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Obamacare: Personal Data Can Be Used For ‘Law Enforcement and Audit Activities’ (weeklystandard.com)
63 points by stfu on Oct 8, 2013 | hide | past | favorite | 30 comments


Is there a politically neutral group that compared this text to the fine print with other insurance providers? The Weekly Standard is a notably conservative, anti-obamacare group (and I wonder to what extent they are overblowing what seems like standard text)

NOTE: I don't mean to suggest that the message is diminished by the political colors of the bearer, but the highlighted clauses seem like fairly standard legal language that appear in other insurance website privacy policies (in contrast to the implication in the article).


I agree, no need for caution when it comes to liberty and due process. The "true" media has never steered us wrong.


The "law enforcement" part is common in privacy policies; if whoever's running a web site gets a subpoena for personal information (or something more exotic, like an NSL), they don't really have the option of keeping it to themselves, and the clause just acknowledges that.

This leaves "audit activities"; is that a phrase defined elsewhere in the document?


While common, and almost arguably a rewrite of their other privacy policy, this phrasing is actually different than what is used on roughly every other maryland .gov site, which all share privacy policies, even where they have forms or other info being submitted. I can find a very small number of trivial exceptions to this.

So it is at least a little surprising.

The ACA of course, is many thousand pages. I have no idea if they are required to have this.

I'll point out that while it's currently 404'ing, california's "covered california" site had a privacy policy up that said something similar:

http://webcache.googleusercontent.com/search?q=cache:Tqicl-X...

"Health care operations: Information may be shared with health plans and government agencies to oversee how the insurance is being provided, for quality assurance, audits, for fraud and abuse prevention programs, and for planning and management purposes;"

"Other limited purposes: Information will be shared for other purposes when we are required by law to do so, such as for workers’ compensation, public health activities and risks, health oversight activities, law enforcement activities, coroners, medical examiners and funeral directors, military and veterans affairs, national security and intelligence activities, protective services for the president and others, and for inmates."


Not sure about the document, but I can wager an informed guess as to what "audit activities" means.

I've gone through the Massachusetts Health application process(the model for the ACA). To qualify for subsidised healthcare, your current income cannot be more than 300% of the poverty line. If you qualify for subsidized healthcare, you are told that you must notify Mass Health if your financial situation changes.

So, if you applied for Mass Health because you lost your job, you can't stay on Mass Health when you find another one.

The lovely Mass Health bureaucrat made it clear that I was susceptible to an audit and fraud charges if I didn't report an "income event" (I believe that's what she called it) in a timely matter.

Her explanation might shed light on the phrase "audit activities". But I haven't actually read the Obamacare legislation, so I can't say for certain.


I'm willing to bet something like this will be done but I don't know if it's the explanation of the "audit activities" phrase.

Since you can apply for subsidies that take income into account, it stands to reason they would need to do the occasional audit to determine if your current income matches what you claim on the exchange.

How to do that? Well, the IRS is heavily involved in the enforcement of these laws so it stands to reason that every once in a while the exchange will compare notes with the IRS to make sure your stated income on both forms match.

I expect this to happen sometime after April every year.

I'd be curious if there are penalties outlined in the law about getting extra subsidies based on lying on the exchange about your income levels. If you decide to read the law and get to that part of the monstrosity, then let us know what it says.


this is a misleading title in particular because it applies to the maryland exchange's website and not, as a whole, to 'obamacare.'

regardless, how is this any different than any other website handing over information when a lawful request has been made? is there some expectation that exchanges are immune from these sorts of requests from law enforcement agencies?

similarly, is there any question that correspondence with a public agency can potentially be entered into a public record? this doesn't actually overturn doctor patient confidentiality (which would be worthy of a scary headline), it's just enumerating the same problems you likely already need to contend with when dealing with private insurance.


similarly, is there any question that correspondence with a public agency can potentially be entered into a public record?

As many HIPPA-related documents as I've had to sign as a consultant working in/around medical and as a patient, I'd have assumed HIPPA was in force here as well since we're talking (a) medical info that is (b) personally identifiable.


agreed, it would be particularly disturbing if a govt service were flaunting its blatant disregard for hippa (which, again, would be headline-worthy for that reason alone)


"[W]e may share information provided in your application with the appropriate authorities for law enforcement and audit activities."

Sounds like fraud detection and reporting. Is this really a problem?


"Do you use illegal drugs? If so which ones. When did you last use? How often do you use?"

Yeah no risk at all with this...


Illegal drugs? Think a tad bit differently, think of states where marijuana is legal but is still illegal on the Federal level.

If you go to surgery you really should tell them about drug usage to make sure they compensate in their drugs, but the Feds might be interested to know as well.


Hadn't thought of that, but yeah, that's pretty big.


No, not at all, until they want to screen a suspect list for anyone with a history of limping, say, or baldness, or some other damn fool thing.

Better question: is fraud detection and reporting really worth leaking your personal data to the .gov?

I think not.

EDIT:

Downvote, downvote, but don't be surprised when this turns out to be a terrible idea.


Absolutely there's a problem. The current wording puts no limits on how the data may be used. If the purpose is solely for fraud detection then it needs to say that and there needs to be serious penalties for violating it.


Until it is explicitly stated, yes. I want to know how my personal data is being used, especially when the data is gathered through a program that I do not support.


The Weekly Standard appears to have a very partisan tone in this article and others concerning the Affordable Care Act. Obviously, the ACA is politically divisive. Everyone should be able to debate and critique it, but those who do condemn the approach need to propose a viable, stronger alternative.

This isn't an academic debate in which we have the luxury of finding a perfect solution. As Howard Zinn said about politics, "We're on a moving train." I worked for a health care center in a city where 1/3 of residents were uninsured, unable to afford check-ups and essential services. A similar dynamic exists in hundreds of other U.S. regions.

So, if you shoot holes in a solution (in this case, the ACA), please add to the conversation by proposing alternatives to address the urgent, obvious problems in U.S. health care.


Wait, so you're saying that if I see something as a bad idea I have to propose alternative solutions before I can say anything?

If you see my alternative solutions as a bad idea does the rule apply to you as well? Do you just repeat the idea I say is bad to refute my idea you say is bad? Doesn't seem a good way to debate, just seems a good way to shut down disagreement.


It's about how you phrase things - and your intentions. It's the difference between...

The Affordable Care Act will never work because it's too expensive.

And...

What steps can we take to make affordable healthcare more financially viable?


Who gets to define the appropriate way to phrase things?

I see the difference between your two examples but they don't necessarily work for me in terms of what you were saying.

There's nothing wrong with saying the ACA will never work because it's too expensive. It's an opinion that could be proven wrong. A potential intention is to stop the ACA because it is too expensive and I fail to see what's wrong with that intention if the person actually feels that way. A good response to the statement is to ask for details as to why one would think that, not tell them to offer alternatives or shut up.

As for your second example. If I were a big supporter of the ACA my answer to your question is easy, the answer is simply the ACA. Which does not further the debate in any way.

Maybe the "about how you phrase things" and "intentions" should be considered a two-way street?


You mean like this one?

http://www.weeklystandard.com/articles/small-bill

Yup a one page bill was submitted and shot down. Just because the media didn't tell you that alternate plans were being submitted doesn't mean they didn't happen.


I never said that no one proposed an alternative. I said that not enough people are being constructive and proposing alternatives.


The law enforcement and audit activities kind of makes sense with the territory. In my mind, at least. BUT if personal emails and details are therefore considered public record, doesn't that completely break HIPPA privacy requirements? Requirements the government wrote?!


I was thinking more like people who logged in, created an account, then got sticker shock and decided not to sign up.

Well, now the government has a database of people who aren't enrolled and can now start fining them. Add in the fact that the IRS can simply take money from their bank accounts and you have some real issues with this law.


I'm generally for governments doing things, in terms of personal ideology.

That aside, I think that we need to take a big step back from making everything we can think of automated, integrated, and available online until we take a hard look at the role of privacy and the nature of public records about individual's information.


I wouldn't have clicked on a news article six years ago with "Bushighanistan" in the title and I won't do it today when a fundamental human right is derided with such a stupid name.

This country needs to grow up.


FUD (Considering the source)


Affordable Care Act


The President himself, said he likes the term "Obamacare".


Which still doesn't make it right.




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