Congressional Republicans Reveal Secret Love for Obamacare

As healthcare.gov slowly lurches into functionality, the battle lines around the health-care law are returning to their pre-October state. Giddy conservative hopes for the law’s immediate disintegration, or its quick repeal, have ebbed, and in their place opponents have returned to hoping that the law will fail because not many people will want to buy health insurance. Ross Douthat warns, or perhaps fantasizes, that the immediate collapse may have been averted, but the long, slow collapse may yet beckon on the horizon.

The new-old mechanism for the law’s predicted demise is that only the sickest or poorest Americans will enroll — “the law can work only if people who don’t necessarily benefit immediately from its provisions decide to participate anyway,” argues Douthat. But this is a misguided understanding of how insurance works and why people want it, a point that has been demonstrated most convincingly by the eagerness of the toughest Obamacare customer base you can imagine: congressional Republicans.

The still-fresh GOP messaging about the failed website launch turns out to be highly instructive. As part of their message campaign, Republicans in Washington, and their staffers, made displays of their difficulties, or alleged difficulties, enrolling in the new exchanges. For instance, Representative Chuck Fleischmann complained about the website freezing, and being forced to pay high premiums.

Why is he going through the bother and financial cost? “I am not a fan of Obamacare,” Fleischmann told Politico. “But I was bound and determined to try to comply with the law. I’ve done everything in my power to try to do that.” That is an awfully strange way to put it. Remember, a Supreme Court ruling reduced the individual mandate to a mere tax, and Fleischmann could comply with the law by paying a small fee for going without insurance. Instead he is enrolling anyway.

And of course the great hope of the conservative movement has been to foster a massive boycott of the exchanges – burn your (imaginary) Obamacare card, pay the tax instead. The Koch brothers are paying activists to flood college-football tailgate parties, plying undergraduates with free pizza and beer so they’ll listen to their pitch to boycott the exchanges. The Weekly Standard has an unintentionally comic reported dispatch from one such effort in South Bend, Indiana, where conservative activists attempt to drum up enthusiasm among frigid, demoralized Notre Dame undergraduates (“‘If this was a sunny day, this would be packed. Everyone would have their Opt-Out stickers on,’ said Matt Zepeda, a junior.”) Even as they try to goad Americans into following the boycott, conservative activists themselves have blithely ignored it. Salon’s Brian Beutler fruitfully trolled Amanda Carpenter, a speechwriter and senior communications adviser for Ted Cruz, over Carpenter’s high-profile complaints about the slowness of the health-care site, producing this head-smacking confession:

I don’t want to be uninsured. When even as fanatical an ideological cadre as Ted Cruz’s speechwriter blurts her desperation to join Obamacare, it suggests that conservatives have deeply miscalculated.

The problem here is that their definition of who would “benefit” is exceedingly narrow. You “benefit,” by his way of thinking, only if your actuarial costs exceed your financial contributions. But that isn’t how most people think about insurance. Insurance isn’t a kind of gamble where you bet you can beat the house by consuming more in medical care than you pay in premiums and deductibles. It’s protection from risk. People like that protection. They will pay to acquire it.

None of this is to say that the exchanges will quickly and seamlessly fill with desperate customers. It will remain a glitchy, halting process filled with bureaucratic aggravation — much as private insurance has been until now. The botched website rollout gave conservatives a powerful weapon to batter the credibility of Obama and his eponymous law. But the short-term benefits of website bashing also lured them into confessing the hopelessness of their long-term plan.

CBSNEWS.COM--- Medicare Fraud: A $60 Billion Crime

Of all the problems facing the United States right now, none are more important than health care. President Obama says rising costs are driving huge federal budget deficits that imperil our future, and that there is enough waste and fraud in the system to pay for health care reform if it was eliminated.

At the center of both issues is Medicare, the government insurance program that provides health care to 46 million elderly and disabled Americans. But it also provides a rich and steady income stream for criminals who are constantly finding new ways to steal a sizable chunk of the half trillion dollars that are paid out each year in Medicare benefits.

In fact, Medicare fraud - estimated now to total about $60 billion a year - has become one of, if not the most profitable, crimes in America.

This story may raise your blood pressure, along with some troubling questions about our government's ability to manage a medical bureaucracy.

If you want to find Medicare fraud, the first place you should look is South Florida, where 60 Minutes and correspondent Steve Kroft were told it has pushed aside cocaine as the major criminal enterprise.

It's a quiet crime - there are no sirens or gunfire. The only victims are the American taxpayers, and they don't even know they are being ripped off.

FBI Special Agent Brian Waterman, who 60 Minutes rode with for several days, told us the only visible evidence of the crimes are the thousands of tiny clinics and pharmacies that dot the low-rent strip malls.

You don't even know they're there because there's never anyone inside. No doctors, no nurses and no patients. "This office number should be manned and answered 24 hours a day," Waterman explained, standing outside one of those small, unstaffed businesses. The tiny medical supply company billed Medicare almost $2 million in July and a half million dollars while 60 Minutes was there in August, but we never found anybody inside, and our phone calls were never returned.

Sometimes, they don't even have offices: we went looking for a pharmacy at 7511 NW. 73rd Street that billed Medicare $300,000 in charges. It turned out to be in the middle of a public warehouse storage area. "They've already told us that there's no offices here," Waterman told Kroft. "There are no businesses here. In fact they are not even allowed to have a business here."

Waterman is the senior agent in the Miami office in charge of Medicare fraud. And Kirk Ogrosky, a top Justice Department prosecutor, oversees half a dozen Medicare fraud strike forces that have been set up across the country.

The office Kroft visited operates out of a warehouse at a secret location in South Florida and includes investigators from the FBI, Health and Human Services, and the IRS.

"There's a healthcare fraud industry where people do nothing but recruit patients, get patient lists, find doctors, look on the Internet, find different scams. There are entire groups and entire organizations of people that are dedicated to nothing but committing fraud, finding a better way to steal from Medicare," Waterman explained.

"Is the Medicare fraud business bigger than the drug business in Miami now?" Kroft asked."I think it's way bigger," Ogrosky said. Asked what changed, Ogrosky told Kroft, "The criminals changed." "Sophistication," Waterman added.

"They've figured out that rather than stealing $100,000 or $200,000, they can steal $100 million. We have seen cases in the last six, eight months that involve a couple of guys that if they weren't stealing from Medicare might be stealing your car," Ogrosky explained.

"You know, we were the king of the drugs in the '80s. We're king of healthcare fraud in the '90s and the 2000's," Waterman added, speaking about South Florida.---SNIP---more at CBSNEWS.COM/60 minutes web site

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MOST RECENT MEDICARE FRAUD: U.S. authorities have charged 49 Russian diplomats and their spouses with conspiracy to commit healthcare fraud, alleging they stole $1.5 million from the American government via a years-long Medicaid fraud...the diplos falsified govt documemnts, lied about their income and citizenship status in order to qualify for pregnancy care, births, and post-natal medical. The Russians were also charged with conspiracy to steal government funds and make false statements WRT to health care. Medical costs associated with 92 percent of births to Russian diplomats (2004 to 2013) were illegal--covered by soaking U.S. taxpayers.

The FBI found conniving Russian families spent tens of thousands of dollars on luxury goods and vacations while exploiting Medicaid funds. The State Department would need permission from the Kremlin to prosecute due to diplos immunity. (Excerpt) more at thewire.com ...

Insurance fraud is an old, old scheme---pols use to get into office and keep themselves in office. Read on.

EXHIBIT ONE: a NJ school supt was arrested in the fall of 2010 and charged with 17 counts of bribery, mail fraud and wire fraud.

Authorities say that while serving as NJ high school superintendent, he and his co-conspirator, a Maryland insurance broker, concocted a scheme to inflate school insurance charges and kick back part of the money as bribes.

The two are accused of concealing more than $1 million in bribes from insurance brokers and other service providers. The company, Federal Hill Risk Management, served as the insurance broker for the NJ Regional school district from 1978.

Court documents say the two men spent stolen money on home renovations, watches that cost tens of thousands of dollars, and other personal expenses......and also allegedly bought a girlfriend - also on the school district payroll - a car and other gifts, including money for the college tuition of one of her relatives, according to court papers.

A federal investigation of the insurance broker of Baltimore has to do with NJ municipalities and NJ school plans---he is under state indictment for allegedly bilking $2.6 million from one school district and more than $200,000 from the muni, and was indicted by a federal grand jury.

The broker's son-in-law and a business partner were charged with stealing $216,000 from the NJ muni for a nonexistent wellness program for city workers.

A state grand jury issued an indictment in July charging money laundering, conspiracy, forgery and theft by deception. Authorities said they bilked $2.6 million from the schools over a six-year period.

A third man, of Bernardsville, pleaded guilty to theft by deception and false representation for a government contract in the same scheme targeting the school district.

The co-conspirators are alleged to have lied to the school’s insurance carrier, Cigna----they told Cigna that the school board authorized the insurance carrier to pay fees on behalf of the school board from its medical claims bank account for health care related programs and services that never existed, authorities said. That money, stolen from Nov 2003 to July 2009, went into personal bank accounts, the indictment alleges.

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EXHIBIT TWO: Judy Rapfogel a 37-year Silver employee---now COS to NY Dim Speaker Sheldon Silver---is under investigation after her husband, William Rapfogel, was fired as CEO of the NY Metropolitan Council on Jewish Poverty.

Investigators said Mr Rapfogel bought insurance policies for the Met Council at inflated prices and pocketed some of the excess funds as kickbacks....and directed other funds from the insurer to NY political campaigns.

INSURANCE SCAM OF LONG-STANDING---NYT REPORT--Sixteen years ago, Judy Rapfogel, now chief of staff to Democratic Sheldon Silver, ran for the NY City Council---the seat was in Mr. Silver’s home district and was unusually heavy on political firepower, especially when compared with Judy Rapfogel's rather modest campaign budget of $160,000.

But among the various campaign expenditures for Council candidate, Judy Rapfogel, was a disproportionate sum spent on a seemingly peripheral need: automobile insurance. The insurance payments accounted for 6 percent of Judy Rapfogels campaign’s spending, and cost more than double what the campaign spent to lease the vehicles themselves.

Fast forward to 2013---sixteen years after her losing campaign, a criminal complaint filed against Ms. Rapfogel’s husband has cast new light on Judy's long-ago insurance payments. Mr. Rapfogel is accused of conspiring for more than 20 years to pad payments from the tax-exempt Met Council (largely subsidized by state, city and fderal taxpayers), to a small Long Island insurance brokerage in exchange for kickbacks from the brokerage.

Century Coverage Corporation, the insurance brokerage at the center of Mr Rapfogel's criminal complaint, is the same one that Judy Rapfogel’s 1997 campaign paid for unusually large insurance coverage.

A spokesman for Mr. Silver said that Ms. Rapfogel was also not aware that her 1997 campaign had paid Century. The treasurer for Ms. Rapfogel’s campaign, Freda Fried, did not return calls or e-mails. Ms. Fried is Mr. Rapfogel’s sister.

Judy Rapfogel has not been implicated in the criminal case against her husband but is now being connected peripherally via the Century Insurance payments for her 1997 campaign.....she has hired a lawyer.

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Authorities said Rapfogel is suspected of stealing $5 million and kept at least $1 million in kickbacks for himself with the rest going to unnamed co-conspirators....... and paid no taxes on the ill-gotten gains.

Investigators seized about $400,000 in bricks of cash Rapfogel stashed in his and Judy's home. Judy Rapfogel said "she did not know" about her husband's stash and did not know about the $100,000 cash gift he gave to their son to purchase a house.

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Since 2003, city and state politicians have steered $5 million to the Met Council in discretionary funds known as “member items.” By law, charities like the Met Council cannot return the favor by assisting candidates directly or indirectly. But Rapfogel appears to have pushed the interpretation of that law, and at times, Rapfogel’s role as a fund-raiser has been quite direct.

Mr Rapfogel is listed in campaign finance records as collecting $18,250 for assorted candidates from 1994 to 2007. Nearly half of that money — $8,500 — came from people tied to Century Coverage. Century executives and their relatives have also donated or raised $130,000 for politicians who have funded the Met Council, records show.

One such politician is Speaker Silver, who has appropriated $868,000 in discretionary funds to the Met Council since 2006, and received $8,500 for his political committees from Century employees, records show.

Democrat David Weprin is another. From 2004 through 2009, when he was a city councilman, Weprin’s campaign committee received eight checks totaling $4,950 from Century employees. During that time, Weprin sponsored $700,000 in discretionary funds for the Met Council. Weprin, now an assemblyman, did not return calls seeking comment.

A source close to Rapfogel said Rapfogel would let candidates receiving donations tied to the insurance company know that he was responsible for raising it. The source said that from Rapfogel’s perspective, using the insurance company to spread campaign donations “became an indirect way to do what he couldn’t do directly — make political contributions.”

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