Did Dentists Data Manipulate Enrollment Numbers?

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doctor at deskWhether you call it the Patient Protection and Affordable Care Act or Obamacare, the new healthcare policies in the United States are rife with controversy. Some say it’s socialized medicine while others say that healthcare is a fundamental right, one that the government should help provide for its citizens. Some say it’s not the right way to address the nation’s healthcare woes due to free market concerns, while others insist that the ACA is the answer because healthcare is a basic human right.

One fact that cannot be denied is that there have been hiccups with the implementation of the program. Technological issues with enrollment were a trending topic early on and even led to the change of leadership atop the Department of Health and Human Services.

Among many of the results of this rocky start were lawsuits and questions about which aspects were legal and which were a violation of citizens’ rights. Penalties placed upon those who declined to get health coverage was a contentious aspect, as was the debate over whether that penalty could be considered a tax.

Now there are media reports of enrollment numbers being inaccurately reported by the government. At best, it is cited as simply a sloppy job of tallying numbers. At worst, it’s an orchestrated effort to misrepresent the number of people enrolled in ACA programs.

According to Bloomberg, the agency double-counted those who were signed up for dental care only, adding the roughly 393,000 individuals to the tally of those enrolled in health programs. That meant that it was reported to the media that there were 7.3 million people enrolled (in August 2014) but the actual number was 6.9 million. The error was discovered and the health department acknowledged it on November 20, 2014.

 

How the Government is Responding to the Issue

medical advocacyAccording to CNBC, U.S. Health and Human Services Secretary Sylvia Mathews Burwell announced on Twitter that the mistake was “unacceptable” and that she would be taking steps “to ensure this kind of mistake does not occur again.” She has been on a media blitz of sorts, attempting to project the image of transparency and competency as well as stressing that her department strives for such values in all of its work surrounding the healthcare act.

Burwell stated in later media interviews that she would be communicating her disappointment throughout the department and that she would be “putting in place measures to ensure that this kind of mistake does not occur again after we understand why it happened.”

In October, the number of enrolled people fell to 6.7 million, likely telling the story of declining enrollment in healthcare plans. Bloomberg reported that the 7 million mark was important to President Obama’s administration, as that number is looked at as a benchmark.

While Bloomberg reports that Burwell is getting her 77,000-member department to increase its transparency through meetings seeking suggestions for improvement, Congress is also getting involved.

California Republican Darrell Issa, who leads the House Oversight and Government Reform Committee, led a hearing to get information from Marilyn Tavenner, who is the administrator for the Centers for Medicare and Medicaid Services. Issa is quoted in the Bloomberg story as saying the numbers provided by Tavenner in the past are “deceptive and obscured the number of Americans running from exchange plans.”

The number problems have also given opponents of the healthcare law new ammunition in their criticism of the program. Furthermore, they are demanding answers from those administering the problems.

One top Republican in the House of Representatives was paraphrased in the CNBC article as saying that the Obama administration should be required to explain the figures, including the people who had knowledge of it and when they discovered the issues.

Because of the scrutiny early on and the very tumultuous national climate when it comes to talking about whether the ACA is legal or the best thing for the country, government figures are spending their time and efforts in one of two places – either defending the program or badmouthing it. So in a way it is simply business as usual for those people, just using a different issue as the talking point.

 

What is the Cause of This?

At the simplest explanation, a mathematical or categorization error added people getting dental coverage to both the dental totals and the medical numbers. Unfortunately, the cause for the calculation error seems to differ based on who is being asked for the sound byte.

1418756681_thumb.jpegIssa, a critic of the healthcare policies, has come out with quotes stating he believes that the HHS and the Obama administration have been engaging in deceptive statements and figures.

In the CNBC story, he was quoted as saying “The claim that this was only accident[al] stretches credulity. The administration misreported the ACA’s enrollment figures not once, but twice, and officials cautiously changed their statements from ‘health plans’ to ‘marketplace coverage.”

Burwell has gone to great lengths to explain that the numbers problem was a simple mistake with no ill will or shady ambitions behind it. When Chris Hayes of CNBC pressed her during a conversation about releasing the findings of an investigation into the mistake, Burwell did not confirm nor deny. Rather, she reemphasized that her department will put measures in place to prevent the mistake from happening again.

Issa said in the CNBC story that the HHS must tell the public what happened, about who knew about the errors and when they knew about them.

While dental care is a part of the new healthcare law, it is often overshadowed by media oversight of this medical aspect, according to CNBC. Journalists focus on the issues of primary doctors, specialists, hospitals and prescription drugs – things that get ratings and raise emotion. This is believed to be a partial explanation as to how the mistake was not discovered immediately.

 

What Does It Say about the ACA’s Success?

Instead of the 8 million people reported to be enrolled in the program in May, the actual number in September was 6.97 million. That drop of almost 13 percent can definitely be used as proof that Americans are perhaps fleeing the ACA for other healthcare choices. Reasons could be that they found healthcare elsewhere besides the exchanges, they could have failed to pay for premiums or simply dropped out for other reasons.

Burwell has already been working to tamp down expectations for enrollment, according to CNBC. She recently said that her office was expecting 9.1 million people to be enrolled by the end of 2015. That greatly falls short of the 13 million total that the Congressional Budget Office has been projecting.

Even worse for the administration, opponents are jumping on a series of videos recently released showing a consultant who helped design the ACA talking about how a lack of transparency was part of the plan when designing the ACA. According to CNBC, Jonathan Gruber, who is an economist at the Massachusetts Institute of Technology, was seen on the video talking about how the law was written so that it would make costs look less than their actual numbers so that it would be able to gain favor with those in the public or Congress.

One video quotes him as saying that “Lack of transparency is a huge political advantage. And basically, call it the ‘stupidity of the American voter’ or whatever, but basically that was really, really critical to getting the thing to pass.”

Regardless of whether the reports of numbers-padding is true, it can’t be denied that the implementation of the Affordable Care Act has been a great help to numerous Americans who had previously struggled to attain affordable healthcare insurance. Opposing views will always exist in any political platform, but the good of the American public should be the main focus, no matter what political stance you take.

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