The Hawaii exchange handed the GOP a loaded gun: Reported up to 20,000 bogus enrollees last year.
But actually, he thought as he re-adjusted the Ministry of Plenty’s figures, it was not even forgery. It was merely the substitution of one piece of nonsense for another. Most of the material that you were dealing with had no connexion with anything in the real world, not even the kind of connexion that is contained in a direct lie. Statistics were just as much a fantasy in their original version as in their rectified version. A great deal of the time you were expected to make them up out of your head. For example, the Ministry of Plenty’s forecast had estimated the output of boots for the quarter at 145 million pairs. The actual output was given as sixty-two millions. Winston, however, in rewriting the forecast, marked the figure down to fifty-seven millions, so as to allow for the usual claim that the quota had been overfulfilled. In any case, sixty-two millions was no nearer the truth than fifty-seven millions, or than 145 millions. Very likely no boots had been produced at all. Likelier still, nobody knew how many had been produced, much less cared. All one knew was that every quarter astronomical numbers of boots were produced on paper, while perhaps half the population of Oceania went barefoot. And so it was with every class of recorded fact, great or small. Everything faded away into a shadow-world in which, finally, even the date of the year had become uncertain.
--George Orwell, Nineteen Eighty-Four
Let's hop in the Wayback Machine, shall we, Sherman?
Here's what I posted on my FAQ page over two years ago:
my data comes from a variety of sources, including the HHS, the State-Run Exchange press releases and news outlets ranging from small local newspapers to major national news outlets. I do not guarantee that any of their data is accurate, but I do guarantee that any of their data that I enter into the spreadsheet is as accurate as I can make it given my limited time and resources. Occasionally I may make an honest mistake; when this happens, I attempt to correct it as quickly as possible and will also post an explanation of what happened in the blog as appropriate.
...Is it possible that some of the numbers provided by the HHS, local news outlets or national news outlets is erroneous? Of course. If so, is this deliberate on their part? Anything's possible, but I doubt it. We're all human; reporters make mistakes; editors make mistakes; government employees make mistakes and I make mistakes. All I can say is that I'm doing the best I can to keep the data on this site as accurate as I can, and I promise to make corrections (with notifications of those corrections as appropriate) as quickly as I can if they happen.
When you visit the link, it goes to a video interview with the executive director of the HI exchange, who states, when asked "do we know how many signups there've been so far?" that "it's about 12,000; we were at 250 this time last year, so we've made a lot of progress."
Now, hold the phone a minute. According to the Kaiser Family Foundation, Hawaii only has around 53,000 residents total who are even eligible to enroll via the ACA exchange to begin with.
More to the point, HI only enrolled 8,600 people as of last April, and that number had grown to 10,750 as of the end of September.
So...my question is, does that "12,000 so far" figure include the current 2014 enrollees, or does it only include 2015 enrollees (renewals of existing plans + new additions)??
I'm actually a bit curious about the "new" specification here. Last week the head of the HI exchange gave an interview in which he gave the number as being 12,000, but it turned out that was a cumulative number which included all of the enrollments from last year (whether they had renewed yet or not) as well as the new additions. I thumbnailed it as being around 1,200 enrollments for 2015.
Therefore, I'm not sure how to take "nearly 1,500 new residents" in this case; that may mean "new for 2015 including renewals" or it may mean "new for 2015 not including renewals". Either way, the number isn't large enough to impact my spreadsheet/projections, but it's still a bit irritating:
Hawaii's updates are particularly frustrating because they have a tendency to only give the cumulative plan selections to date, mixing together 2014 & 2015 numbers regardless of whether they've actually enrolled/re-enrolled for 2015 or not. Therefore, it's refreshing to see a (relatively) straightforward update out of the Aloha state.
...Of course, they couldn't help but mix numbers together later in the story:
...To date, roughly 13,500 residents have signed up for health insurance coverage that will begin on Jan 1.
Kissel noted that the Connector has also connected 50,000 to the expanded Medicaid program, which came in with the Affordable Care Act at no cost to the state.
(sigh) OK, so what they really mean here is that there Hawaii has around 10,000 current QHP enrollees for 2014 and has added 3,500 for 2015. Presumably most of the existing 10K will be autorenewed this week, after which this confusion will hopefully be a moot point.
...The Connector had about 1,000 people enrolled at this time last year. As of Thursday, that number had grown to 16,000.
...More than 365 small businesses, with 2,400 enrollees, have joined the Connector through the Small Business Health Options Program, or SHOP, in part because of tax deductions available to them, Kissel said.
Another 50,000 people have been added to the Medicaid rolls in Hawaii, Kissel said. Whether those new enrollees were part of the 100,000 to 150,000 uninsured in Hawaii when the Connector launched in October 2013, or they’ve left other plans to get insurance, the Connector isn’t sure.
The 16K QHP figure jibes with the 3,500 figure given back on 12/18, considering that renewals weren't included at that time. I'm not sure how the other 12.5K breakout, though it's likely around 10-11K renewals and another 1,500 - 2,500 new additions. Ultimately it doesn't really matter, I suppose; the numbers are too small to impact my projection chart much anyway, and an enrollee is an enrollee.
The enrollment data from Hawaii has been sporatic and a bit squirrelly, with the few numbers being thrown around sometimes including the cumulative plan selections including 2014 enrollees whether they renewed for 2015 or not. When I posted my last Hawaii update, I was suspicious (at 16.1K, it was nearly twice last year's tally), but the article seemed pretty confident about the numbers, so I went with it.
This evening, I was immediately concerned when I saw the lede...
The Hawaii Health Connector said about 13,356 residents signed up for Obamacare coverage in the three-month enrollment period that ended Sunday.
...and even when I saw the closing line, I worried that this included people who selected a plan in 2014 but either didn't pay up, dropped out over the course of the year or just didn't bother renewing for 2015 (ie, nationally, total plan selections as of April 19 were 8.02 million, but only 6.7 million were still enrolled as of October and only 6.3 million renewed for 2015):
The Connector's total enrollment since launching in October 2013 is approximately 23,000.
I wanted to be certain, so I contacted the reporter and after some back-and-forth, she double-checked with the head of the HI exchange, who said...
@charles_gaba Exec. director says there are currently 23k who selected plans for 2015.
— Kristen Consillio (@kconsillio) February 17, 2015
The ACA exchange enrollment reports out of Hawaii have been continually confusing as hell. One day it's 16,000 (more than twice 2014's total); a month later it's only 13,300; then just hours later, I receive "confirmation" (directly from the exchange director, supposedly) that it's actually 23,000...specifically for 2015 policies.
While this was screaming out as a big red flag, I grudgingly accepted it...only to have the rug yanked out from me when the official ASPE report came out in March, giving the official final number as 12,625...which is right in line with what I was expecting in the first place (around a 50% increase over their total in April 2014, and 17% over their total as of September 2014).
I haven't heard anything out of Hawaii since then...until tonight, when I read this:
By this spring, when enrollment opened once again to accommodate stragglers eager to avoid an income tax fine for failing to have insurance, the Health Connector had already surpassed its fiscal year target of 30,000 sign-ups. Kissell said that total has now grown to 35,000 — a number Connector officials identified last year as the break-even point for sustainability.
30,000?? 35,000?? What the heck is going on here?
...However, even so, that would still mean that they've somehow added another 11,625 since Open Enrollment ended...more than doubling their 2015 tally. That doesn't make any sense either.
...since mid-April, every story I've seen about the HI exchange has their "2015 enrollment" numbers up between 35,000 - 40,000, which makes absolutely no sense, even when counting QHP "selections" whether paid for or not. There's no way that they've managed to triple their enrollments in the 3 months after open enrollment ended, especially when they didn't get anyone to enroll during the #ACATaxTime special enrollment period.
So. There you have it. The Hawaii ACA exchange flushed a bunch of money down the toilet on a barely-functional tech platform, they pulled the plug and shifted everything over to HealthCare.Gov. Disappointing, but whatever; it's done, right?
Cut to today's Honolulu Star-Advertiser: (behind firewall, here's the key snippets):
The Hawaii Health Connector inflated the number of residents enrolled in Obamacare in 2015, state officials contend.
The nonprofit Connector, assigned to enroll Hawaii residents in medical insurance under the Affordable Care Act, repeatedly said it signed up nearly 40,000 people in coverage last year, despite federal reports stating otherwise.
Now that the state has taken over functions of the Connector and moved enrollment to the federal marketplace, healthcare.gov, Gov. David Ige’s administration told the Honolulu Star-Advertiser that number is bogus.
“The 40,000 just is not a real number,” said Laurel Johnson, Ige’s deputy chief of staff. “It’s so high as to be ridiculous. The prior estimate of 40,000 cannot be verified by any state or federal database.”
Hawaii’s Obamacare enrollment numbers have been all over the place depending on the source. Hawaii Medical Service Association confirmed it enrolled approximately 12,000 members on the Connector last year, while Kaiser Permanente Hawaii said it signed up 7,300 individuals on the exchange. Combined, HMSA and Kaiser signed up about half the number Connector officials have claimed.
Ige’s representatives told lawmakers at a briefing Wednesday that the latest federal figures show 16,803 people were covered under Obamacare in 2015 and that 15,400 have signed up for coverage so far this year. Johnson said there is no way to verify actual exchange enrollments for last year because Connector reporting systems have been shut down.
The story goes on to quote several of my own blog entries above, along with the former director of the HI exchange, Jeff Kissel...who says that he "can't explain" the discrepancy and there's "nothing he can do about it" now. Lovely.
The good news here is that 1) the knuckleheads who were running the HI exchange can't do any more damage, and 2) the federal HHS report numbers were accurate (or at least as accurate as possible). The combined 19,300 figure between the two insurance carriers for last year is in line with the 16.8K HHS/ASPE report figure, once non-payments and normal churn are taken into account. And even the final official plan selection tally from the ASPE report last spring had the tally at just 12,625, which means whatever else got messed up, no one at HHS was trying to inflate the numbers.
Still, I can already see Republicans adding this talking point to their "Government Bad! Obamacare Bad! Democrats Bad!" talking point list, and on this one I really can't say that I'd blame them.
At least it proves that Ms. Consillio and I weren't crazy last year.