Hearing on the Integrity of the Affordable Care Act’s Premium Tax Credit

Hearing on the Integrity of the Affordable Care Act’s Premium Tax Credit

f t # e
Washington, July 23, 2014 | comments




Hearing on the Integrity of the
Affordable Care Act’s Premium Tax Credit


_____________________________________

HEARING

BEFORE THE

SUBCOMMITTEE ON OVERSIGHT

OF THE

COMMITTEE ON WAYS AND MEANS

U.S. HOUSE OF REPRESENTATIVES

ONE HUNDRED THIRTEENTH CONGRESS

SECOND SESSION
________________________

July 23, 2014
__________________

SERIAL 113-OS10
__________________

Printed for the use of the Committee on Ways and Means

 

COMMITTEE ON WAYS AND MEANS
DAVE CAMP, Michigan,Chairman

SAM JOHNSON, Texas
KEVIN BRADY, Texas
PAUL RYAN, Wisconsin
DEVIN NUNES, California
PATRICK J. TIBERI, Ohio
DAVID G. REICHERT, Washington
CHARLES W. BOUSTANY, JR., Louisiana
PETER J. ROSKAM, Illinois
JIM GERLACH, Pennsylvania
TOM PRICE, Georgia
VERN BUCHANAN, Florida
ADRIAN SMITH, Nebraska
AARON SCHOCK, Illinois
LYNN JENKINS, Kansas
ERIK PAULSEN, Minnesota
KENNY MARCHANT, Texas
DIANE BLACK, Tennessee
TOM REED, New York
TODD YOUNG, Indiana
MIKE KELLY, Pennsylvania
TIM GRIFFIN, Arkansas
JIM RENACCI, Ohio

SANDER M. LEVIN, Michigan
CHARLES B. RANGEL, New York
JIM MCDERMOTT, Washington
JOHN LEWIS, Georgia
RICHARD E. NEAL, Massachusetts
XAVIER BECERRA, California
LLOYD DOGGETT, Texas
MIKE THOMPSON, California
JOHN B. LARSON, Connecticut
EARL BLUMENAUER, Oregon
RON KIND, Wisconsin
BILL PASCRELL, JR., New Jersey
JOSEPH CROWLEY, New York
ALLYSON SCHWARTZ, Pennsylvania
DANNY DAVIS, Illinois
LINDA SÁNCHEZ, California

JENNIFER M. SAFAVIAN, Staff Director and General Counsel
JANICE MAYS, Minority Chief Counsel


    

SUBCOMMITTEE ON HUMAN RESOURCES
CHARLES W. BOUSTANY, JR., Louisiana, Chairman

DIANE BLACK, Tennessee
LYNN JENKINS, Kansas
KENNY MARCHANT, Texas
TOM REED, New York
ERIK PAULSEN, Minnesota
MIKE KELLY, Pennsylvania


JOHN LEWIS, Georgia
JOSEPH CROWLEY, New York
DANNY DAVIS, Illinois
LINDA SÁNCHEZ, California

 



_______________________________

CONTENTS

_____________________


Advisory of July 23, 2014 announcing the hearing


WITNESSES

Seto Bagdoyan
Acting Director, Audit Services, Forensic Audits and Investigative Service, Government Accountability Office
Testimony


________________________________


Hearing on the Integrity of the
Affordable Care Act’s Premium Tax Credit


Wednesday, July 23, 2014
U.S. House of Representatives, 
Committee on Ways and Means, 
Washington, D.C. 

____________________


The subcommittee met, pursuant to call, at 10:30 a.m., in Room 1100, Longworth House Office Building, Hon. Charles Boustany [chairman of the subcommittee] presiding.

 [The advisory of the hearing follows:]

_________________________________________________________________

 

Chairman Boustany.  This hearing will come to order.  Good morning and welcome to this morning's hearing on the integrity of insurance premium subsidies under the healthcare law. 

Last month, this subcommittee and the Subcommittee on Health held a hearing that showed the administration's failure to implement effective eligibility verification systems would result in billions of the dollars in improper payments going out the door and unexpected tax debts for families across America. 

This morning, we turn to the question of whether the Federal exchange has sufficient controls in place to verify income and identity verification, including Social Security numbers, names and other information.  On September 12th of last year, Chairman Camp, Senators Tom Coburn, Orrin Hatch and I wrote to Comptroller General Gene Dodaro asking that the Government Accountability Office conduct testing to determine whether the administration had in place appropriate internal controls to prevent fraud and abuse in health insurance exchanges.  We asked that they do this through the GAO's forensic audits and investigative service, a team of forensic audit and investigative professionals who conduct special investigations and fraud assessments. 

To test these internal controls, GAO went undercover, created 18 fictitious identities to apply for insurance subsidies online, over the phone and in person.  When GAO applied for premium subsidies online or over the phone with fictitious names, Social Security numbers and documents, it succeeded over 91 percent of the time.  When GAO went to seek help from taxpayer‑funded assisters, five teams out of six, they were turned away or unable to find help.  When GAO sent in fake documents to support their applications, Federal contractors accepted those documents.  Sadly, this is not terribly surprising, but it is really disturbing. 

Time and again the administration has chosen to either ignore the law, or when it does implement the law, it does so with a level of incompetence.  The administration decided the employer mandate would harm its political and electoral interests, so it delayed the mandate.  The administration found that the words of the law would prevent it from implementing Federal subsidies in a way it preferred, it ignored the law, and as the D.C. Circuit ruled yesterday, when the administration sought to implement Federal exchange ‑‑ implement the Federal exchange and created healthcare.gov, the Web site crashed spectacularly.  So when the administration began issuing billions of dollars in subsidies, we found that it did so without regard to protecting those taxpayer dollars from improper payments. 

This is not simply a question of whether one likes the President's health law or the way this administration has gone about implementing it.  The question really is whether the administration is being a good steward of taxpayer dollars and putting in place adequate controls to protect those dollars from fraud, waste and abuse.  This is about whether these subsidies are actually going to those who really need them and who have ‑‑ who qualify them ‑‑ qualify for them appropriately.  The history of the healthcare law's implementation suggests that the answer has been no. 

Today we hear from Seto Bagdoyan, the acting director of the Forensic Audits and Investigative Service on GAO's preliminary findings in this matter.  I want to thank him and GAO for this work. 

And look forward to your testimony, Mr. Bagdoyan, and also look forward to continuing to work with you on this issue. 

Now I would ‑‑ I am very pleased to yield to the distinguished ranking member from Georgia, Mr. Lewis, for the purposes of an opening statement.

Mr. Lewis.  Thank you for holding today's hearing, Mr. Chairman.  I would like also to thank our witness for being here today.  Thank you for being here, sir. 

Mr. Bagdoyan.  My pleasure.

Mr. Lewis.  Let me begin by highlighting a simple and an important fact.  The Affordable Care Act works.  Last week, multiple reports from Gallup, the Commonwealth Fund and the Urban Institute provided Congress with a truth that cannot be denied, explained away or disputed.  Today more Americans have health insurance than they did 1 year ago. 

Many of my colleagues on the other side of the aisle said that no one would sign up for the Affordable Care Act; instead, 8 million people enrolled.  There were claims that part of the law were too expensive, but last month HHS reported the average cost was only $82 per month for those receiving tax credits. 

Let me highlight some more indisputable ACA successes.  Today, more than 17 million children with pre‑existing conditions can no longer be denied coverage, 3.1 million adults can be covered on their parents' plan until age 26, and 105 million Americans will no longer face bankruptcy because insurance companies will stop paying their medical bills.  That is what the ACA did and we should be proud of this work. 

Despite constant attack, the prediction of disaster has simply failed to come true.  Instead, the door to healthcare has opened for millions of Americans. 

Mr. Chairman, I would like to ask unanimous consent to insert two articles into the record.  One is from Politico, entitled, "The Verdict is in: Obamacare Lowers Uninsured."  The second is from the New York Times, entitled, "Obamacare Fails to Fail." 

Thank you, Mr. Chairman.

Chairman Boustany.  Without objection, they will be entered into the record.

[The information follows: Rep. John Lewis 1, Rep. John Lewis 2]

Mr. Lewis.  It is clear that it makes no sense to continue attacks to the fund and destroy the healthcare law.  There should be no fear in a good faith, bipartisan effort to make the ACA stronger and better for future generations.  This is why I look forward to the testimony of the GAO about ways to make commonsense improvements to the ACA.  In fact, there are actions we can take right now to find and fight waste, fraud and abuse.  For example, Congress can provide adequate funding for the IRS and HHS enforcement systems so that all taxpayers will be protected.  We have an opportunity to be proactive and not reactive. 

One thing is crystal clear, one thing is crystal clear:  It is time for political stunts and baseless fear tactics to end.  Success cannot and must not be dismantled.  We will not go back to a time when Americans did not have access to affordable healthcare insurance.  We will not destroy the ACA.  I hope that all of my colleagues on both sides of the aisle will come together to strengthen and improve the historic benefits and protection of the ACA.  It is time to move forward and do what is right, what is just, what is fair and what is responsible. 

Again, thank you, Mr. Chairman, and I yield back my time.

Chairman Boustany.  Thank you, Mr. Lewis.

Chairman Boustany.  Now it is my pleasure to welcome our witness, Mr. Seto Bagdoyan, acting director of Forensic Audits and Investigative Services at the Government Accountability Office. 

Thank you, sir.  We really appreciate your time today.  We appreciate the effort that you have put into this, along with your staff.  The subcommittee has received your written statement.  It will be made part of our formal hearing record.  As is customary, you will have 5 minutes to give your oral remarks, and then we will open up for questions. 

Sir, you may begin.

STATEMENT OF SETO BAGDOYAN, ACTING DIRECTOR, AUDIT SERVICES, FORENSIC AUDITS AND INVESTIGATIVE SERVICE, GOVERNMENT ACCOUNTABILITY OFFICE, WASHINGTON, D.C.

Mr. Bagdoyan.  Chairman Boustany, Ranking Member Lewis and members of the subcommittee, I am pleased to be here today to discuss at a high level preliminary observations from the undercover component of GAO's ongoing review of the Federal healthcare Marketplace to test its enrollment controls.  This review is at the request of this subcommittee, as the chairman mentioned, and others in Congress. 

In terms of preliminary results, Mr. Chairman, we used fictitious identities, false information and forged documents, as well as instructions from the Marketplace itself, to circumvent its front and back end controls. 

Accordingly, we obtained actual coverage for which we are paying premiums, the government is paying premium tax credits on our behalf directly to insurers totaling about $2,500 a month, or about $30,000 a year. 

At the outset, I would note that, one, observations are subject to change as we obtain and analyze additional information; two, enrollment test results can't be projected to the entire universe of applicants; and three, since our work is ongoing and involves the use of certain investigative techniques, I am precluded from discussing many details about this and future work in this setting. 

That said, the results in the two main components of our undercover work are as follows:  First, in 12 fictitious applications, which were made by phone and online, we tested the Marketplace's front‑end controls for verifying an applicant's identity or citizenship or immigration status.  Marketplace applications require attestations that information provided is neither false nor untrue.  The applications also stated income at a level to qualify for income‑based subsidies to offset premium costs for tax credits and reduce expenses, such as co‑pays. 

For 11 of the 12 applications, we obtained subsidized coverage.  For the 12th application, the Marketplace did not allow us to proceed, because the applicant declined to provide a Social Security number as part of our test. 

In terms of back‑end controls, the healthcare law requires the Marketplace to provide eligibility while any identified inconsistencies between information submitted by the applicant and what resides in government databases is being resolved through submission and verification of supplementary documentation.  For each of the 11 approved applications, we were directed to submit supporting documents, such as proof of income or citizenship, but we found the document submission and review process to be inconsistent regarding similar applications.  As of July of this year, we had received notification that some of the forged documentations submitted for two applicants had been verified, thus clearing the back‑end controls for these three documents. 

According to CMS and its document processing contractor, this contractor is not required to look for or detect fraud and accepts documents as authentic unless they are obvious alterations.  We continue to receive subsidized coverage for all 11 successful applications, including those where we did not provide any of the requested supporting documents. 

Second, in six other fictitious applications, we attempted to test the extent to which, if any, in‑person assisters would encourage our applicants to misstate income in order to qualify for income‑based subsidies.  However, we were unable to obtain in‑person assistance in five of six attempts.  For example, one in‑person assister said that he does not provide assistance ‑‑ he provides assistance only after people already have an application in progress.  The assister was not able to help us, because the healthcare.gov Web site was down at the time, and he did not respond to several follow‑up phone calls.  One in‑person assister correctly advised the applicant that he ‑‑ that the stated income would not qualify for subsidy. 

Collectively, our undercover and audit work to date has highlighted key areas of inquiry about the Marketplace's controls, which we plan to pursue in depth during our remaining work. 

Mr. Chairman, this concludes my remarks.  I look forward to the subcommittee's questions.

Chairman Boustany.  Thank you, Mr. Bagdoyan. 

[The statement of Mr. Bagdoyan follows:]

Chairman Boustany.  I want to thank you and your team for this first look at what appears to be a pretty significant problem with process and implementation with regard to these subsidies. 

And these findings, although preliminary, are quite troubling.  Eleven out of 12 applications with false identities were approved and are receiving subsidies.  Applications that falsified citizenship information were also approved.  And then, on the back end, five out of six navigators and assisters are failing to help taxpayers.  Federal contractors seem unable to uncover fraudulent documents.  CMS is either unaware or unable to screen out fraudulent applications nationwide with regard to premiums and subsidies. 

This is all very troubling, and I am glad you are going to continue taking a more in depth look at this, because we look forward to revisiting the issue, but from your work so far, you know, in your official capacity, but also as an American citizen, are you really worried, are you really concerned about the total lack of effective controls that might result in significant fraud and more improper payments in this system as it stands? 

Mr. Bagdoyan.  Thank you for your question, Mr. Chairman. 

I would speak only on my ‑‑ in my official capacity, of course, in this setting, but as I mentioned earlier, our investigative work and our audit work thus far has identified certain areas of concern that we plan to pursue as our work unfolds, as well as areas, such as the database of applicants itself, which will be at the core of our work. 

So I would say in summary that what we have so far is a number of questions that are fundamental regarding the effectiveness of controls, especially at the front end, where the preventative controls are paramount, as well as the back end, where traditionally they are relatively less effective, where you have a situation of a pay and chase, as we discussed earlier.  So we are absolutely committed to focusing on controls in this regard.

Chairman Boustany.  And we know that if we have ‑‑ if we fall back into a pay‑and‑chase situation, it is very difficult to recover those dollars.  Is that correct? 

Mr. Bagdoyan.  Well, according to GAO's fraud prevention framework, back‑end controls are relatively less effective than strong preventative controls, so I would just respond in that context.

Chairman Boustany.  Thank you.  And your work also included interesting findings regarding two contractors and numerous grant recipients.  One concerned a contractor hired to resolve identity verification and a second concerned a contractor hired to process paperwork that is unable to verify whether the document is actually authentic.  Another finding concerned navigators and other assisters who were unable or unwilling to help your undercover applicants despite the fact that they had received tens of millions of dollars in Federal grants. 

Again, I know this is still a preliminary finding, but can you describe in greater detail GAO's experience with these groups?  What ‑‑ you know, what are we ‑‑ what is your recommendation at this point, or do you have one, to correct these problems?  This is troubling, because a lot of money has gone out the door in the form of grants to these ‑‑ you know, these navigators.  I have deep concerns about this. 

Mr. Bagdoyan.  Certainly.  In all three instances, we have had an initial touch with these entities, so it would be premature to reach a judgment about effectiveness or not or certainly what needs to be done about them, but in terms of the contractor who was ‑‑ who has been tasked with verifying identity, they did attempt to assist us during the call process after we were directed by the online system to do so.  And when they were unable to verify our identity, they suggested that we call the call center, and as my statement alludes to, we were able to get coverage that way. 

Regarding the contractor who is tasked with verifying documentation at the back end, there is no provision to look for fraud in the contract itself.  And we confirmed this with CMS officials as well as the contractor officials at our site visit in their facility in Kentucky, so ‑‑

And then in terms of the navigators, again, it is a ‑‑ it is an initial contact, and one person made the correct call on our application scenario, but the other five, for various reasons, were unable or unwilling to assist us.

Chairman Boustany.  Okay.  Do you have any more ‑‑ can you shed any more light on why they were unable or ‑‑ 

Mr. Bagdoyan.  In one instance, one assister said they didn't have sufficient training to do so.  Another one said we needed to make an appointment, because we essentially were a walk‑in at that ‑‑ in that case and ‑‑ but would not pick up the phone to make an appointment.  And another two instances, I believe, there might have been a willingness to do so, but the Web site itself was unavailable at the time.

Chairman Boustany.  Okay.  Well, I appreciate that.  This subcommittee and the Ways and Means Committee as a whole is taking our oversight function very, very seriously.  We know this is a first look.  We appreciate the work you have done, and we know this work is ongoing, and so we will look forward to revisiting these issues as you get more data and hopefully get to a point where you can make some specific recommendations to us. 

I have to say, the initial findings are deeply troubling to me.  We know we are dealing with fraud and abuse in a number of other areas where tax credits and especially refundable tax credits are being utilized, which undermines the integrity of these programs and the intent of the programs to help those who really need help.  And I think we are at a point now, clearly, we are at a point where this ‑‑ these kinds of situations are intolerable.  Whether you are a Republican or a Democrat, we cannot tolerate this level of fraud, abuse, taxpayer waste, and we need to root these things out, so we will look forward to continuing to work with you on these issues.  Thank you. 

I will now yield to my friend, Mr. Lewis. 

Mr. Lewis.  Mr. Chairman, my friend, I want to thank you for yielding. 

Mr. Chairman, I want to ask you a question.  Can you share with the Democratic members of the committee a copy of the letter that you sent to GAO?  It is my understanding that GAO does not make public ongoing investigation. 

Chairman Boustany.  Yeah.  We will be happy to share that letter with you.  I was under the assumption that you had seen it. 

Mr. Lewis.  Well, thank you very much, Mr. Chairman. 

That will be most helpful. 

Mr. Director, let's get right to the heart of the matter.  Have you drawn any conclusion at this point in your investigation? 

Mr. Bagdoyan.  No, sir, we have not.  Our work is ongoing.  As I mentioned earlier, this is our first touch‑through looking at the controls, and we have identified certain areas for further audit and investigation as appropriate, but we can't draw any conclusions based on our current status.

Mr. Lewis.  What is your time frame for concluding this investigation? 

Mr. Bagdoyan.  It is difficult to say at this point.  It could be several months, but our work is very active, and we are receiving new information as we speak from CMS, and we will have a chance to analyze and follow up that, but we are looking at at least several more months, sir.

Mr. Lewis.  What areas are subject to further review? 

Mr. Bagdoyan.  Sure.  In general terms, I think there are various types of controls where they are at along the process, how they interact with each other, who is responsible for them, how they might benchmark against best practice, that sort of thing.

Mr. Lewis.  And the false income information that the GAO gave, would that not be caught up during a true process?  Can you explain this process? 

Mr. Bagdoyan.  I am sorry.  Could restate the question? 

Mr. Lewis.  Yeah.  The false information that the GAO gave, would that be caught up during the true-up process? 

Mr. Bagdoyan.  I think what we used was part of the overall investigative plan, but the identities we employed, the information and the documents were all fictitious.

Mr. Lewis.  The income process, how do you go about getting this information?  Are you free, at liberty? 

Mr. Bagdoyan.  Well, in a general sense, we set our income levels within the range of eligibility to obtain subsidies, and that is pretty much all I can discuss at this time. 

Mr. Lewis.  Okay.  Over the past year, a lot has been made of the problem with the Web site.  Tell me how many fraudulent applications were you able to get past the Web site. 

Mr. Bagdoyan.  Our online applications, as I state in my formal statement, our applications were flagged for identity verification.  We were referred to the contractor, who is tasked with resolving those identity questions.  They were unable to do so.  They referred us to the Marketplace's call center, and through the call center, we were able to bypass the initial flag and obtain coverage.

Mr. Lewis.  Could you tell members of the committee, what are the benefits of cheating the ACA system?  The money goes to the insurance company, not the individuals. 

Mr. Bagdoyan.  Yes.  I mean, we are not receiving the subsidies directly to our accounts.  They are paid by the government to the insurers directly upon presentation of what I would imagine would be some sort of an invoice on a monthly basis.

Mr. Lewis.  Thank you very much, Mr. Director. 

I yield back my time.

Chairman Boustany.  I thank the gentleman. 

Mr. Reed, you are recognized for questioning. 

Mr. Reed.  Thank you, Mr. Chairman. 

Thank you for the testimony today, sir.  One of the pieces of information I found intriguing in your preliminary work is as you went through this work, my understanding is you talked with the officials of CMS that handle this situation, and they indicated to you that ‑‑ the CMS officials told you that their experience has not shown the need for any changes in the eligibility determination process.  So CMS is working with you throughout this investigation, correct? 

Mr. Bagdoyan.  Yes.  We have been in touch with CMS officials and obtained documents and other information. 

Mr. Reed.  Very, very frustrating to me as a member of this oversight committee that the officials that are responsible for trying to implement this program are sending you and sending this body a message that they are not interested in making any changes to improve the situation, even though you have given them examples of clear, egregious violations of the procedures.  Am I misunderstanding the response of CMS? 

Mr. Bagdoyan.  Well, I think that has been their position at the time.  I believe in press reports regarding this hearing, the public statement that CMS made was their willingness to continue to work with GAO and identify areas where improvements were made.  So I would have to reconcile those two statements during the course of our work.

Mr. Reed.  Well, I would hope this oversight process and this public spotlight does do its job and gets CMS on the ball to not send a message that they don't want to work with you and others to clear up this clearly egregious behavior that you have discovered and that you continue to discover as you go forward with this investigation. 

There is another interesting thing in your written testimony that I read, and it is that you indicated that CMS is currently unable to identify who has made a premium payment and who has not.  Is that accurate?  I mean, did I read your testimony correctly? 

Mr. Bagdoyan.  Yes.  That is our understanding, that that part of the back‑end system, that is part of the broader data hub, I believe, has not been constructed, but there is a plan to do so, we just don't have a timeline for that to happen.

Mr. Reed.  Okay.  So there is a plan that CMS has advised to you that they have in order to verify that information? 

Mr. Bagdoyan.  That is our understanding at this time, yes. 

Mr. Reed.  But they can't give you a timeline as to when they are going to get that done or implemented or ‑‑

Mr. Bagdoyan.  That's correct as of this date.

Mr. Reed.  What are the details of that plan? 

Mr. Bagdoyan.  I can't comment on them.  We can check back and see with my staff to determine.  If we have appropriate documentation, we can get back to you on that.

Mr. Reed.  So just say you don't know, and there is probably information out there that you could check? 

Mr. Bagdoyan.  There might be in our work papers set, but I am just not familiar with that plan specifically.  So I don't want to give you a wrong answer.  We will get back to you.

Mr. Reed.  And am I correct in your testimony, though, too, that the insurers have given the information to CMS on the payment? 

Mr. Bagdoyan.  Again, that is our understanding, that the insurers provide a list and an amount of subsidy owed, and the government takes that self‑attestation and reimburses the insurers for the subsidies directly without touching the enrollee, which is an important point to make.

Mr. Reed.  So just so the American people understand that may be enrolled in these situations, what happens if the government doesn't catch the fact that they are not paying their premiums anymore with the individual's responsibility to repay back these premiums that may be erroneously or fraudulently issued to them? 

Mr. Bagdoyan.  Well, I think the requirement is that the applicant or the enrollee continue to make payments to be eligible for the subsidy, but that is a determination that I wouldn't be able to make in terms of what exactly the process would be for the government to follow up with that particular enrollee and determine why the payments are not being made, whether there would be a grace period to restart the payments.

Mr. Reed.  Okay.  But maybe I am not being clear.  So if an enrollee doesn't make the premium payment and the subsidy continues to be provided to the insurer, correct? 

Mr. Bagdoyan.  I ‑‑ that is a possibility, yes.

Mr. Reed.  And then, subsequently, it is discovered that the premiums weren't made, isn't there an obligation on CMS' part or the government's part to go after the enrollee to say, Hey, we gave you a premium subsidy that you are not entitled to, because the premiums weren't made?  Is that ‑‑ that is my understanding of it.

Mr. Bagdoyan.  Thank you for your clarification.  We are aware of situations like that, but so far, the audit part of our work has not focused on it, and we will be focusing on that area going forward.

Mr. Reed.  Well, I appreciate that, because I am very concerned about the fraud and everything that you have uncovered in this preliminary report, but I am also very concerned that enrollees don't understand what is coming down the pipeline, because if CMS doesn't do its job, if the government doesn't do its job, if they continue to engage in this fraudulent behavior, then premiums are going out.  That is one thing.  That is wrong.  That is illegal.  That is a clear violation.  But also if the premiums go out and the enrollees have pay back those premiums because of some type of mistake that the government made, I hope the American people understand they are the ones who are going to be on the hook to have to pay this back, and not the insurer. 

I yield back, Mr. Chairman.

Chairman Boustany.  Thank the gentleman. 

Mr. Crowley, you are recognized for 5 minutes. 

Mr. Crowley.  I thank you, Mr. Chairman. 

I am interested in hearing about the concern for the enrollees.  That is very interesting.  My friend from New York spoke so eloquently about concern for the enrollees.  I would just add for the record that 52 times my colleagues on the other side of the aisle have voted to repeal the Affordable Care Act, 52 times.  I am not asking you to comment on that, but just to state for the record that 52 attempts by my colleagues on the Republican side of the aisle have been to repeal the entire act itself, so it is interesting to hear about the concerns for the enrollees. 

Quite frankly, Mr. Bagdoyan, I think that this hearing is premature.  You have stated yourself that you have not finished your investigation.  Is that correct? 

Mr. Bagdoyan.  Yes.  The work is ongoing on the investigative and the audit front, yes. 

Mr. Crowley.  And I would suggest that possibly part of that investigation, as Mr. Lewis was referring to, was seeing this through.  Have any of your undercover investigators actually accessed any healthcare through these plans? 

Mr. Bagdoyan.  They have not.

Mr. Crowley.  They have not.  And they are paying a premium ‑‑ they are paying a premium, and the government is giving a subsidy directly to the insurance companies, correct? 

Mr. Bagdoyan.  That is correct.  As part of the investigative scenarios, that is correct.

Mr. Crowley.  So it appears as though you have operated a very sophisticated criminal operation here, not that your intention is criminal.  In other words, if someone is thinking in terms of a criminal mindset to actually exploit the system, you are kind of working in that ‑‑ that mode in an honest way, I guess you could say, right? 

Mr. Bagdoyan.  Well, that is part of our tasking, to investigate and ‑‑

Mr. Crowley.  And I appreciate that. 

Mr. Bagdoyan.  And it is the authority of the GAO to do that, sure.

Mr. Crowley.  And it is important from an accounting point of view in understanding and saving taxpayers.  This is not accusatory towards you and what ‑‑

Mr. Bagdoyan.  I understand.

Mr. Crowley.  ‑‑ you are doing.  I want to make that clear. 

Mr. Bagdoyan.  No worries.

Mr. Crowley.  But what is the ultimate price here for the criminal?  Is it a free colonoscopy?  What is the ultimate benefit to the criminal who is taking these risks to do this?  You know, this isn't like Medicare fraud where the doctor is actually cooking the books to put more money into his or her pocket.  Why would a noncitizen, for instance, risk discovery by applying for health insurance, or a fraudster with an illegal Social Security Number use them for this purpose when there are other obviously more lucrative ways in which to exploit those things?  Why would they do that? 

Mr. Bagdoyan.  I am afraid I wouldn't be able to comment on the intent of anyone attempting fraud.

Mr. Crowley.  Let me ask you this question, then:  in addition to the penalties in the Federal criminal law, the ACA has civil penalties for providing false information.  Is that correct? 

Mr. Bagdoyan.  I believe that is my understanding.

Mr. Crowley.  So, in a perfect world, if people ‑‑ again, if these were real criminals, if they were attempting to did this, they would probably be ‑‑ they would have some knowledge that possibly there would be some penalties if this were uncovered.  Is that correct? 

Mr. Bagdoyan.  I can't speak for individuals.  There is, I think, sufficient information.

Mr. Crowley.  And, in fact, the two penalties are as stiff as $25,000 for failure to provide information and $250,000 for providing false information.  That is a substantial amount.  Is that not enough, or do you think we should maybe increase those penalties?  Do you think that those penalties would have some impact on the criminal's intent to pursue this? 

Mr. Bagdoyan.  Again, Mr. Crowley, I would be hesitant to comment on that. 

Mr. Crowley.  I appreciate that.  I see that ‑‑ I know that I am running out of time, but I see that my colleagues once again on the other side of the aisle are using this as an opportunity, I think, to exploit their dislike of the Affordable Care Act, and I know that they don't like it, I get that, but today, I guess the theatrical selection is much ado about nothing, because there is really nothing here yet until we see what happens in the true‑up what the follow‑up of the IRS would be in terms of determining whether or not that individual was eligible for those credits.  And I know that they haven't helped in terms of making that even more helpful to the recipient of the credits themselves, so I appreciate that.  It is just another attempt to try to smear, I think, the Affordable Care Act. 

More people are getting coverage, as my colleague from Georgia has said, and they are liking it.  All the doomsday predictions haven't come true, and they are now trying to trump up new accusations that ignore the reality of it that people are actually accessing healthcare and enjoying it. 

Yes, there are instances where people misstate or wrongly estimate their income, and for those inconsistencies, they are later verified and corrected, and if not, they have to pay it back. 

So I think, you know, Mr. Bagdoyan, as I mentioned before, I do appreciate your work and you needing to do this and it is important work that you are engaged in, but I think it has been premature.  It is like having an investigation of organized crime, and talking about an investigation that is going on before you have gotten to the conclusion.  It tips off a lot of people that we may not want to be tipping off. 

With that, I will yield back.

Chairman Boustany.  I thank the gentleman. 

Which underscores why we are taking a serious look at oversight early in this process, to avert problems and taxpayer dollars going out to waste, fraud and abuse, rather than letting this linger on for years on end and taxpayers being caught up in this trap. 

With that, I will now yield to Mr. Roskam. 

Mr. Roskam.  Thank you, Mr. Chairman. 

Mr. Bagdoyan, the gentleman from New York, Mr. Crowley, said that this is an attempt to smear the Affordable Care Act, and I would argue just the opposite.  I think the Affordable Care Act, to use his adjective ‑‑ or his verb, is smearing itself, and he posed a number of hypotheticals to you.  Let me move out of the hypothetical and into the actual. 

So, actually, based on this investigation, there were 12 attempts to defraud the system, and 11 of those attempts were successful.  That is right, isn't it? 

Mr. Bagdoyan.  That is correct, Mr. Roskam. 

Mr. Roskam.  That is not hypothetical.  Those are actual 11 attempts that came up where the bad actor rang the bell and got a benefit that they weren't supposed to get.  That is right, isn't it? 

Mr. Bagdoyan.  That is correct in these 11 instances.

Mr. Roskam.  I find that number, 11 out of 12, shocking, jarring, troubling; you know, pick your descriptor.  Have you come to an opinion based on your experience as to how you would characterize the robustness of the program?  I recognize your admonition at the beginning that you don't want to overlay, but for example, accept this hypothetical:  if this trend were to continue and 11 out of 12 were to continue to be the trend and you were to lay that out over this entire program, how would you describe that net result? 

Mr. Bagdoyan.  Well, again, I would be reluctant to project based on this very limited sample.

Mr. Roskam.  I accept that at face value.

Mr. Bagdoyan.  But as I mentioned, again, and I will underscore it in this instance, is that we have identified several areas of control that need attention, and our audit work will focus on that and benchmark against appropriate standards for us to make any kind of judgment in terms of forward looking in this regard.

Mr. Roskam.  Have you come to an opinion about the robustness of the Internal Revenue Service and their role in the 11 cases that you came across? 

Mr. Bagdoyan.  Our work has not touched the IRS as yet, but they are part of the overall scope of our work.

Mr. Roskam.  So the IRS inquiry is ongoing? 

Mr. Bagdoyan.  It is, yes.  It is ‑‑ it is active work as we speak, and that is one of the agencies we will be touching on in terms of their roles in controlling enrollment.

Mr. Roskam.  And this GAO report, this investigation came about as a result of a specific congressional inquiry.  Is that right? 

Mr. Bagdoyan.  That is correct, at the request of Chairman Boustany and others.

Mr. Roskam.  I think that we are going to continue to have these episodic insights into the weakness of some of these things.  And what we need to be doing and what Congress needs to be doing is advocating an overall structure for oversight.  

I have introduced H.R. 4158, which would create a special inspector general to monitor the Affordable Care Act, or SIGMA.  Congress has appointed special inspectors general for things like the Troubled Access Recovery Program, TARP, Afghanistan, Iraq and elsewhere, where literally billions of dollars in waste have been uncovered. 

And if you think about the scope of what we are talking about here, CBO projects that over a trillion dollars in Affordable Care Act subsidies are going to be paid out over 10 years.  Those types of numbers just absolutely take your breath away.  Even if a portion of the trend that you uncovered continues, these numbers are really jarring. 

The special inspector general approach that I have advocated would have a similar role with jurisdiction that spans all implementing agencies, and the ability to bring important data to light and hold the administration accountable.  And in the case of subsidies, it is given specific oversight over the IRS and its implementation of the law more broadly, but also its subsidy verification and overpayment recapture process.  So I think that there is a real opportunity here. 

Your insight is incredibly helpful.  I want to join my colleagues in thanking you for the work that you are doing.  We are not over‑characterizing it, but we are really concerned about the depth and the problems that you have identified and articulated.  Thank you for your time. 

And I yield back.  Thank very much.

Chairman Boustany.  Thank the gentleman. 

Mr. Paulsen, you are recognized for 5 minutes. 

Mr. Paulsen.  Thank you, Mr. Chairman. 

And I thank you for taking the time to be with us this morning.  You know, we already knew that we were unable to verify income and eligibility information.  We have had that discussion in this committee as the law has been put into practice, for those that are applying for health insurance, but this review, the review that you provide today, calls into question whether the government is even able to verify that these people who are applying for insurance are who they say they are.  I mean, just those folks, it is just ‑‑ you know, the 11 out of the 12 cases that you mentioned earlier as a part of this review. 

And just to follow up a little bit on what Mr. Roskam had said, it is troubling to follow on the heels of your report, knowing full well that the inspector general for tax administration has already found seriously inadequate controls available in administering their part of the law.  HHS, the Office of the Inspector General has already found their internal controls are deficient.  And now we have this report where you have laid out 11 of 12 successful cases in defrauding, essentially defrauding the system.  So we know that improper payments in other Federal programs have cost money.  You look at the EITC over a 10‑year period, costing taxpayers $132 billion.  If you apply that percentage to what would be transpired into this extensive, expensive program with the Affordable Care Act, Obamacare, we are talking real money here, real money that can be prevented. 

But let me ask you this.  I want to just follow up on a little different line of questioning, Mr. Bagdoyan.  You stated that six of your 18 applicant scenarios included in‑person applications through the navigators and those in‑person assisters, but you tested ‑‑ your testing had one problem.  In five of the six scenarios, they were either unable to find these individuals or they were turned away, correct? 

Mr. Bagdoyan.  Well, the six cases are independent of the other 12, because they focused on testing the income control.  And the five who were unable to assist us was done, as I mentioned earlier, for a variety of reasons.  They said they didn't have sufficient training to do so, they focused on a narrow part of the applicant population, two of them were experiencing some Web site access problems at the times, and another one told us that we needed to make an appointment.  When we attempted to do so onsite, we were advised to call, but our calls were unsuccessful.

Mr. Paulsen.  Okay.  So you have worked through this scenario.  We know that CMS awarded these navigators that you were approaching $67 million in grants to help consumers complete their eligibility applications and the enrollment forms, and then other in‑person assisters received this money as well, but your testimony, then, is suggesting that many of these groups may be pocketing that money, taxpayer money, without providing the services. 

Can you just describe a little bit about what your experience and GAO's experience was at trying to obtain in‑person assistance in your applications? 

Mr. Bagdoyan.  Yes.  I would refer you to my answer earlier.  There was a mix of having to make appointments, we were not able to make them on the spot, and we didn't get our phone calls returned, and there were also Web site problems.  Someone said that they didn't have sufficient training, so they were uncomfortable in performing the service. 

Mr. Paulsen.  So there is insufficient training, the Web sites, you know, may be inaccurate or not working correctly.  Do you expect that later, GAO, through your ongoing investigation, is going to name those entities where you sought assistance but you were unable to obtain it?  In other words, is there going to be a trail of accountability here?  Is that going to be part of your recommendation?  Do you see that happening? 

Mr. Bagdoyan.  Well, we will have to look at the assister issue in the broadest context possible within the controls focus of our work.  I can't really comment beyond what the implications are to the entire assister population, because this was, again, a very narrow slice of that population that we looked at.  So we will take a variety of factors into consideration, but in terms of naming names, I don't think that at this time or in the future, we would necessarily go that route.

Mr. Paulsen.  Well, and let me just ask this, then.  So knowing 5 of 6 or 11 of 12, we are talking high percentages here, right, 80 to 90 percent of issues here.  Is a part of the investigation, I would expect, accountability, right, as a part of your investigation, maybe not naming names, but naming those that ‑‑ where the contracts were let, where the navigators were supposed to be providing these services, where there is no accountability in essence, correct? 

Mr. Bagdoyan.  I think from the perspective of looking at the controls in their totality, that is an area that we will take a look at, but, again, I would emphasize the narrowness and the smallness of our sample, and the percentages would be out of whack if we had something that would be projected to those populations. 

Mr. Paulsen.  Thank you, Mr. Chairman. 

Yield back. 

Chairman Boustany.  Thank the gentleman. 

Mr. Davis, you are recognized for 5 minutes. 

Mr. Davis.  Thank you very much, Mr. Chairman. 

And thank you, Mr. Director. 

It seems to me that this is a very interesting investigation, that we are investigating what we think might happen.  And I guess from watching television, I am of the opinion that much of the forensic work relative to investigations are about things that have occurred, and we are trying to find out how and why.  It is interesting to me that the focus of the investigation is on individuals who would qualify for a subsidy, yet that there isn't anything that we can project they are going to benefit; that the beneficiaries become the insurance companies.  It certainly does not become them.  So if we can't establish any intent relative to fraud, then we can establish that maybe somebody who was helping them or somebody who was giving them information had not been trained as well as they should have been and, as a result of that, mistakes occur, and yet we still focus on them. 

Let me ask you, is the 11 out of 12, is that really accurate?  I mean, it is hard to determine the accuracy of projections sometimes.  Anyway, things don't always go as it looks as though they would, but is the 11 of 12, is that a firm level of accuracy that we really could expect? 

Mr. Bagdoyan.  Thank you for your question.  The intent of this sample was not to project in any way.  It is too small of a sample to do so, anyway.  The intent of this phase of our work, the investigative undercover phase, is basically to identify areas for potential focus for our future work in terms of the overall controls and then the specific controls and tools and how they interact, where they are in the process and how they might work or not work depending on their application.  So it was not intentional on our part to say, Well, 11 out of 12 we can project to the entire universe of applicants.  And that is one of the limitations that I identified in my oral comments.

Mr. Davis.  I have always thought and felt that a bit of prevention is worth much more than the cure, and so surely if we can prevent things from happening, but I guess I am wondering, where would the money come from since we have not passed an HHS appropriation bill, since "cut, cut, cut" has been the theme of our colleagues on the other side?  Where would the money come from to do this broad investigatory work that related across the board to these individuals who could get a subsidy, but it wouldn't go to them?  I mean, what is ‑‑

Mr. Bagdoyan.  Well, certainly, sir, I can't comment on the budget necessarily to do this work, but I would concur with your earlier comment about the importance of preventative controls, what we call the front‑end controls.  That is part of GAO's fraud prevention framework.  So I would agree to that extent, that that is where the action has to happen, because the back‑end controls traditionally are less effective.

Mr. Davis.  Well, thank you very much. 

I yield back. 

Chairman Boustany.  I thank the gentleman. 

Before we go to the next questioner, I also want to make the point, and I think you ‑‑ it is highlighted in your report, that you ‑‑ even though the sample size is small, you sampled diverse areas of the country, rural and urban.  So it sort of gives us, even with a small number, kind of a broad snapshot of ‑‑ within the confines of those small numbers, that we have a trillion dollar program over 10 years, we are very concerned about the integrity of the program, and safeguards on the front end, which we know are more effective than trying to go through pay and chase, which as we know from other programs, that is not effective in recouping and protecting taxpayers.  And so I just wanted to make that point, and if ‑‑ and I want you also to state for the record a little bit about the fact that you looked at diverse areas, both urban and rural. 

Mr. Bagdoyan.  Certainly we tried to have a representation of different geographic locations in the country, and within those geographic locations, we attempted to represent urban and rural settings so that we had, given, again, our limited sample, as diverse coverage as possible.

Chairman Boustany.  And you will continue the investigation along those same lines, so ‑‑

Mr. Bagdoyan.  Right.  As more information becomes available, the more we analyze, we will identify, as appropriate, additional steps in that regard, yes.

Chairman Boustany.  Thank you. 

Mr. Marchant, you are recognized for 5 minutes. 

Mr. Marchant.  Thank you, Mr. Chairman. 

And thank you, Director, for this report. 

I guess the word is out to America that what we have suspected all along is true.  Wall Street Journal says fictitious applicants get to U.S. health insurance tax credits.  The Washington Post says, Federal uncover investigation signs up fake applicants for ACA coverage and subsidies.  And then NBC comes out and says, GAO sting finds it easy to fake it.  Get Obamacare premiums. 

So what we have suspected since we passed this law and it began to be implemented is that it is another Federal program that is going to be easily scammed and easily accessed by someone willing to commit fraud.  We have several programs in the Federal Government that we find out daily that that is happening to. 

I guess we also found out what the new definition of a navigator is.  The new definition of a navigator is a fraud assistant agent.  It is something that we have suspected since the first TV and news stories came out when we found people in these agencies not being able to answer questions, some of them had criminal backgrounds.  From the very beginning, we suspected that the people that were going to be assisting people to sign up to this program were not qualified to do so.  This report, this preliminary report completely ratifies that. 

In one of these stories, it says that 4.3 million of the applicants have some inconsistency in their application, 4.3 million, and the agents and the contractors that are supposed to be vetting these inconsistencies are so far behind, they will never catch up, never catch up to verifying these inconsistencies. 

This last year, this year, we will have spent $17 billion on this program, another Federal program.  Where did the money come from?  The money came from taxpayers.  In the last year, millions of taxpayers in the United States have found out that they are paying for Obamacare; they are paying in extra taxes.  So it is the responsibility of this committee, it is the responsibility of this Congress to make sure that those taxpayers, those hardworking taxpayers do not have their money wasted, and so I think that your preliminary report has done a great service to this Congress and this committee, because it is giving us some direction now in finding out exactly how to address this problem. 

When you gave the navigators the information, did you provide income information? 

Mr. Bagdoyan.  Yes.  I would refer you to my opening statement where I said that the one person who did assist us, correctly identified our income, which we gave this person, as being outside the boundaries of qualifying for a subsidy.  So we did provide a number, and this assister assessed that number and correctly told us that it was outside of that bound.

Mr. Marchant.  So your ‑‑ in these 11 to 12 cases ‑‑ in all 12 cases, you provided the IRS with income that was verifiable and you provided them with a Social Security Number that was verifiable? 

Mr. Bagdoyan.  We provided a series of data points as part of the application, but I will remind you that the six navigator scenarios are not intended to seek coverage like the other 12 were.  So it is a technical nuance, but it is a very important one to make.  But we did provide information online during our online application process, and then when we switched over to the telephone process, we were submitting various bits of information, yes.

Mr. Marchant.  So you could draw the conclusion that, as flawed as the Web site started and as flawed as it is and as flawed as it is, and now on the back end as you described, catching those fraud and catching those inconsistencies, the Web site, you found you ‑‑ it was much more difficult on the Web site to give them false information and sign up than it was if you would switch to a navigator? 

Mr. Bagdoyan.  Well, we were flagged on the online process.  We were referred to the contractor, who was intended to clarify or verify our identity.  When they weren't able to do so, they directed us to the call center, and that is where we got through in terms of obtaining coverage. 

Now, I would say that when we did provide information as part of the application process, there were inconsistencies that were flagged, and we subsequently received requests to submit documentation which would be ‑‑ to substantiate the information we were providing, and that is the documentation that is now at the back end with the contractor, who processes that documentation.  And as I mentioned earlier, in several instances regarding two of our applicants, those documents have been verified as authentic.

Mr. Marchant.  Thank you, Director. 

Chairman Boustany.  I thank the gentleman. 

Ms. Jenkins, you have 5 minutes. 

Ms. Jenkins.  Thank you, Mr. Chairman.  Thank you for having this important hearing. 

Mr. Director, thank you for being here.  We are very concerned about this GAO report and your findings that the premium tax credit offered by enrollment in the exchange is vulnerable to abuse.  In particular, it is concerning to me.  This subcommittee has held two similar hearings on this topic this year.  And your findings have confirmed our fears. 

When Commissioner Koskinen of the IRS testified on this subject back in May, he told this subcommittee that he hoped, he hoped taxpayers would do certain things, such as notifying the exchange of life events, so that their subsidies would be adjusted, but acknowledged that more public outrage might be necessary to ensure that the enrollees are compliant. 

In June, a panel of tax experts told this subcommittee that it was very unlikely that taxpayers would notify the exchange of their life events.  I am afraid that this will leave those receiving premium tax credits on the hook for thousands of dollars in penalties in the future. 

Now this GAO report highlights the broader problem of intentional waste, fraud, and abuse of premium tax credits by providing that these agencies simply do not have the infrastructure necessary to verify this information before handing taxpayer dollars to bad actors.  Instead of doubling down on the investigating wrongful premium tax credits, CMS issued a proposed rule in late June that will automatically reenroll participants in the exchange for 2015. 

So I have several questions for you.  First, do you believe that the administration currently has the ability to accurately verify eligibility for these premium tax credits?  And do you believe that it will be possible for CMS to accurately verify eligibility for the current enrollees in time for open season in November? 

Mr. Bagdoyan.  Thank you for your question.  At this point, we haven't touched those areas, but they are within the scope of our work.  And as appropriate, we will follow up vigorously.  And again, within the broad context of looking at all the controls, that would be part of the picture, definitely.

Ms. Jenkins.  Okay.  But you saw nothing that indicated that these ‑‑

Mr. Bagdoyan.  Not at this point.  We narrowly focused on our investigation at the beginning of our overall work to, again, touch several controls and see which areas were candidates, if you will, for additional focus. 

Ms. Jenkins.  Okay.  Fair enough.  Could you just comment on whether you believe automatically reenrolling exchange participants is a good idea? 

Mr. Bagdoyan.  I can't comment.  That is really not part of our scope right now.  So I can't comment on that. 

Ms. Jenkins.  Okay.  Thank you. 

I yield back. 

Mr. Bagdoyan.  My pleasure. 

Chairman Boustany.  I thank the gentlelady. 

We will next go to Ms. Black for 5 minutes. 

Mrs. Black.  Thank you, Mr. Chairman. 

I want to thank you for having this very important hearing.  These are subject matters that we have been talking about for quite some time, at least since I have been here for the last 3 and a half years and ones that are close to my heart. 

I want to reiterate the fact that this is so important, as you said, Mr. Chairman, that these dollars do not go out the door and then us try to retrieve them.  We know from other tax credits that have been given, that there is billions of dollars that go out and we never receive those back.  So this is so important that we get this right now and take care of this, because those dollars are precious, and they need to be used for people that truly need the assistance.  So thank you again.  Let me ask you about something that is not in your report and has not been mentioned here today, and that is there were two major planks to the ACA.  One is the verification of an income to make sure that someone qualified for those subsidies.  But the second was that if you had employer‑sponsored insurance, you would not be eligible for those subsidies.  And I don't see anything here to show that that is one of the major planks that we should be looking for.  Are you looking at that major plank in the work that you are doing? 

Mr. Bagdoyan.  I am not familiar with that particular aspect.  It is a big plan.  But we would be happy to get back to you on that particular point. 

Mrs. Black.  Well, I know that the data hub was supposed to do a lot.  And we looked at that data hub from the beginning and knew that it was very complicated.  As a matter of fact, a number of people who are experts in the industry said it was so complicated they didn't believe that it ever could be done.  So the data hub was supposed to be one of the mechanisms to be used, but I am just really curious, because I don't know that we know how many people currently are applying for these subsidies that potentially would not be eligible because of their employer‑sponsored insurance.  So I would really love to hear back from you on what your thoughts are on that because it is a major plank.  And I think that we have got to make sure that that one is covered as well. 

As far as the income verification goes, again, the data hub was supposed to be the mechanism to be used that it would then ping into the IRS.  The IRS would then get that information back to say whether that was good information or not.  But would it make sense in your opinion that they would be using something, say, like Equifax that is being used by the SNAP program to verify income? 

Mr. Bagdoyan.  I believe Equifax does have a role, but I would have to, again, check and confirm that and get back to you. 

Mrs. Black.  Do you also know in your investigation whether this administration has provided any deadline for these contractors to complete the remaining inconsistencies?  Because I understand there is a large number of those.  So, in the meantime, people potentially are getting the subsidies, but it seems that it is going to take a long time to have those inconsistencies verified.  Do you have any information to share with us on where this administration is going? 

Mr. Bagdoyan.  Based on our visit to the document processing contractor's facility, they are actively trying to clear out the backlog of inconsistencies.  But in terms of timing, I would have to again get back to you on that if there is a specific end date for that process.  But as you can imagine, there are hundreds of thousands of application‑related documents that need to be vetted and cleared.  And there are also, as my statement alludes to, a number of documents which cannot be matched against applications as well. 

Mrs. Black.  And then my final comments, really more comments than anything, but when we looked at the navigators, and I read all of the rules and regulations related to the navigators, and noted at that time that it would be pretty difficult for a navigator with a small amount of training that they received to even be able to help somebody work through a very complicated system, especially if that individual had a complicated application process.  So I would be very interested to see what additional information you get back about what navigators are able to do for those who come to get assistance.  And there certainly is a difference between the navigators and the navigator assistants, the assistant navigators, because there is a big difference in their training.  So I would be very interested to see, as you complete your report, on the kind of information and help that are given to people, given the amount or the lack of education that they really have in order to take on that role. 

Thank you, Mr. Chairman. 

Chairman Boustany.  I thank the gentlelady. 

Mr. Kelly, you are recognized for 5 minutes. 

Mr. Kelly.  I thank the chairman. 

Mr. Bagdoyan, thanks for being here today.  I was reading through your testimony last night.  United States Government Accountability Office.  That is who you represent.  What is your job?  I mean, why even create a GAO? 

Mr. Bagdoyan.  Well, GAO exists to serve the Congress in its investigative and oversight capacity in its broadest term. 

Mr. Kelly.  Okay.  So, I mean, it is kind of an early detection, right?  I mean, if you were in the private sector ‑‑ I got to tell you, I came out of the private sector.  If I had the ability to go to an agency before I made an investment, kind of the look‑before‑you‑leap type of philosophy, because in the private sector you are not allowed to make a mistake.  You go out of business.  To have the ability to look ahead and see what the total cost of this program was going to be; where are the traps on this?  Where were the downfalls on this?  What could possibly go wrong?  When you look at the numbers, these are staggering.  There is nobody in the private sector that would look at this model and say you know what, I think that is acceptable.  My God, you just can't do those things, not in the private sector. 

Now, in government, it is kind of fun because we work with OPM.  And for those of you that aren't in the private sector, that means other people's money, in this case hardworking American taxpayers' money.  So it is easy to throw those dollars around and say you know what, unintended consequences.  Doggone it, we did it again.  And we are going to have the GAO do a study.  And then you do a study, and we say, well, wait a minute that is too limbed.  You can't tell me that and expect me to believe that somehow down the road this has a happy ending.  What do you see coming?  And I am just talking about from a practical everyday American's outlook on life.  People that get up every morning, throw their feet out over the bed, go to work so that they can put a roof over their children's heads, spoons on the table, clothes on their backs, and keep giving money to a government who they are trusting to spend it the right way, and we are finding out that they don't even trust us any more than that because we have wasted so much of it.  The district that I come in, you know what people watch?  They don't watch dollars, they watch pennies.  And the old adage is if you watch pennies, you pay attention to pennies, the dollars will add up.  My God, $17 trillion and climbing in the red ink here, and we are still saying, you know what, this is all hypothetical.  Come on, if we can't do these wonderful things.  But it comes down to this.  Our job in this body is to protect the hardworking American taxpayers' investment, their tax dollars, and make sure that they are being spent the right way.  And if we find something wrong, early detection is always the best way to get a correction.  Certainly in your health it is much better to find out early on that you are on the wrong trajectory and you have to change your lifestyle or you have got to do something. 

So just tell me, the GAO, the job that you are doing, you are looking at things right now, and there has got to be bells and whistles going off everywhere.  And it is my understanding that the administration was told, you know what, light is not green.  It is yellow, and it is about at the end of its yellow term.  It is going to turn red real quick.  You better look before you leap.  You better make sure that you are spending this money the right way because you are collecting it from people who go to work every day and put that money in this furnace.  That is where the revenue comes from.  It does not come from Congress.  It comes from the American taxpayer. 

So I just wonder, as you go on with this study, is there anything that you look at and think, well, my gosh, I think if we keep going the way we are going, things are going to be all right because this is all hypothetical.  And I got to tell you I am fed up with every issue that involves policy that affects the American people to be about politics.  Really?  Really.  If you came here for a political career and you didn't come here for the people that you represent, then my God, take a look at the mirror and say, am I still doing what they sent me to do?  So you are sitting there every day.  You are watching this go on.  You got to sit there and just pull your hair out and say, you know, I keep telling them that it is not working.  I keep telling them that they are wasting dollars.  And they keep saying to me, too early.  Too early.  This is too partisan.  You are seeing this coming.  Where does this lead as we go forward? 

Mr. Bagdoyan.  Mr. Kelly, our work is definitely ongoing.  In the next several months, we will be looking again, as I mentioned earlier, at a wide range of issues.  And when we issue our report, we are likely to have recommendations to address the issues we have identified and direct those recommendations to the relevant agencies.  And they are supposed to get back to us with their specific plans within 60 days of how to begin implementing those. 

Mr. Kelly.  I hope it works better for you than for me, because the people I have talked to said, you know what, Kelly, you got to get reelected.  I have just got to get through this cycle.  The people I talk to, the bureaucrats, the problem is that you folks don't understand, this is our career.  And we will keep doing what we have to do.  There is something drastically wrong here.  And I would hope that you are able to stay on line and keep doing what you do best. 

I just think that sometimes you try to help people, and they turn a deaf ear and a blind eye to what you have offered them.  And I see that happening here.  And at the end of the day, it is the American taxpayer who foots the bill for every single thing that comes out of their pockets.  And they have co‑signed a note for the future that includes their children, their grandchildren, and their great grandchildren.  And we sit here with our eyes covered and our ears plugged and say, no, no, no, this is just politics.  It is not politics.  This is about people, and it is about the American people.  I thank you for your work.  And please keep doing what you are doing.  God bless you. 

Mr. Bagdoyan.  Thank you. 

Chairman Boustany.  I thank the gentleman.  I think he made a very eloquent case for early and aggressive oversight because he certainly made clear that the American people do want accountability. 

Thank you, Mr. Bagdoyan.  Thank you to you and your staff for appearing before us today, and the important work that you are doing.  Please be advised that members may have additional questions they may submit in writing to you. 

Mr. Bagdoyan.  Absolutely.

Chairman Boustany.  And we expect answers to be made part of the record. 

And with that, this subcommittee now stands adjourned.

[Whereupon, at 11:42 a.m., the subcommittee was adjourned.]


Member Submissions For The Record

Rep. John Lewis 1
Rep. John Lewis 2


Public Submissions For The Record

Tim Albright




f t # e