Political Animal


January 03, 2012 10:45 AM The ACA actually combats fraud and abuse

By Steve Benen

John McDonough has a good piece on an overlooked benefit from the Affordable Care Act: it’s doing quite well in combating fraud and abuse, which in turns saves Americans quite a bit of money. (via TOA)

Members of Congress of both parties often complain about fraud and abuse in Medicare and Medicaid (M&M), usually charging that the President is not doing enough to keep bad guys from stealing money from these vital programs.

Guess what? Thanks to provisions in the Affordable Care Act (ACA/ObamaCare) and to an unprecedented effort by the Obama Administration, more progress has been made in the past three years to combat health care fraud and abuse than ever before. There was a 68.9 percent increase in criminal health care fraud prosecutions from 2010 to 2011, and 2010 was already the highest ever.

McDonough helped work on the ACA’s provisions related to fraud prevention, and sketches out the areas in which the law is improving enforcement.

Part of the effort involves hyper-charged efforts to catch bad guys through the Health Care Fraud Prevention and Enforcement Action Team (HEAT), and a bigger part involves re-engineering the system to keep them out. For example, prior to the ACA, if a bad guy got kicked out of one state Medicaid program for fraud, he got kicked out of one program; under the ACA, when he gets kicked out of one, and he gets kicked out of all them, including Medicare. That’s smart, and that’s just a tiny bit of what the ACA does on fraud & abuse.

Let’s take stock for a moment, shall we? Much of the Affordable Care Act won’t take effect until 2014, assuming it survives until then. But provisions that are already in place have:

* brought coverage to 2.5 million young adults;

* delivered big savings for seniors on prescription drug costs;

* given a significant boost to small businesses through ACA tax credits;

* slowed the growth of Medicare spending;

* provided new treatment options for cancer patients like Spike Dolomite Ward;

* saved taxpayer money by cracking down on fraud;

* and offered new coverage protections for those with pre-existing conditions.

These are tangible, real-world benefits, making a meaningful difference in people’s lives. It’s also a reminder that the health care law, polls and attacks notwithstanding, is working.

Of course, all of these benefits and improvements will quickly disappear if Mitt Romney is elected and follows through on his commitment to repeal every letter of this law.

Steve Benen is a contributing writer to the Washington Monthly, joining the publication in August, 2008 as chief blogger for the Washington Monthly blog, Political Animal.


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  • Mudge on January 03, 2012 10:48 AM:

    The other day Atrios said, "You know, we really could use some people campaigning on doing stuff for people." Although he probably meant mortgages, doing stuff for people (meaning people who do not earn 7 figures) appears to be solely a Democratic effort.

  • Jilli on January 03, 2012 10:48 AM:

    As a cancer survivor, I can't imagine why anyone that has suffered a major illness or with a family member who has suffered a major illness would vote for a republican and their ridiculous claims to repeal the ACA. I'm fortunate and have insurance (right now), but who knows what the future holds - I'm thankful that I will always be able to get coverage. It's a huge issue.

  • stormskies on January 03, 2012 10:51 AM:

    One of the key benefits of the Affordable Care Act is the fact that due to the efforts of Senator Sanders from Vermont 15 billions dollars has been committed to expanding the Community Health Care clinics around our country that are based on your income. This makes these clinics accessible to poor people, and those in real need. This money will go into hiring new doctors and nurses to staff these new clinics.

    This fact has been completely ignored by the Corporate Media, and even on this blog: why I don't know.

  • Anonymous on January 03, 2012 11:01 AM:

    These are tangible, real-world benefits, making a meaningful difference in peopleís lives. Itís also a reminder that the health care law, polls and attacks notwithstanding, is working.

    Except.... in the Faux nooze world .
    Things are different there you know.
    You can tell in letters to the editors and in conversations who has had their world view given them by Faux.
    And this is what the GOP panders to and convinces to vote against their own self iterest.

  • DAY on January 03, 2012 11:03 AM:

    but, but, "ObamaCare' is a job killing, tax increasing, abortion funding disaster!
    I know, because my TeeVee tells me so.

  • chi res on January 03, 2012 11:08 AM:

    Next thing you know, republicans will be saying that fraud and abuse are actually good things, and that's why Obamacare must be repealed.

    (come to think about it, they already think fraud and abuse are good things...)

  • jjm on January 03, 2012 11:13 AM:

    @chisres: The GOP is the patron saint of fraudsters.

  • c u n d gulag on January 03, 2012 11:14 AM:

    GOP POV:
    We must screw-up or kill ACA, ASAP!

    It might prove that government CAN do some good - and people will wonder wtf we've been talking about since, oh, government began.

    Good government MUST be stopped!
    VOTE GOP!!!

    hollow, chyurin

    "Hollow" CRAPTCHA!
    Don't think being nice to me will make me hate you any less.

  • martin on January 03, 2012 11:25 AM:

    Of course, all of these benefits and improvements will quickly disappear if Mitt Romney is elected and follows through on his commitment to repeal every letter of this law.

    Only if the Dems in the Senate let it happen.

    If they lose the Senate AND the new Repub Majority gets rid of the filibuster, it could happen. Otherwise, it would take the Democrats selling us down the river (again).

  • zandru on January 03, 2012 11:52 AM:

    It's a Cinch...

    ... that the media (except NPR) and White House won't harp on these achievements; probably won't mention them at all.

    So it's up to us, as surrogates, to start talking about ACA's benefits. Take one or two of the achievements, bone up on the details (thanks, Mr. B, for the convenient links!), and hold forth at the water cooler, local $tarbux, family gatherings - well, you know the drill. Post links on your Facepage, tweet like a songbird, and blog away. (This year, I've resolved to try to enter the 21st century...)

  • homerhk on January 03, 2012 12:39 PM:

    It's all well and good blasting the GOP for being for repealing Obamacare but the real villains, as far as I'm concerned, are the false friends of the President, the Dems in congress and on "left" or "liberal" blogs who have spent the past 2 years ridiculing this - pretty substantial and progressive legislation - as a corporate sell out, a nothingburger, a betrayal when in fact it really is, in the words of some lowly schmoe - a big f**king deal!

  • Kiweagle on January 03, 2012 1:13 PM:

    @zandru on January 03, 2012 11:52 AM: You beat me to the punch, which is that the Democrats will completely ignore the lessons of the 2010 congressional elections and avoid any mention of the ACA's benefits and rapidly accumulating accomplishments. This will, of course, provide the same cover of ignorance the GOP used to such great effect when lying about "ObamaCare". About half of all Republican's still think it will destroy Medicare and involve Death Panels, for God's sake.

    @homerhk on January 03, 2012 12:39 PM: That "lowly schmoe" you're referring to Vice President Joe Biden.

  • maryQ on January 03, 2012 1:16 PM:

    Don't you think that, for balance, you need to find a news story about someone whose loved one's life was terminated by a Death Panel? I think until you prove that this _hasn't_ happened, there is no reason to conclude it's not a problem. In fact, I think you need to find me a case where a Death Panel decided -NOT- to terminate someone's life, based on a specific provision of the ACA. It's not enough to say that Death Panels don't exist. How do I know you aren't involved in the cover up.

    OK, that was fun.

    homerhk-I'm with you. While I still believe that the real villains are the GOP, and their media stenographers, lots of folks on the left have done their best to demonize ACA (and Obama) for what it does not have, rather than provide a reasonable counter narrative to the Republican lies and smears. So we get
    "Death Panels"
    "This Sucks! No Public Option! Obama Sucks"
    followed by
    "Death Panels"

    with friends like these.....

  • ShadeTail on January 03, 2012 3:50 PM:

    homerhk - I was going to write something similar.

    I've been living in fear for years because my family depends on my husband's health plan. He has a very good one because he's a unionized high school teacher, but nothing is certain.

    We have two boys and I have some vicious pre-existing conditions. What if we somehow lost my husband's health plan? Pre-ACA, I wouldn't have been insurable for any price. Now a lot of my worry is gone, for myself and my sons.

    And these fair-weather liberals, who don't know shit about the real world, whine and piss and moan about how bad the ACA is? Whenever I see one of them carrying on like that, I feel the urge to wrap my hands around their throats and squeeze.

  • Phil Perspective on January 03, 2012 5:15 PM:

    And these fair-weather liberals, who don't know shit about the real world, whine and piss and moan about how bad the ACA is?

    Care to name names?

  • Doug on January 03, 2012 8:00 PM:

    Phil Perspective, on the assumption you REALLY want names, may I suggest you go to the bottom your screen and click on "Political Animal Archives"? It might take a few minutes, but you'll be amply rewarded.
    How ANYONE can call themselves "progressive" and maintain a "half-empty glass" mentality about legislation, I'll never know...