Proving You Don't Have Health Insurance

What if you have health insurance but pretend you don't so you can get health insurance. A stretch? Perhaps not.

If you are applying for the Obamapool health insurance (PCIP) one of the qualifying criteria is indicating that you do not have coverage now and have not been insured for at least 6 months.

You are also required to say, and produce proof, that you have been denied health insurance in the last 6 months or have been offered a policy that contains an exclusionary rider for a pre-existing medical condition. The proof of the rider is submitting an actual copy of the rider from coverage that was approved by a health insurance company.

Of course if you have the rider, the policy was issued, which means, even if you decided to decline the offer, you had health insurance in the last 6 months. This would seem to preclude the applicant from qualifying for Obamapool coverage.

Which brings us to the next question.

If you state on the application that you do not have health insurance, and have not had health insurance for the last 6 months, how will they know? I am not suggesting anyone file a fraudulent application, but how many times will the administrator actually follow up to verify you don't have coverage? And how do they prove you don't have coverage? Almost any investigation could be considered a violation of your HIPAA privacy rights.

This is like the question that asks, "When did you stop beating your wife?". The question presumes you were beating your wife. In much the same way the folks at PCIP, if they question your truthfulness about prior coverage, might ask you to prove you don't have something. How will they do that?

What are the penalties for lying on the application in order to get PCIP coverage? The promise of Obamacare was coverage for all but in the case of those who need health insurance the most you are asked to go without health insurance for 6 months or lie if you are simply hoping to get a more affordable premium.

What a country.

Comments

  1. "When did you stop beating your wife?".
    Exactly so. I wonder if HHS Secretary Shecantbeserious wants to be out there prosecuting cases for fraudulent apps.

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