Po-taye-to, Po-tah-to: ACA exchange enrollment did NOT "drop" by 13% in March, it *increased* by 21%!
2018 MIDTERM ELECTION
Time: D H M S
A couple of days ago, the CMS division of the HHS Dept. released a huge data dump on effectuated ACA exchange enrollment data through March 31st, 2015.
Among the major takeaways was that as of 3/31/15, effectuated (ie, active/paid for) private policy enrollments via the ACA exchanges stood at 10,187,197 people.
The spin on this via both the New York Times and the McClatchy Washington Bureau is that this means that "13% Left Health Care Rolls" (the Times) or, alternately, that "U.S. marketplace health plan enrollment falls to 10.2 million" (McClatchy).
Depending on your perspective, neither of these are accurate (although the first headline is worse; "13% left healthcare rolls" makes it sound as though over 40 million people suddenly became uninsured nationally).
The claim in both cases, of course, is that since 11.7 million people selected private policies as of 2/22/15 and only 10.2 million were actively enrolled as of 37 days later, that a whopping 1.5 million people must have "dropped" their policies in between.
However, in order for people to 13% to "leave" their ACA enrollments or for the number enrolled to "drop" to 10.2 million, they would have had to have been actively enrolled in the first place.
Except that for the most part, they weren't. As Republican detractors kept screaming throughout the entire process last year, you aren't actually enrolled until you've paid your first monthly premium.
As far as I can tell, the payment rate this year is actually somewhat higher than it was in 2014 (at least 90% vs. 88%). However, that still means that roughly 1.17 million of the people in question never paid their initial premium...which means that they were never enrolled in the first place.
In other words, the actual attrition rate (that is, the net reduction in effectuated enrollments) from 2/22/15 until 3/31/15 was only about 3%, not 13%...and the actual net reduction in enrollments as of 3/31 was only around 330,000, not 1.5 million.
In fact, technically speaking, the number of people enrolled in effectuated policies increased from around 8.4 million in February to 10.2 million in March, as all the folks who enrolled (and paid) between 1/16/15 - 2/22/15 had their policies kick into effect (see the Effectuated Enrollments line in The Graph). That's a 21.4% spike.
Some of this comes down to spin and semantics, I suppose. Last year the GOP wouldn't shut up about "But how many have PAID???", and while this became something of a running joke here, I always made sure to emphasize that it was a perfectly legitimate question to ask...as long as you waited until the payments were actually due.
In other words, the problem with both the NY Times and McClatchy stories is more about the way the headlines are worded than anything. We already knew that around 88% of those who selected their policies last year paid their first premium; to me, the big story here is that this increased to at least 90%.
It's all a matter of perspective, I suppose.