- Who the hell are you?
Once upon a time I was a freelance website developer in Michigan. I still am, technically, but since late 2013 I've spent about 95% of my time doing healthcare policy data analysis, education, advocacy & blogging.
- Why are you doing this?
When the Affordable Care Act Healthcare Exchanges went live on October 1st, 2013, I was curious as to how the enrollments were going. I assumed that the Health & Human Services Department (HHS), or at the very least one of the major news organizations (NY Times, Washington Post, CNN, USA Today, whoever) would be running some sort of daily (or at least weekly) tally of the numbers in something resembling real time.
I was rather surprised to find out that not only was HHS only going to be releasing their enrollment data on a monthly basis, but the data being provided by the major news outlets seemed to be scattershot at best. Yes, there were plenty of numbers being released, but no one seemed to be doing so on a regular, consistent, state-by-state basis. There was a lot of great reporting being done, but I could only find a couple of others that were tracking the actual data daily, so I decided to do so myself.
Since then, both the HHS Dept. as well as most of the state-based ACA exchanges have gotten much better and more transparent when it comes to enrollment data, but I've also expanded the site to cover a variety of other ACA-related topics and data, as well as other healthcare policy developments.
- So, this wasn't your idea originally?
Not at all. I was actually inspired by a guy named Aaron Strauss, who had set up a Google spreadsheet to track the numbers. I set up my own version and beefed it up with additional data to give a more complete picture. Eventually Mr. Strauss abandoned his own effort, but I applaud him for getting the ball rolling. There was also a similar project started by The Advisory Board Company, but they abandoned their project in early November. There was also an organization opposed to the ACA called "Enroll Maven" which launched a website to do something similar, but that was only for the first Open Enrollment Period, and they've long since closed up shop.
- Are you a professional statistician or analyst?
No. Or at least, I wasn't until recently...I guess I qualify as a professional analyst at this point.
- Are you a doctor, nurse, pharmacist, orderly or other type of healthcare industry worker?
- Are you an insurance company employee?
- Are you a healthcare expert?
That depends on your POV. I wasn't when I started doing this in October 2013. Eight years later, I'd say yeah, that's a fair assessment, at least when it comes to the ACA itself.
- Are you a paid political operative? Do you work for a political party?
I'm active in the local Democratic party, but purely as a volunteer. I'm not paid by any political party to do this.
- Do you work for ANY political organization?
I wasn't for the first 5 1/2 years that I did this. On June 1, 2019, I entered into a part-time independent contractor agreement with the Center for American Progress (CAP), a left-leaning policy think tank, to do occasional healthcare data analysis and healthcare policy reform advocacy on their behalf. The advocacy portion mostly included educating people about the "Medicare for America" universal healthcare coverage proposal, which was largely based on an earlier proposal from CAP. HOWEVER, I was already a huge fan of (and advocate for) that earlier proposal long before I discussed any such arrangement with CAP.
My contract with CAP ended last year, however.
- What do you really think of the Affordable Care Act?
I think it's a huge, cumbersome, insanely overcomplicated law that creates a ton of headaches.
However, I also think that the healthcare system in the United States prior to the ACA was already cumbersome and overcomplicated, with its own headaches...and that it was hurting poor and middle-class people in terribly unfair and immoral ways. There are some elements of the ACA which I don't like at all, but I feel that the good that it does far outweighs the bad. The ACA has stopped some of the worst abuses of the industry, brought decent healthcare coverage to millions of people who didn't have it before, forced insurance companies to use at least 80 - 85% of their premium revenue for actual healthcare costs, and has paved the way for individual states to build upon it to hopefully expand affordable coverage to everyone in the country going forward.
So yes, overall I do want the ACA to work. However, wanting it to doesn't mean that it will. ACASignups.net was created to try and get a sense of whether or not it is working.
Going forward, I want to see major improvements to the ACA in the short term (i.e., the next 3-5 years) followed by having it gradually replaced with a true universal, comprehensive coverage healthcare plan for the long term.
- Does your data have a liberal bias, then?
Keep in mind that the ACA--or at least, the Private Exchange Enrollments portion of it--is hardly a "liberal" law. It requires millions of people to agree to pay private, for-profit corporations billions of dollars each year, which isn't exactly part of the "progressive" political philosophy.
Having said that, 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.
- Who's paying you to run this site?
For the first year, no one; it was purely a labor of love. For the second year, my work was funded exclusively via individual, one-time donations.
For the third year and since, I've been funded via a patchwork of donations via Patreon or PayPal; banner ad arrangement with the Robert Wood Johnson Foundation and several private companies; and occasional freelance writing pieces for other sites.