GRAHAM-CASSIDY REPEAL BILL DEADLINE:

Time: D H M S

Does ACASignups.net have a future now that HHS says they'll be releasing data weekly?

On April 30th, 2014 I posted the following:

...Originally, I had planned on only running this project (and thus, this website) until the official March 31st open enrollment deadline.

I assumed that a few days after that, the official numbers would be in, the spreadsheet & graph updated one final time, and I'd pull the plug on it. Mission accomplished, served its purpose, job well done, etc.

However, a few things changed between then and now.

...I'm officially committing to keeping things going through the 2nd enrollment period, which runs from November 15, 2014 through February 15, 2015.

However...who knows? Perhaps the HHS Dept. will change their policies and methodology on releasing enrollment data the second time around, and this site will no longer be necessary? After all, if they had done what I wanted them to do in the first place (release at least the top-line enrollment data on a weekly basis), I never would have felt the need to start this project. Maybe they'll do so for Year Two?

...Or, perhaps interest will die off to the point that there's really no point in keeping things going any further, and I'll drag the site limping into 2015 as a whisper of its former self. We'll see how it goes.

Again, thanks to everyone for everything. It's been a hell of a ride so far. Where do we go from here? For myself, hopefully...eventually...single payer.

Until then, the ACA will have to serve as a gateway.

Cut to May 22, when I posted the following open letter to the HHS Dept. upon learning that they were discontinuing even the monthly enrollment reports during the off-season:

...some have suggested that you're stopping the reports because the post-April numbers won't be so flattering after all. Of course, that 9M or so number will be reduced by two factors: The 10% or so who never got around to paying their first premium...Others, as critics are quick to point out, may pay their first month's premium but might not follow up on that due to inability or unwillingness to keep paying each month.

How much will this reduce the "official" exchange QHP total? Beats me; estimates I've seen have ranged all over the place. Let's call it 25%. That would bring the official total down to around 6.08 million.

So, sure, that would be disappointing compared to the 8M+ number that the administration has been touting until now.

On the other hand, that would still be right in line with the CBO's revised projection number of 6 million from February.

...So...if Dems are happy with the ACA, and the insurance companies are happy with it, and the 11 million or more people who are newly insured are, presumably, reasonably happy with it...why are you blocking further monthly reports?

Whatever the reason, I hope you change your minds on this policy--or at the very least issue a clearer and more understandable rationale for it.

Then, on August 27th I posted another open letter to newly-announced Healthcare.Gov "CEO" Kevin Counihan entitled, "Make my job obsolete, please!" in which I gave seven pieces of advice for HC.gov data transparancy for Year Two:

  • 1. Start issuing the enrollment reports again!
  • 2. Make 'em weekly, while you're at it!

No, I'm not expecting a 40-page tome to be fully researched, compiled & edited every week. That would be an awful lot to ask. However, a simple press release with the major numbers (broken out by state, anyway) would do the trick. You don't need to go into Metal Levels, Age/Ethnicity Demographics or any of that for the weekly reports, but at least provide 2 hard numbers for each state (+DC): Total QHP enrollments & Total Medicaid/CHIP enrollments through the exchanges.

  • 3. How to handle attrition
  • 4. Include how many have paid for each START DATE.
  • 5. Abandon the "automatic re-enrollment" policy ASAP.
  • 6. Separate out "Renewed from 2014" enrollments from "Newly Enrolled for 2015"
  • 7. Don't fear poor numbers.

Then, a week or so ago, when it was revealed that HHS had overstated the number of current QHP enrollments by around 393,000 people (either deliberately or by accident), I posted a screed about it.

That brings us to 2 days ago, when HHS announced the official first-week enrollment number for Healthcare.Gov, along with the following additional statement:

Similar to last year, each month, CMS will produce a report that provides a detailed look at plan selection across the Federally Facilitated Marketplace and State-Based Marketplaces. In addition, CMS will release weekly snapshots of preliminary data.

This was followed by the initial snapshot, which looked like this:

In other words, after the "dental plan" debacle, HHS has finally decided to take at least 3 of my seven suggestions: They're bringing back the reports (which they were probably going to do anyway) , they're making them weekly, and they're separating out "renewals" from "newly enrolled".

As for the other 4:

  • The attrition data won't be relevant until mid-February at the very earliest, since none of the 2015 policies will even start until January anyway.
  • Similarly, the "start date" payment data also won't be relevant until at least mid-January. This is likely a long shot to expect for HC.gov, however, since they're still working on the payment verification back-end, I believe.
  • It's obviously way too late to change course for the "auto renewal" policy. That's a shame because it's likely to cause massive confusion depending on the state, but so be it.
  • As for "poor numbers"...well, so far the initial numbers are pretty damned good, so hopefully that won't be an issue.

Anyway, that brings me back to the title of this post. If HHS is finally going to issue weekly data reports, is there still a need for this site going forward? After all, the whole reason I started it in the first place over a year ago was because HHS wasn't doing so:

Seriously, though, HHS should really start releasing the official (accurate) numbers of actual signups for all 50 states (or at the very least, the 36 states that they're responsible for) on a daily--or at least, weekly--basis. I don't care if it's a pitifully small number. 100,000? 10,000? 100? 10? Even if it's in single digits, release the damned numbers. Be upfront about it. Everyone knows by now how f***** up the website is, so be honest and just give out the accurate numbers as they come in.

Well, let's see. The good news is that they have stated that they'll bring back the monthly reports and are adding the weekly "snapshots", which crosses out a good chunk of what I've been asking for since last October.

It's also interesting that they're making such a point of breaking out the Spanish-language version data (4 of the 12 data points given are specific to Spanish-language data).

However, let's consider what it isn't included in those "weekly snapshots" (assuming that the table above includes everything that they plan on putting out):

  • No state-by-state breakout of the plan selection number
  • No Medicaid/CHIP enrollment numbers (either total or state-by-state)
  • None of the weekly data includes the 14 state-run exchanges, which should likely make up around 25% of the total private enrollment total.
  • Amusingly, the snapshot also does not include any dental plan data at all, although HHS Secretary Burwell did specifically note that dental plans are not mixed in with the 462K figure.

Don't get me wrong, I'm not criticizing HHS here--I'm very glad that they're doing this much, at least. This covers perhaps 60% of the reason I started the ACA Signups project.

The question, then, is what about the other 40%? Is there any point in my continuing to obsessively aggregate the data publicly if HHS has finally gotten the hint and started doing it themselves on a more frequent basis?

I'll keep things going through the end of OE2 (mid- to late February), but just like last year, after that I'll have to reevaluate how much need/interest there is in my keeping things going any further. The next big ACA-related issues after that should be the SCOTUS King/Halbig ruling/fallout next summer.

In short, after that there will still be plenty of ACA-related news...but the importance of precise exchange enrollment data will probably fade off, and the more official (accurate) data HHS starts releasing on a frequent basis, the less need there will be for the particular niche that I've carved out for myself.

Comments welcome.