Another Unforced Error Rattles ACA Year 2 Open Enrollment

The disclosure that a calculation error caused the Obama administration to add an extra 400,000 people to ACA enrollment figures for months puts a dent in the 2015 open enrollment, in part because it fits a narrative of a lack of transparency for reporters who cover the administration.

So much for smoother second year.

Just when open enrollment for 2015 under the Affordable Care Act (ACA) appeared to be going well after the disaster of a year ago, officials with HHS were forced to admit last week that enrollment numbers were inflated due to a calculation error, by including freestanding dental plans with medical plans.

The error caused CMS Administrator Marilyn Tavenner to tell Congress in September that 7.3 million Americans enrolled in private insurance through the ACA, when in fact the number was 6.7 million, short of original Congressional Budget Office estimates.

And, of course, that’s well short of the 8 million figure celebrated on the White House lawn in April by President Obama, in the days after open enrollment ended on a positive upswing. The turnaround defied expectations after the horrific start due to problems with the federal website HealthCare.gov. The ACA brand took a serious blow, and then-HHS Secretary Kathleen Sebelius was not given a spot next to the president at that ceremony. She resigned days later.

New HHS Secretary Sylvia Mathews Burwell was selected to ensure a smoother enrollment period this time, and she appeared to be delivering one, announcing last week that the first weekend had brought 500,000 log-ins and 100,000 applications. But as several news outlets reported, updates from HHS, including demographic data and state-by-state breakdowns, have been unavailable. This is in contrast with data releases from states running their own exchanges.

The revelation about the miscalculation came the same week that recordings were uncovered showing MIT economist Jonathan Gruber, who worked on ACA passage, saying it relied on the “stupidity” of American voters. While that was described as a misstep by an individual, the miscalculation of 400,000 enrollees was not so easily dismissed. These gaffes come as Americans are as divided over the ACA as ever, with a new poll from the Kaiser Family Foundation showing that 22% want to expand the law, 20% want to leave it as is, and 29% want a full repeal. A review of surveys published in The American Journal of Accountable Care found that Americans who had ACA policies were using them and, for the most part, liked them.

Announcement of the calculation error brought an avalanche of criticism, not only from Republican opponents of the law, but also from reporters who cover healthcare, and from Washington-based media who feel this lapse fits a pattern of a lack of transparency. Obama communications officials have tangled with the Washington press corps over a host of issues, including access to covering the president at fund-raisers to the incident involving the Justice Department tapping phones at an Associated Press office.

Sarah Kliff, the well-regarded healthcare writer for Vox, notes that the administration is in a no-win position: either it purposely inflated the numbers, or its incompetence hampered open enrollment 2 years in a row. Either way, she writes, both the public and skeptics in the capital will have a hard time believing solid enrollment numbers from HHS.

“It’s just at the moment that Obamacare's marketplaces are running better than ever that this series of sloppy mistakes make it look like worse than anyone thought,” she wrote.

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