HHS to stop issuing monthly reports (UPDATE: Confirmed)
2018 MIDTERM ELECTION
Time: D H M S
I received some disturbing news this morning which, if true, will piss me off to no end.
Supposedly, now that the open enrollment (and extension) period is over, the HHS Dept. has decided NOT to issue any further monthly ACA exchange enrollment reports going forward.
I don't know if this only means that they're mothballing the reports from now through November (when the 2nd open enrollment period starts up again), which would be bad enough, or if they mean permanently (which would be far worse).
I should stress that I have not confirmed this yet; if this information is incorrect, disregard everything below.
Assuming this news is accurate, however, HHS has lost their mind and will deserve every bit of criticism that they receive over it.
I've said many times before that the only reason that I started this website in the first place is because neither the HHS Dept. nor the major news media outlets seemed to be willing (or able?) to post accurate exchange enrollment data on a timely basis (and by "timely", I mean daily or weekly, not monthly, which is just too damned long in the modern political/media world).
I've also said repeatedly that obviously HHS can't be expected to issue the big, 30-page detailed report with all the cross-tabs and demographic breakdowns on a weekly basis...but they could certainly at least issue a weekly "summary" report that gives the top-of-the-fold numbers (X QHP enrollments this week, Y Medicaid/CHIP determinations), along with at least unofficial state-by-state numbers (that is, if the unofficial number for Florida is 23,452 QHPs, state it as "est. 23,000" or something like that to allow for wiggle room in case a small percentage turn out to be clerical errors or whatever).
However, they never did that. Aside from the official monthly reports, the only data released by HHS was when they happened to cross some major milestone (3 million, 5 million, etc). At first I assumed that they didn't have the numbers available yet, but if they were able to announce arbitrary milestones being crossed, they obviously had a fairly good idea of where things stood on a daily basis. There was no technical reason not to issue weekly summaries as I described above, just policy decision reasons.
In any event, for over 6 months, the way I operated this site was by using the reports from the state-based exchanges (California, New York, Washington State, etc.), which were being issued weekly or biweekly to fill the gaps and extrapolating from those to get a rough idea of the national picture. Once in a blue moon I'd manage to get the QHP tally for one of the states on the federal exchange via an obscure reference in an interview with an HHS representative or other official. Then the official monthly report would come out, I'd see how well I did, and for the most part I was pretty damned accurate month after month.
Now, in some ways, HHS waiting so long to issue their numbers has been to my advantage--them doing so (and the mainstream news media outlets failing to aggregate the enrollment data which was availble on a daily/weekly basis) created a data vacuum which I filled with this website. I gained a lot of attention, media exposure and kudos for doing so. I got to be interviewed on Al Jazeera, NPR, Vox, the Washington Post and other media outlets. I won high praise from a Nobel Laureate who writes for the New York Times, etc etc. It was a fun ride (although I always knew that my 15 minutes would end at the same time the open enrollment period did). It gained me some very nice donations which helped cover my business losses from the time I spent on the project.
On the other hand, it also left me with a nasty case of shingles at 43 years old from losing so much sleep and putting myself under so much stress, so there's that.
My point is, all this time I've been pushing for HHS to issue enrollment data more frequently, not less.
So, that brings us to today. If it's true that HHS is stopping issuing even monthly reports, that would be a huge mistake, for several reasons.
Yes, of course with the open enrollment period over, the enrollment numbers have plummeted, and the nation has mostly stopped paying attention since there's not that much to see. However, the numbers are still rising. The last HHS report (which ran through 4/19/14) came in at 8.02 million QHPs, but I have every reason to believe that a good 100,000 more people enrolled over the next 11 days of April. My personal guess is that there's been another 100,000 or so added over the first 3 weeks of May (remember, Nevada is still accepting open enrollment stragglers, among other things).
Medicaid enrollment is year-round. SHOP enrollment is year-round. Native Americans (around 5 million) can enroll year-round.
More importantly, Qualifying Life Events are year-round. That means if you get married, divorced, have a kid, adopt a kid, move from one state to another, lose a job or other assorted major life changes, you can still enroll in a QHP via one of the ACA exchanges.
In fact, I have no evidence of this, but my gut feeling is that there will probably be around 100,000 new enrollees per month even in the off-season.
Now, of course many people will be leaving exchange QHPs via these sorts of changes, inability to continue paying and so forth...but that's a separate discussion. The point is that the enrollment numbers will continue to fluctuate from month to month, and healthcare reporters (and other interested parties) want to see that data as close to live as possible.
I realize that some federal reports are only done quarterly, bi-annually or annually, but others (like the jobs/unemployment reports) come out weekly. Why? Because they're important.
The ACA is the Obama administration's single most important policy. Whether you support or oppose it, you have to admit that the ACA has a significant impact on the rest of the economy and many other aspects of American society. It is, in the words of Vice-President Biden, "a Big F*cking Deal".
I'm not saying that HHS should issue enrollment reports monthly for all eternity; perhaps starting in 2017, under the next administration they can ease up on it (although I'd like it if they kept doing so permanently). However, for the remainder of President Obama's term in office, at least, they should absolutely continue to issue monthly reports even during the "off season".
And if they really meant that they aren't planning on issuing the reports during the 2nd enrollment period either, God help them because they'll be pilloried by both opponents and supporters...including myself.
UPDATE: I just received confirmation from a source at HHS; they aren't specific about how often they'll be issuing updates but it sure sounds like they're scrapping the monthly reports for the time being. Bad move:
HHS issued monthly enrollment reports during the first marketplace open enrollment period in order to provide the best understanding of enrollment activities as it was taking place. Now that this time period has ended, we will look at future opportunities to share information about the marketplace that is reliable and accurate over time as further analysis can be done but we do not anticipate monthly reports.
UPDATE x2: Oh goody. On top of everything else, this development has me mentioned in the same sentence as Darrell Issa. Thanks a lot, HHS Dept...
— Kyle Cheney (@kyledcheney) May 21, 2014