Ninety percent of everything has unspeakable problems, so, of course, 90 percent of anything to do with new Patient Protection and Affordable Care Act (PPACA) programs has unspeakable problems.
Various people will complain that, for example, a PPACA public health insurance exchange has problems with verifying whether applicants live in the right market to buy the coverage they want to buy, whether they’re citizens of the United States, or whether they actually exist.
The exchange (or other targeted entity) will often concede that it has verification system problems, then go on to add that the verification problem isn’t that big of a deal, because the insurance applicant, the exchange plan issuer, the exchange system services vendor, or other potential bad guy is subject to attestation requirements.
In other words, someone who could be lying has to swear, upon penalty of perjury, that he or she is telling the truth. Eventually, if he or she is lying, the Internal Revenue Service (IRS) or some other entity may use the kinds of verification systems the IRS now uses to catch problems with bank account interest reporting to catch PPACA perjury. The liars could end up being characters in a new, health-flavored sequel to “Orange Is the New Black” titled, “Orange Is the New Black: PPACA Perjurers Unit.”
On the one hand, the PPACA public exchange applications do require the people who fill out the applications to swear that they are giving honest answers, under penalty of perjury, and that they know they may be subject to penalties under federal law if they lie. I’m sure just about every other application or bidding process associated with PPACA has some kind of similar attestation process connected with it.
On the other hand, seriously: Perjury attestation provisions might work on insurance company executives, actuaries and information technology vendors, but what consumers read all of these Web agreements and perjury attestations that they’re signing? What percentage of the consumers, who, say, apply for special enrollment period (SEP) coverage have any idea what perjury is, even immediately after they finish reading a definition of perjury?
Typical consumers don’t even believe that lying on an insurance application is wrong. They think the entities trying to keep sick people from buying health coverage, or trying to keep sick people from getting free health care, are wrong. Just about the only people with the stomach to say no to seriously ill people are insurance company money managers who see how fast the cash is flying out the door and how quickly the till is likely to run dry, or health care providers who are exhausted from providing free charity care to patients who, in many cases, look as if they could have done a much better job of preparing to handle their own medical expenses.