Rep. Lee Terry's H.R. 3362 Counters Administration's Refusal to Release Missing ObamaCare Exchanges Data
by David Hogberg, Ph.D.
On January 13 the Department of Health and Human Services (HHS) finally released an enrollment report on the ObamaCare exchanges that not only listed the number of people who had selected a private plan or enrolled in Medicaid, but also contained data on the age and gender breakdown of enrollment and how many people qualified for a subsidy.1
As yet publicly unknown: the number of people who have had difficulty enrolling in coverage, how many enrollees have paid their first premium and how many times HHS has failed to transfer crucial information to insurance companies.
The House of Representatives is set to vote January 16 on H.R. 3362, the "Exchange Information Disclosure Act," a bill authored by Representative Lee Terry (R-NE) intended to help the Obama Administration overcome its extreme reluctance to release information on the exchanges.2
H.R. 3362 requires the Administration to release data on the number of unique website visits, the number of individuals who have "created an account" on HealthCare.gov versus those who have actually enrolled in a plan, and how many people are actually paying their premiums. It also mandates the release of data regarding how many people have had trouble logging on to HealthCare.gov, enrolling in coverage or calculating their premium subsidy, and the amount of difficulty HHS has had transferring information on enrollees to insurers. The legislation also requires HHS to release such data on a weekly, instead of the current monthly, basis.
Rep. Terry's legislation or something like it is perhaps the only way to force the Obama Administration to release crucial data. Right now, the Administration treats information about the exchanges in a manner that can be charitably described as "politically convenient." If the data reflects poorly on ObamaCare, the Administration finds all sorts of barriers that prevent expediting its release. It releases the data only when it can no longer afford not to and then releases as little as it can get away with.
Amazingly, those barriers vanish into thin air on the rare occurrence when the data can be used to put a positive spin on ObamaCare. In such instances, the Administration releases the numbers faster than you can complete the sentence, "If you like your health plan…"
HHS Secretary Kathleen Sebelius testified about the exchanges before the House on October 30 and the Senate on November 6, 2013.3 In her House testimony, Sebelius suggested to Rep. Terry that if enrollment data for October were released any earlier than the middle of November, the data would be unreliable. At the Senate hearing she told Senator Orrin Hatch (R-UT) that the data could not be released prior to mid-November because HHS was still dealing with the "834" piece.
Known formally as an "834 EDI Transmission," this is an electronic file that HHS must send to insurance companies to let them know that a person has enrolled in one of their health plans through the exchange.4 Presumably these are the reasons why both the October and November enrollment reports were released 11 days after the end of the reporting period.
Fast forward to December 24, the deadline to sign up on the exchange for coverage beginning January 1. If Sebelius' testimony in late October was any indication, the Administration wouldn't be able to release "reliable" data on how many people had enrolled through the December deadline until the middle of January. But on December 29, the Administration announced that more "than 1.1 million people enrolled in a qualified health plan via the federally-facilitated Marketplace from October 1 to December 24, with more than 975,000 of those enrolling this month alone."5 Two days after that, the Administration released more data showing that over 2.1 million people had signed up through state and federal exchanges.6
If data could be released five to seven days after the December deadline, why couldn't HHS release data in a similarly timely fashion in October and November? It's not likely that "834 piece" problems would have prevented release of this data in October and November as, despite any such problems, HHS still would have data on who enrolled in the exchanges. Furthermore, whatever difficulties HHS was having with 834s don't seem to be resolved. News stories have appeared as recently as January 15 about patients who have enrolled in health insurance coverage through the exchanges only to find, when they sought to use the insurance, that the insurer has no record of their enrollment.7
The most reasonable explanation is that the enrollment number for the October period was only about 106,000 and for November about 365,000. Those figures were a public relations disaster for ObamaCare, and so the Administration wanted to delay their release as long as possible. But in December, enrollment had jumped to a much more positive, headline-generating 2.1 million, and so the Administration wanted those figures reported quickly.
Rep. Terry's bill would enable the public to get more detailed information on how well the exchanges are working. Both Senate Majority Leader Harry Reid and President Obama may try to stop the bill, but legislation that merely requires more accurate and timely data is not easy for Congress to oppose. If a significant number of House Democrats join Republicans in voting for it, opposition to it in the Senate may crumble.
David Hogberg, Ph. D., is senior fellow for health care policy at the National Center for Public Policy Research.
1 "Health Insurance Marketplace: January Enrollment Report. For the period: October 1, 2013 – December 28, 2013," ASPE Issue Brief, Dept. of Health and Human Services, January 13, 2014.
2 Representative Lee Terry, "Exchange Information Disclosure Act," H.R. 3362, October 29, 2013, at http://www.gpo.gov/fdsys/pkg/BILLS-113hr3362ih/pdf/BILLS-113hr3362ih.pdf (January 14, 2014).
3 "Sebelius-Enrollment," January 14, 2014, at http://www.youtube.com/watch?v=Jh5Au2R1_Ac (January 15, 2014).
4 Sarah Kliff, "ObamaCare’s most important number: 834," Washington Post, October 23, 2013, at http://www.washingtonpost.com/blogs/wonkblog/wp/2013/10/23/the-health-care-laws-most-important-number-834/ (January 13, 2014).
5 Marilyn Tavenner, "Enrollment Surged to the Deadline for Coverage on January 1," HHS.gov/HealthCare Blog, December 29, 2013, at http://www.hhs.gov/healthcare/facts/blog/2013/12/enrollment-surged.html (January 13, 2014).
6 Susan Cornwell, "Over 2.1 million have signed up for ObamaCare: officials," Reuters, December 31, 2013, at http://www.reuters.com/article/2013/12/31/us-usa-healthcare-enrollment-idUSBRE9BU0FK20131231 (January 14, 2014).
7 "ObamaCare Leaves Some Patients High and Dry," CNNWire, January 13, 2014, at http://fox8.com/2014/01/13/obamacare-leaves-some-patients-high-and-dry/ (January 15, 2014); and David Martosko, "'They had no idea if my insurance was active or not!': ObamaCare confusion reigns as frustrated patients walk out of hospitals without treatment," The Daily Mail, January 2, 2014, at http://www.dailymail.co.uk/news/article-2532869/They-no-idea-insurance-active-not-At-Virginia-hospitals-Obamacare-confusion-reigns-frustrated-patients-walk-out.html (January 15, 2014).