Georgia: AJC story on ACA enrollment illustrates the importance of being careful how you word things


via Ariel Hart of the Atlanta Journal-Constitution:

The pace of Obamacare enrollment this year is up 9% so far in Georgia, a turnaround from declines since the beginning of the Trump administration. Nationwide, the pace of enrollment is up 2%.

Wait, what? Where on earth is she getting either of these numbers?

In Georgia specifically, ACA exchange enrollments are only up 4.5% vs. last year...and as I note at the link, even that's misleading because Thanksgiving was included in Week 4 last year but won't be counted until Week 5 this year.

"National" numbers are impossible to compare because the Snapshot Reports only include 38 states. Most of the other 12 (+DC), including huge states like California and New York, haven't reported any data yet. However, even if you consider 38 states to be "nationwide", that's still down 2% year over year so far.

Perhaps she meant for the 4th week only? Nope, that's way off the other way: Georgia is up 43% and the 38 states on are up 41% vs. last year...again, highly misleading due to the Thanksgiving factor.

UPDATE: As Wesley Sanders points out, Ms. Hart is using a daily average to compare, which I suppose makes sense since there's a day missing for this year compared to last year:

  • 2020: 6,346/day (103,172/day across 39 states)
  • 2019: 5,819/day (101,038/day across 38 states)

On that basis, yes, it'd be up 9% per day for Georgia and up 2% per day "Nationally".

However, again, the Thanksgiving factor makes this pretty pointless, there is no "national" numbers to compare yet, and even using, you have to subtract Nevada, which split off onto their own exchange this year. The actual 38-state comparison would actually put this year's "national" enrollment up 3.1% over last year on a per-day basis so far if you factor in Nevada's move.

After years of steep hikes, premiums in Georgia are finally stable or even declining. In addition, two new companies have joined the Georgia market.

“It’s really the premiums that drive this,” Custer said. “So it looks like having the stable premiums and more companies in the market is really having an effect.”

I'm actually expecting overall enrollment to be down slightly in Georgia year over year when the dust settles...ironically due to both the declining premiums & additional competitors, depending on how the benchmark Silver plan pricing has changed in various parts of the state. If the benchmark plan is down significantly vs. last year, that means smaller ACA subsidies, which in turn means Reverse Silver Loading will be at play for 2020.

Many factors play in to whether people sign up for ACA insurance. Some good factors may drive down ACA sign-ups, such as more people getting job-sponsored insurance. The ACA only sells individual plans.

Except that "The ACA" doesn't "sell" anything at all. It's the name of the law. Health insurance carriers sell individual market policies which are required to be compliant with ACA provisions, and this article purports to be referring to ACA-compliant individual market policies sold on the ACA-created insurance marketplace exchanges.

Furthermore, there's a whole second exchange market for Small Business market plans, although admittedly that's almost a rounding error in terms of enrollment and many states don't have any SHOP offerings at all, so I'm willing to give Ms. Hart a pass on that one.

...But the market is better established now that there’s been no attempt to repeal the ACA this year. In addition, the big thing in Georgia is prices. Most Georgia companies’ premium changes were in the single digits, except for Alliant, whose average premium price fell 10.2%.

Alliant's avg. premiums are dropping 14.6% in 2020. The 10.2% figure is outdated...that's what they proposed back in August, but the approved rates dropped further in the end.

Popular or not, the future of the ACA is unclear. Georgia is one of several conservative states that are suing to repeal the ACA. In the meantime, both Georgia and federal officials have been pushing forward alternatives to ACA insurance that are cheaper but may not cover as much.

"Several" actually means 20 states, although it's down to 18 now thanks to Democratic candidates winning the Attorney General positions in Colorado and Wisconsin. And it's not just that the "alternatives" "don't cover as much", they don't cover nearly as much and in fact don't have to cover anything since they don't have to let people with pre-existing conditions enroll at all.