We had to pass the Patient Protection and Affordable Care Act to know what was in it, and we had to implement it to know what was wrong.
Now, how will we know it is actually working?
There are lots of metrics (both real and made-up) on the failures of the ACA, and a few similarly questionable indices on the law’s success. For example, there were several recent stories on how there were more people buying pot than signing up for insurance in Colorado. Amusing, perhaps, but not very useful.
Both CFOs and journalists are very suspicious of metrics and statistics, and both have asked me for advice on how to tell if the ACA is working over time.
There are not many sources of objective information. I look forward to getting statistics from the U.S. American Community Survey. Many people don’t know about this survey, but it’s a good one. Starting in 2000, the Census Bureau took the long-form census and set it up as an ongoing continuous survey of the United States (about 50,000 random citizens per month), asking questions on health insurance coverage along with multiple other data points. If the ACA is working, this should show an increase in the number of people with insurance, starting with the 2014 report, which will be released in 2015. I’ll be watching.
On a faster reporting cycle, we’re starting to get more detailed statistics on the marketplace enrollees, with the Department of Health and Human Services releasing some demographic breakdowns on enrollments through December. Nice to learn that after two fairly low enrollment months (364,000 through November), HHS is reporting that there was an increase in plan selection in December with enrollment numbers growing by over 1.7 million in December to a now-cumulative three-month total of more than 2.1 million enrollees.