"Once is happenstance. Twice is coincidence. Three times is enemy action."

So sayeth James Bond creator Ian Fleming.

A week ago, American Enterprise Fellow and right-wing BS artist Scott Gottlieb (MD) tried to make it look like the 2016 Open Enrollment numbers were lagging behind last year by deliberately ignoring a) the 2-week enrollment period differential and b) the millions (at least 2.28 million) of auto-renewals which were added to the total just days after his claim.

While the number of auto-renewals ended up being a bit lower than I expected, they still brought the 2016 same-point comparison up from Gottlieb's claim of 36% behind 2015 to 25% ahead...with an unknown additional number of auto-renewals (I'm guessing around 150K) yet to be added over the next week or so.

Then, a few days later, Gottlieb struck again by trying to claim that only 1.8% of the U.S. population had enrolled via HC.gov "by the end of open enrollment".

I noted that:

  • 1) open enrollment doesn't actually end for another 5+ weeks;
  • 2) the actual percentage thru HC.gov is actually much higher already (2.6% as of 12/19, if you divide 8.25 million into 320 million)
  • 3) about 25% of total exchange enrollments are via the state-based exchanges anyway (meaning the total is likely more like 3.4% by now anyway...around 10.9 million or more), and most importantly,
  • 4) dividing into the ENTIRE U.S. population is stupid in the first place, since 90% of them aren't eligible to enroll in exchange policies anyway.

In other words, instead of 1.8%, it's actually more like 34% of the eligible population already.

Well, today, Gottlieb has decided to bring out the derp a third time just ahead of Christmas Eve:

CMS says 2.1M or 26% of current #Obamacare enrollees under age 35 vs 33% and 29% during same time in 2015 and 2014 -> deteriorating risk mix

— Scott Gottlieb, MD (@ScottGottliebMD) December 22, 2015

This is nonsense on the face of it.

As I noted in response:

@reihan @ptbrennan11 @KipPiper Gottlieb is dividing 2.1M into 8.2M instead of 6.0M. He's not including auto-renewals.

— Charles Gaba (@charles_gaba) December 23, 2015

@reihan @ptbrennan11 @KipPiper or more to the point, he's included autos in the denominator but not the numerator. Assumes 0 autos under 35.

— Charles Gaba (@charles_gaba) December 23, 2015

You see, when CMS issued their data dump on Tuesday, they also noted that of the 6.0 million people who actively enrolled in 2016 policies by the January deadline (either re-enrollees or new additions), 2.1 million of them are under 35 years old, whcih is considered vitally important to a decent risk pool.

Gottlieb ignored the very clearly stated caveat in the press release stating:

Of the nearly 6 million total consumers already enrolled for 2016 coverage, 2.4 million are new consumers, compared to 1.8 million new consumers in the same period for OE2. Note: None of the OE2 and OE3 figures reported in this document include individuals auto-enrolled for January 1 coverage. Nor do they include plan selections in the 13 State-based Marketplaces that use their own technology platform.

...Consumers Are Younger: The average age of a consumer in OE3 is lower through the deadline for January 1st coverage this year than through the deadline in OE2. In fact, there are nearly twice as many consumers under the age of 35 ahead of the deadline for January 1 coverage this year compared to last. By the end of the first deadline this year (December 17), there were about 2.1 million HealthCare.gov consumers under 35 years old, compared to about 1.1 million before the first deadline last year. Those under 35 composed 35% of HealthCare.gov consumers by the end of the first deadline this year, compared to 33% before the deadline last year for January 1 coverage.

Instead, Gottlieb simply divided the 2.1 milion young people (which doesn't include auto-renewals) into the 8.25 million total HC.gov enrollees (whic does include auto-renewals) to come up with his 26%.

Put another way, Gottlieb is claiming that there isn't a single person under 35 years old included among those 2.28 million people who were automatically renewed...when the odds are that it's actually somewhere in the 30-40% range.

Of course, it's possible that the auto-renewal crowd skews older, which means that when you add them to the mix, the overall average percent of young people could be slightly lower than 35%. And, in fact, when you compare the current percent under 35 now to the 36% under 35 during the full 2015 open enrollment period, it's one point lower already.

HOWEVER, the youth market tends to delay until the last minute--not just the mid-December deadline, but the final deadline. Take a look at the 2014 open enrollment period, where the trend was laid out visually (I don't have a similar breakdown for 2015, unfortunately):

As you can see, during the first 2 months, only 30% of enrollees were under 35; for the second two months, 33% were, and for the last 2 months (including the 2-week overtime period) it was up to 38%.

I'd be willing to bet that the remaining enrollees for 2016's open enrollment period will likely be something like 38% under 35 as well, which should bring the overall percentage up to around 37% or so...perhaps 1 point above last year.

But even if that doesn't end up being the case, Gottlieb's 26% claim for the current HC.gov enrollees is nonsense...which he knows damned well.

For more on this silliness, see Richard Mayhew at Balloon Juice.