, people may deflate their income because they realize, for instance, that claiming to make only $30,000 instead of $70,000 means they will qualify for higher subsidy amounts.

Data like this prompted the Trump administration to issue a proposed rule in March, attempting to limit the ways individuals can game the system. The reconciliation bill would codify some of those proposals in legislation, as opposed to regulations, and contains other similar reforms. Of course, those changes may impact coverage outcomes, which brings us back to Kaiser.

In the methodological section of its report, Kaiser admitted that it also analyzed enrollment by income group and used much of the same Census Bureau data that Paragon analyzed to come up with its conclusions last year. So, I asked Kaiser a simple question: Did they see the same problematic trends (i.e., potential fraud) that Paragon did — and if so, why not mention that fact in the report?

The response I got from Jared Ortaliza, one of the authors of the Kaiser study, included some methodological explanations, along with a final sentence that proved the most telling: “I don’t think this has any relevance to the Paragon analysis.”

That says it all in a nutshell. Leftist organizations like Kaiser don’t care whether changes in insurance coverage occur because people claimed they qualified for subsidies when they didn’t, or even because they were living in this country illegally but were receiving government-funded coverage. Both represent sources of potential coverage “losses” due to the reconciliation bill, yet many might argue that such groups never should have qualified for taxpayer-subsidized insurance initially.

Kaiser only cares about the number of people with coverage — preferably, with government-run coverage. It doesn’t matter whether such “coverage” doesn’t actually provide care — a former state Medicaid director once described a Medicaid card as a “hunting license [that gives] you a chance to go try to find a doctor”— or how much it costs taxpayers.

Conservatives should stop trying to play the left’s game and instead focus on more important metrics, including our $36 trillion in debt. Otherwise, our nation will rapidly discover what Margaret Thatcher famously observed nearly half a century ago: “Socialist governments traditionally do make a financial mess. They always run out of other people’s money.”