I know you are joking but this agent is either going to lose his license, go to jail, or both (hopefully).
Homeless: The Untapped Demographic?
- Thread starter VT33
- Start date
I know you are joking but this agent is either going to lose his license, go to jail, or both (hopefully).
- 5,058
oh for sure, jail + loss of license + fined
I think this guy has watched too much tv..If he thinks "going on the record" as being unapologetic for his part in this is going to help him, he's dead wrong.
The punch line is he's a tax accountant talking that crazy shitt.
The punch line is he's a tax accountant talking that crazy shitt.
He must be the world's worst tax accountant.
Every one of these homeless people who enrolled and claimed $11,700 in income would have to file taxes on their panhandling and show an AGI of that level to keep their subsidy next year.
The self employment tax on $11,700 is over $1700 for the year, I wonder where they are supposed to get that money.
I would hate to be this guy when 600 pissed off homeless people come after him if and when they get to that point. Of course, he will probably be in jail by then...
Convict 1 - "So, what are you in for?"
Agent - "I fraudulently enrolled homeless people in Obamacare"
Convict 1 - "You might want to keep that on the down low or you'll be someone's down low"
- 4,716
What are they going to do??? Run him over with their shopping carts.....
I have question, How does that medi___ outfit know whether someone has insurance or not?
- 5,058
Homeless payday check
- 2,525
What are they going to do??? Run him over with their shopping carts.....
I have question, How does that medi___ outfit know whether someone has insurance or not?
Nothing that those homeless varmints are receiving is "free". The clinics are receiving taxpayer dollars, charity contributions. The Med assist program is receiving donations from pharma companies (who take tax write offs and/or raise prices for the paying customers). Kennedy does raise a good point when suggesting that these do-gooders should try to accommodate these homeless varmints by aiding them with insurance costs, copay reductions. Why couldn't the Med Assist program continue to provide the free Rx to their customers with the Coventry insurance? The costs to provide them the RX would be the same, wouldn't it? Free is still Free. All of this constant free stuff only encourages ppl to not get off their butts and get Obamaocare as our Great Leader intended. All across Los Angeles, there are low cost county clinics that don't require proof of income. By making those so available to people, what kind of incentive is there for people to go buy their subsidized insurance even when they can afford it?
I'll play the devil's advocate here. First, let me assure you that I think that this guy is slimy. However, on almost all points, he's right.
1. This is the kind of stuff that Navigators are paid to do.
2. The ACA is built for people exactly like this - people who don't really qualify for Medicaid or these charity programs, but qualify instead for ACA.
3. Declaring your true income (including barter, street hustling, free rent for services rendered, panhandling, etc.), is correct. Yes, it is taxable income. Yes, it should be declared. Yes, it applies to MAGI. It's not a crime for an Accountant to tell these people that they should declare that income. He's right. It's a crime for them to NOT declare it and a crime for them to use these free community services when/if they actually qualify for ACA. The people telling the homeless to NOT declare their income so that they can get these free services is actually as much wrong as this guy is (or more). As one poster stated, the money for those community services comes from taxpayers too, and it's a sort of subsidy.
4. It only takes about $33 a day to reach the $11,700 income level. The article says that expanding Medicaid would solve it. It wouldn't. It would just take 38% more than $33 a day to reach that level.
This guy will probably lose his license before a DOI investigation, and probably lose his CMS certification. But jail? A prosecutor would have to prove that these people didn't really have income from barter, street hustling, free rent for services rendered, etc., which is nearly impossible to prove. The prosecutor would have to prove that the Accountant should not have told them they should declare this income. Impossible. Ask an IRS agent. Of course they should declare the income. The prosecution would have to prove that they were not eligible for ACA. Wrong again. This is the stuff the ACA is made of. If the prosecution tried to prove that the client was better off with the community medical services, Medicaid etc., the point would be that the client didn't actually qualify for those services due to the true level of income.
So, in the court of public opinion, this guy is slimy (and I agree). But that's how the ACA is written, and how the tax laws are written in regards to true income.
Where he will probably get nailed is if a large percentage of the homeless people state (or can prove) that they did not authorize the purchase, did not disclose their true income to him, did not sign (or authorize him to sign) the app for them, did not pick a plan, etc. That would be a huge issue in front of DOI or CMS.
By the way, the article did not say he processed 600 apps in one day. It says he has 600 such clients, and George from Health Sherpa noticed that he processed a large volume in 2 particular days, with the same income and same address, so George sent in a fraud alert. George probably thought they were fictitious names and social security numbers, which is truly fraud. I doubt that George knew he was declaring $33 a day in true income and signing them up for ACA based on the fact that they qualified for it.
To further my "devil's advocate" point, I actually agree with this guy in saying that these charities and community sources should provide money to pay the extra premium to move from a $0 bronze plan to a 94% CSR plan, instead of urging them to not claim true income so they could qualify for Medicaid instead of ACA.
Slimy? Absolutely. And this is what will make CMS drop the hammer on agents like they did for MAPD.
Last point - what was this guy thinking? Was he thinking, "Hey, I'll build a business from low-income people who I can't track, who won't document income, who I can't find at next OEP, then I will suffer CMS and DOI investigations as well as the court of public opinion, all to get a commission for a few months, minus the $25 per app HealthSherpa fee????" Could it be possible that he is an Accountant, with a Lawyer, backed by a group that is proving a point about the sliminess of the ACA rules, and those who lie about their income in order to get into ACA or out of ACA (into Medicaid)? A radical group could undermine the ACA quickly by signing up all the people that truly qualified for it. After all, this is what the ACA actually says.
Note - I'm sure I'll be beheaded by those who think I'm saying this guy's tactics are correct. I'm not. I wouldn't sell ACA to the homeless like this, and I wouldn't estimate someone's MAGI like this guy did (or like a huge number of ACA agents are doing!!!!!!). I wouldn't sign up people without their knowledge, or pick plans for them, etc........ Nor would I market insurance to a vulnerable section of society like the homeless. (Actually, the law urges Navigators to sign up these segments of society!). But my point is that looking at what MAGI income actually means, and what qualifications for ACA vs qualifications for Medicaid/free services means, then this guy is right.
1. This is the kind of stuff that Navigators are paid to do.
2. The ACA is built for people exactly like this - people who don't really qualify for Medicaid or these charity programs, but qualify instead for ACA.
3. Declaring your true income (including barter, street hustling, free rent for services rendered, panhandling, etc.), is correct. Yes, it is taxable income. Yes, it should be declared. Yes, it applies to MAGI. It's not a crime for an Accountant to tell these people that they should declare that income. He's right. It's a crime for them to NOT declare it and a crime for them to use these free community services when/if they actually qualify for ACA. The people telling the homeless to NOT declare their income so that they can get these free services is actually as much wrong as this guy is (or more). As one poster stated, the money for those community services comes from taxpayers too, and it's a sort of subsidy.
4. It only takes about $33 a day to reach the $11,700 income level. The article says that expanding Medicaid would solve it. It wouldn't. It would just take 38% more than $33 a day to reach that level.
This guy will probably lose his license before a DOI investigation, and probably lose his CMS certification. But jail? A prosecutor would have to prove that these people didn't really have income from barter, street hustling, free rent for services rendered, etc., which is nearly impossible to prove. The prosecutor would have to prove that the Accountant should not have told them they should declare this income. Impossible. Ask an IRS agent. Of course they should declare the income. The prosecution would have to prove that they were not eligible for ACA. Wrong again. This is the stuff the ACA is made of. If the prosecution tried to prove that the client was better off with the community medical services, Medicaid etc., the point would be that the client didn't actually qualify for those services due to the true level of income.
So, in the court of public opinion, this guy is slimy (and I agree). But that's how the ACA is written, and how the tax laws are written in regards to true income.
Where he will probably get nailed is if a large percentage of the homeless people state (or can prove) that they did not authorize the purchase, did not disclose their true income to him, did not sign (or authorize him to sign) the app for them, did not pick a plan, etc. That would be a huge issue in front of DOI or CMS.
By the way, the article did not say he processed 600 apps in one day. It says he has 600 such clients, and George from Health Sherpa noticed that he processed a large volume in 2 particular days, with the same income and same address, so George sent in a fraud alert. George probably thought they were fictitious names and social security numbers, which is truly fraud. I doubt that George knew he was declaring $33 a day in true income and signing them up for ACA based on the fact that they qualified for it.
To further my "devil's advocate" point, I actually agree with this guy in saying that these charities and community sources should provide money to pay the extra premium to move from a $0 bronze plan to a 94% CSR plan, instead of urging them to not claim true income so they could qualify for Medicaid instead of ACA.
Slimy? Absolutely. And this is what will make CMS drop the hammer on agents like they did for MAPD.
Last point - what was this guy thinking? Was he thinking, "Hey, I'll build a business from low-income people who I can't track, who won't document income, who I can't find at next OEP, then I will suffer CMS and DOI investigations as well as the court of public opinion, all to get a commission for a few months, minus the $25 per app HealthSherpa fee????" Could it be possible that he is an Accountant, with a Lawyer, backed by a group that is proving a point about the sliminess of the ACA rules, and those who lie about their income in order to get into ACA or out of ACA (into Medicaid)? A radical group could undermine the ACA quickly by signing up all the people that truly qualified for it. After all, this is what the ACA actually says.
Note - I'm sure I'll be beheaded by those who think I'm saying this guy's tactics are correct. I'm not. I wouldn't sell ACA to the homeless like this, and I wouldn't estimate someone's MAGI like this guy did (or like a huge number of ACA agents are doing!!!!!!). I wouldn't sign up people without their knowledge, or pick plans for them, etc........ Nor would I market insurance to a vulnerable section of society like the homeless. (Actually, the law urges Navigators to sign up these segments of society!). But my point is that looking at what MAGI income actually means, and what qualifications for ACA vs qualifications for Medicaid/free services means, then this guy is right.
Last edited:
Similar threads
Latest posts
-
-
Los Angeles Fires Become Existential Test for California’s Stopgap Insurer- Latest: marindependent
-
