2013-11-18

This week's target in the never-ending Republican crusade to sabotage the Affordable Care Act is the Obamacare navigators, the dozens of community groups, hospitals and other non-profit organizations who have received federal grants to help Americans enroll in new health insurance plans. After launching a House probe of the groups and enacting draconian state restrictions on their activities, Republicans are warning that the navigators, like Nigerian email scammers, could be criminals intent on stealing Americans' identities.

Unsurprisingly, this GOP's cynical attempt to prevent Americans from obtaining health insurance is a double fraud. After all, President Bush's unfunded $400 billion Medicare prescription drug program used navigators, too. Many of the same groups are Obamacare navigators now. (Some of the Bush navigators, like ACORN and the arch-conservative 60 Plus Association, are not.) And as it turns out, the real threat to bilk billions of dollars from the American people isn't a bunch of non-profit social workers with foreign sounding names, but comes from national hospital chains and device manufacturers with very American names like Florida Governor Rick Scott.



As TPM's Dylan Scott reported Monday, Senate Minority Leader Mitch McConnell is leading the GOP effort to slander the navigators. The last thing Americans seeking health coverage need, McConnell warned, "is to worry about some felon stealing their identity." Last week, conservative talking point bulimic Ann Coulter went a step further, selectively using the record of Medicare fraud to argue that "the country is now chock-full of people who come from cultures where criminality and government corruption is a way of life":

Do you notice anything that stands out about the list of convicts? Would any of their names have sounded strange to Ben Franklin? Of 22 people convicted of defrauding American taxpayers by fraudulently billing Medicare or Medicaid, at least 17 have almost comically foreign names.

One name that wouldn't have sounded strange to the likes of Ben Franklin is Rick Scott. And as you'll recall, before he became Republican Governor of Florida, the man with the all-American sounding name presided over the company that committed perhaps the largest Medicare fraud in history. As the Miami Herald recounted in June 2010:

"As I have said repeatedly, Columbia/HCA made mistakes, and I take responsibility for what happened on my watch as CEO,'' Scott said in a written statement Friday. He has denied knowing frauds were taking place while he was there, and he was never charged with any crimes.

However, federal investigators found that Scott took part in business practices at Columbia/HCA that were later found to be illegal -- specifically, that Scott and other executives offered financial incentives to doctors in exchange for patient referrals, in violation of federal law, according to lawsuits the Justice Department filed against the company in 2001.

The doctor payments were among 10 different kinds of fraud identified by the Justice Department in its 10-year probe of the company, records show. Three years after Scott left Columbia/HCA, the company admitted wrongdoing, pleading guilty to 14 felonies -- most committed during Scott's tenure -- in addition to paying two sets of fines totaling $1.7 billion.

Unfortunately for Ann Coulter, Rick Scott's bio does not include any mention of his being a Nigerian prince. But his former company Columbia/HCA shares a similar profile with many of the firms trying to steal billions from American taxpayers. In her 2011 interview with said Don White, spokesman for HHS's Office of the Inspector General, Sarah Kliff explained why "industry executives may soon end up becoming the poster children for health-care fraud:"

Small-time fraudsters represent a small fraction of the Medicare and Medicaid fraud that's committed, White argues. Last year, the Justice Department recovered $3 billion in false claims overall, a record $2.5 billion of which came from the health-care sector. And, the HHS spokesman points out, big pharmaceutical and medical device corporations are among the worst offenders: Last year alone, the DOJ says it recovered $669 million from Pfizer, $302 million from AstraZeneca and $193 million from Novartis. That's why the Obama administration has focused on "large corporations, pharmaceutical companies who are illegally marketing" drugs that haven't been tested, White concludes.

Back in Washington, Texas Republican Senator John Cornyn has called for the entire Obamacare navigator program to be shut down. That's an amazing demand for him to make, given that he along with most of his GOP allies voted for President Bush's Medicare Part D drug program that used the very same kind of navigator network to help sign up 43 million American seniors for private prescription plans. As Bush's Health and Human Services Secretary Tommy Thompson announced in May 2004:

"Seniors and persons with disabilities need to take advantage of the real savings and real money that is on the table for them...We want to be aggressive in reaching out to these beneficiaries so they don't miss out on this meaningful benefit to help pay for their medicines."

In July, Thompson's successor at HHS Mike Leavitt explained to Washington Post op-ed page readers how the Bush administration accomplished their aggressive outreach to millions of new Medicare Rx plan beneficiaries:

Before the program was implemented, only 21 percent of seniors had a favorable opinion of it, and 66 percent didn't understand what the reform would mean for them.

So we spent 18 months devising and implementing a campaign to explain the prescription drug benefit, prepare seniors as well as partners -- such as community groups, churches, pharmacies, insurance plans and state and local governments -- and then sign people up. A national bus tour supported each phase. The summer before enrollment (the same period that the ACA is in now) we logged more than 600,000 miles and visited 48 states. As secretary, I made 119 stops in 98 cities. I learned that with a program like the ACA, you can't count on Washington to sell it. You have to reach people where they live, work, pray and play.

To put it another way, Bush's Medicare drug plan navigators helped the government "reach people where they live, work, pray and play." But with the White House currently occupied by a Democrat and the nation's first African-American president, Republicans now pretend, those navigators aren't partners but the equivalent of Nigerian identity thieves.

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