Friday, September 19, 2014

The "7.3 Million"

The administration finally released the Obamacare enrollment count this week.

Like everything else about their scorekeeping we got a number. Just one number. A number that was conveniently better than we had expected. And, we got no real context for the number or any of the back-up information.

I thought this quote in a Politico article was telling:
The figure is complex to unravel. The number came from the health insurers, who told the Obama administration every month how many people are covered by Affordable Care Act plans. A CMS official said Thursday that in prior monthly reports, the numbers varied widely, but recently stabilized."
So this tells us a couple of things:
  1. The carriers have been reporting the number of people they have been insuring in the exchanges to the Obama administration for months.
  2. The monthly enrollment numbers have "varied widely."
Up until now, the administration as repeatedly said they didn't have the enrollment numbers.

Why haven't they released these monthly reports on an ongoing basis?

Why can't we see all of the prior reports?

The numbers have "varied widely?" Did they finally get a number they conveniently liked?

The 7.3 million enrollment number would seem to suggest only a 9% attrition factor when most carriers have been reporting that about 15% haven't paid just the first month's premium.

Even with the lack of transparency about just what these numbers mean, I can find at least one obvious problem with them. As I thought of the administration's release of 7.3 million it occurred to me that they said the 7.3 million included all enrollments through mid-August.

Under Obamacare, after a person has paid their first premium, a health plan can't cancel anyone until they have gone three months without making a payment.

So, they are effectively double counting by including the "adds" while also keeping the "deletes." The 7.3 million figure includes all of the enrollments that have occurred through mid-August. But the number also still includes every person who has failed to make a premium payment in June, July, and August––since the carriers can't yet knock them off the rolls. The health plans tell me there is a 2% to 4% monthly attrition rate. That means the 7.3 million could be overstated by 6% to 12% of the total.

When the administration kept repeating the "8 million enrolled" figure it was convenient to do so even though we all knew it was a misleading number.

Now the administration apparently finds the 7.3 million tally convenient.

One number, out of context, with no back-up.

Even though the back-up exists––and apparently has for months.

Transparency?

I don't think we will really know what's been going on until we ultimately get a Government Accountability Office (GAO) audit.

AP Story - Spin Meter: Those Changing Health Care Numbers