If the IRS or NSA scandals involving misuse of private data were troubling, consider the implications of the new information databases created in the name of health care. The newly-launched Affordable Care Act creates a massive electronic registry of private information that is accessible to bureaucrats in agencies ranging from the Internal Revenue Service to the Department of Homeland Security. Its a wonder how Americans who are becoming increasingly concerned with federal surveillance and domestic spying programs could in any way approve of the so-called Obamacare law.
The Affordable Care Act opened exchanges for customer enrollment on October 1st, the federal furlough notwithstanding. The federally-run exchanges, euphemistically called “new health insurance marketplaces,” are accompanied by collection of a wide variety of personal data, which can now be legally shared numerous faceless government agencies — agencies which previously had to snoop, steal, or spy to get it. No longer will any of our intimate medical details be reasonably considered either private or protected.
To facilitate this forfeiture of individual privacy, the Department of Health and Human Services has created a massive, comprehensive database to record and store Americans’ personal information called the Federal Data Services Hub. The Government Accountability Office (GAO) reports that the purpose of the Data Hub is to provide “electronic, near real-time access to federal data” and “access to state and third party data sources needed to verify consumer-eligibility information.” No longer will any of our intimate medical details be reasonably considered either private or protected.
The Electronic Health Records (EHR) — which we are repeatedly told will improve the quality of healthcare — are also the most convenient way for the government to create this permanent database of information on every American citizen. Americans are expected disclose all the information for the Hub under the guise of ensuring that everyone enrolled in the Obamacare exchanges obtains the best insurance coverage for themselves. Medicaid now wishes to require patients’ “social and behavioral” information included in these records and have these patients’ records linked to public health departments.
The Obama administration and the CDC have conspired to pay hospitals and doctors to shift towards the EHR to “encourage widespread EHR adoption.” The incentives for participating in the program to expand EHR use include up to $44,000 through the Medicare EHR Incentive Program and up to $63,750 through the Medicaid EHR Incentive Program. Those who do not comply are subject to penalties. Hospitals and doctors not using EHRs by 2015 “will see a 1 percent reduction in their Medicare and Medicaid fees each year.”
This chart outlines the “meaningful use” program that requires doctors and hospitals to collect and report data to the federal government in order to receive reimbursement. The first step of the “meaningful use” program currently requires reporting the demographics and smoking history of a patient. The second step, coming in 2014, will require the patient’s family health history. This will ensure that your private information is available to the federal government regardless of the nature of the insurance you carry.
On September 4th, the Department of Health and Human Services (HHS) posted information indicating that the Centers for Medicare and Medicaid Services (CMS), the government agency charged with running Obamacare, is employing the National Academy of Sciences to figure out how best to incorporate social and behavioral data into patients’ electronic health records.
The “meaningful use” criteria, objectives, and measures will evolve in three stages over the next five years. A study by the National Academy of Sciences, begun this July, is currently making recommendations for including social and behavioral data to the EHRs for step 3, planned for 2016.
On June 14 of this year, the HHS issued a 253 page rule which allows individuals’ protected health information (PHI) to be traded among various agencies, without the consent of patients, for the purpose of making sure that those enrolled in Obamacare exchanges are getting all of their “essential benefits.” Indeed, it claims that HHS already has the power to disclose PHI because Obamacare “is a government program providing public benefits.”
When Sen. Max Baucus, (D-Mont.) asked for a “a complete list of agencies that will interact with the Federal Data Services Hub,” HHS listed seven other federal agencies with access to PHI: Social Security Administration, the IRS, the Department of Homeland Security, the Veterans Administration, Office of Personnel Management, the Department of Defense and the Peace Corps. And that is in addition to the Medicaid databases linked to the Hub.
The same GAO that defined the purpose of the government Data Hub, one year earlier reported on weaknesses in IRS security systems that ”continue to jeopardize the confidentiality, integrity, and availability of the financial and sensitive taxpayer information.” The IRS will be one of the primary agencies that “interact” with the Federal Data Services Hub.
The list of categories in the “system of records” within the Hub “includes, but may not be limited to”: Social Security numbers, income, family size, citizenship and immigration status, gender, ethnicity, email addresses, incarceration records, enrollment status in other health plans, tax information, employment information, patient medical records, pregnancy status, list of disabilities, welfare information, and demographic data (e.g. address, birthdate, physical description…). Truly massive!
On May 31, 2013 the CMS released this fact sheet to allay fears that so much personal information would be concentrated in one place. It reads: “The hub will not store consumer information, but will securely transmit data between state and federal systems to verify consumer application information.”
But a little known regulatory notice, filed on February 6, 2013, explicitly refutes that assertion. It reads: “The system of records will contain personally identifiable information (PII) about certain individuals who apply or on whose behalf an application is filed for eligibility determinations for enrollment in a qualified health plan (QHP) through an Exchange, and for insurance affordability programs.”
So, the hub will collect and store personal information and lots of it. Further down in that same fact sheet, the charade of privacy is laid bare in one final statement from the CMS:
ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM A. Entities Who May Receive Disclosures Under Routine Use. These routine uses specify circumstances, in addition to those provided by statute in the Privacy Act of 1974, under which CMS may release information from the HIX without the consent of the individual to whom such information pertains. ...
The Federal Data Services Hub represents the “largest consolidation of personal data in the history of the republic,” noted Stephen Parente, a University of Minnesota finance professor.
This unprecedented, centralized database of sensitive personal information will be just one click away from some low-level federal bureaucrat’s finger without your consent. “Entities who may receive disclosures under routine use” include “federal agencies, state agencies, agency contractors, consultants, CMS grantees, and non-profit entities operating exchanges for states.” In other words, the Obamacare Data Hub is a community organizer’s dream come true.
Others have warned that the database is vulnerable to abuse by the numerous government agencies involved, including the IRS, the Department of Homeland Security, state Medicaid databases, and the Social Security Administration. Considering the federal government’s track record with keeping personal information secure, one can only imagine just how much damage the government will now be capable of doing with so much of data readily accessible to agencies that, until now, could only dream of wielding such power.
The ongoing scandals involving the IRS’s misuse of citizens private information for purpose of targeting political groups along with the NSA’s massive, secret domestic surveillance program should have every American anxious about the prospect of a centralized, online database of social and behavioral data being shared between government agencies. Most of the new hires charged with signing customers up for the Obamacare exchanges, the so-called navigators, will not even be undergoing background checks or fingerprinting due to the rushed nature of the entire law.
If the potential for abuse by the government itself isn’t great enough, consider what all this compiled, sensitive data could be used for in criminal hands. Everything that an unsavory person would need to steal and wreck someone’s identity is contained in those hackable, stealable databases. An identity thief would be delighted to have access to the Data Hub.
And its not just identity thieves who love the concept of the Data Hub. Imagine how valuable this information would be to a home invader. Health records, personal income, job info, and family size would be perfect for “casing” future victims. Find a wealthy, single-occupancy home of a sickly or disabled person and a burglar’s work is made easy, with only clicks of a mouse. The potential for abuse is vast.
In the past, the NSA at least had to work for the information it abuses. Now, we are expected to readily hand over our personal information, being told that the administration of our own health care depends on it. Recall the hotly debated “Individual Mandate” to buy insurance; there is nothing voluntary about this exchange. Americans are being forced to purchase healthcare and not even your private insurance will protect your private information because the hospitals and doctors will be forced to use EHRs.
The creation of a giant register of personal information on every citizen by the state is such a blatant violation of the 4th amendment’s protection of our privacy that many citizens fail to grasp it for the bold maneuver that it is. Many who do recognize it as a lawless repudiation of individual rights feel helpless to stop its relentless march. Obamacare is a mechanism to control choices and collect data; an indefensible intrusion into the lives of the American people who are forced accept it. Americans can trust the federal government to protect thier privacy with electronic health records at their own risk, or take the advice of the HHS and pay cash. The trove of sensitive personal data will only as secure as the bureaucrat in front of the keyboard.
Contact your congressmen and let them know how you feel about the Affordable Care Act sharing your private health information: