Podcast Center
Video Center
Webcasts
Resource Center
Events
March 03, 2014 at 06:12 AM
On the one hand, I have a lot of fun covering “public health insurance exchange enrollment activity.”
It’s a lot of fun to try to figure out how the various Patient Protection and Affordable Care Act (PPACA) exchanges have organized their activity reports to make detecting enrollment trends difficult or impossible.
Example: The federal government and many state-based exchanges publish cumulative totals, not weekly or monthly totals. So, anyone interested in month-to-month changes in activity has to get out a calculator or a spreadsheet, do a lot of subtracting last-period totals from the new totals, and pray to whatever powers protect us against math errors.
It’s a little like a cross between an easy form of Sudoku and skydiving.
Then there’s my carefully chosen term “activity level.”
I torture the English language because the exchange managers refuse to give us sales figures. They insist on telling us “how many people have selected qualified health plans” through the exchanges and may or may not have paid for the coverage.
The sneakiness seems all the more silly when I see some state-based exchanges reporting, in excruciating, accurate, transparent detail, how well or poorly they’ve done.
The sad thing is that some of those transparent exchanges — example: the Minnesota exchange and the Nevada exchange — have had their own startup problems. But I sincerely hope that, whatever turns out to be right or wrong about the theory of the PPACA exchange program, the transparent exchanges end up doing as well as any can within the system, just because they (or whomever wrote the Sunshine laws that govern them) have tried so hard to do the right thing.
On the other hand, the obsession with the idea that the exchanges should enroll 7 million people in QHPs, and that each state should meet its enrollment goal seems absurd.
Folks came up with those projections with a long, arduous, intense process that was probably about as reliable as asking a Ouija board, or using March 23, 2010, as the natal date for PPACA and plugging that into a Web-based horoscope generator.
