Decision #1: The “Honor System”

Applicants to Healthcare.gov must enter their current income level. This is a pivotal piece of data for the system: income alone is used to determine if the applicant will be presented with the option to: a) purchase full-price or subsidized health insurance policies; or b) if the applicant will be directed towards Medicaid/CHIP programs. This determination is calculated according to the new Modified/Adjusted Gross Income (MAGI) scale.

However, Healthcare.gov does not perform any checks at all (such as requiring the submission of pay stubs, the prior year’s tax return, etc.) to verify the income amount entered by the applicant. This all-important piece of data is accepted by Healthcare.gov on the “honor system.”


Talk about massive potential fraud....