Monday, May 5, 2014

Numbers Game

With all of the numbers swirling about the Affordable Care Act, it's getting harder to keep track of what has been "accomplished" by the new law.  The White House tells us there were 8-Million sign-ups through the exchanges throught the extended, extended deadline.  The Health and Human Services Department admits that 6-Million people had policies canceled because of standards contained in the ACA.  The same Department claims 3.1-Million people under the age of 26 signed up for health insurance on their parents' plans--but that is actually a 2010 estimate of how many people could enroll that way--no actual numbers have been produced to support that claim.

Over the weekend in an interview with NBC, House Minority Leader Nancy Pelosi claimed 15-million people had "gained coverage" since the ACA went into effect.  Representative Pelosi must have access to numbers that no other source has been provided with yet.  Perhaps she has inside knowledge of how many people were covered in state Medicaid programs, or she saw employment data of people who were hired by companies offering private health insurance.  Either way, 15-million is a far cry from the 30-Million figure that she used tirelessly to quantify the number of people "desperate" for health insurance in 2010. 

Another new number over the weekend was the 248-Million dollars the state of Oregon spent in setting up their own health care exchange, only to admit that it will never work properly--and that next year, everyone will have to register through the Federal exchanges.  You may recall, President Obama took (mostly) Republican governors to task for not setting up their own exchanges--forcing more people to use the inoperable website to sign up for policies.  Imagine the $1000-per-person-signed-up cost of Cover Oregon applied to all fifty state budgets.

And then over the weekend we learned that only 2/3rds of all "enrollees" had actually paid their first month's premiums.  I'll admit, that was actually much higher than I expected.  If you had asked me to make a prediction on how many people had actually paid for their new policies, I would have put it at 1/3rd.  But the real important numbers--and hopefully they will actually be tracked (you never know with this administration)--will be how many people keep paying the premiums. 

There is a very easy way to game the system here.  The deadline for enrollment--in order to meet the Individual Mandate--will be February 15th from now on (barring Obama Administration extensions without Congressional approval).  Some of the insurance companies in the exchanges are giving enrollees up to 60-days to make that first payment--while still getting "coverage".  That means a person who goes to can sign up for a policy--get their number, which must be provided on their income tax return (since the IRS is the "enforcement agency" for the individual mandate)--and file their 1040 showing that they are "legally covered" all without spending a penny.  Math nerds--like Paul Ryan--probably have their graphing calculators ready to work out the charts that will show a rollercoaster-like pattern of enrollees before April 15th and the subsequent drop following tax day.

Those who love the ACA will tell you that it's "not about the numbers"--and that if even "one person now has health insurance it's all worth it".  But if you are going to have a sustainable program, the numbers have to line up eventually.  As I always like to say, Math always wins.

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