Coyote Blog

I have not seen anyone notice this yet, but perhaps it is just because I have obsessed over the pathetically bad Commonwealth Fund survey whose findings were demolished by the numbers in the October report (here and here).  Well, it turns out, the October report actually proudly highlights the Commonwealth Funds report,  and quotes this line from the Commonwealth Fund in Appendix D:

Of those who have visited the Marketplace, 21 percent enrolled in a plan.

WTF are you doing including this survey finding in a report that essentially makes a laughing stock of this very finding?  Let's review what numbers we have in the October report:

• From our chart here, the people covered by a "clicked" plan (sorry, but that is their circumlocution, not mine) were 106,185  (note this is generous because it is not actual enrollments, which will be less)
• From the same chart, the people who were found eligible for Medicaid were 396, 261 (note this is generous as this is not actual enrollments, which will be less).
• Finally, from the same source are total web visitors times 1.78  family members per visitor (to make our ratio apples to apples) of 47,840,217.  See here for further explanation of why this calculation is necessary

This gives us a percentage of web visitors of 1% that managed to do something kindof sortof close to enrollment.

This demonstrates just how insane the 21% figure is from the deeply flawed Commonwealth study.  So why in the hell is the Obama Administration quoting it as authoritative in their report?  Do they think anyone is dumb enough to use the 21% figure instead of the 1% figure?  Is this just providing ammunition to political hacks who want to spin the story in Obama's favor?  Did the Administration or possibly OFA actually pay for that study?

The only effect including that 21% number has on me is to say that Obama likely has a bigger problem -- If 21% of visitors THINK they enrolled and less than 1% actually did so, aren't a lot of people in for a rude shock?

A while back, I pointed out this poll from some group called the Commonwealth Fund.  In mid-October, on average about 15-18 days into the exchange process, they polled a group of non-corporate-insured adults (e.g. individual market or uninsured) about whether they had visited an exchange and what had been their experience.

The finding that stood out to me was that 21% of the people they interviewed that said they had visited an exchange reported that they had signed up for a policy (from the wording of the question, this probably includes both private policies and Medicaid signups).

I thought this seemed crazy-high.  And now new data from the Administration is confirming it.   The Administration is reporting about 106,000 "selected a plan" in October -- a very generous definition since it includes people who put a plan in their shopping cart but did not purchase it.  Not a definition of a sale that Amazon.com would ever use.    Further, another 400,000 or so were "found eligible" for Medicaid, whatever that means though it sounds well short of "enrolled."  So call it generously 500,000 people by the end of October.  The other key bit we need is that the Administration is reporting about 27 million unique visitors to these sites.  So at best we are looking at 1.9% of exchange visitors kind-of-sort-of-maybe having done something that approaches being enrolled.

This puts the Commonwealth Fund polling an entire order of magnitude off, at 21% vs. 1.9%.  And remember their survey occurred in the middle of the month, when the web site was not even working, and one can assume that successful enrollments were back-end loaded in the month.  The CF was nice enough to respond to my emails but were unable to explain the discrepancy, other than the sample size was low making the results unreliable.  So why the hell do it, and then put out a press release?

One explanation for part of the discrepancy may be in those who have created user accounts (normally a trivial task on a private site but a Herculean accomplishment on Healthcare.gov) but have not actually purchased a plan.  The Obama Administration says that there are about a million of these, so in addition to the 1.9% that put a plan in their shopping cart, there are another 3.7% that created a user account and gave the Feds enough info to assess subsidy eligibility, but who have not selected a plan.  Remember, that this was the minimum hurdle the Obama Administration originally set even to see insurance plan prices, and is still the minimum hurdle to get a subsidy quote.  It will be interesting to see the conversion rate of people once they find they are not getting free stuff from Uncle Sugar.

Even so, this only adds up to 5.6% of people who visited the exchange and had any sort of success (in most cases far short of enrollment) at all.  Way short of 21%.  Remember that we you see "studies" like this in the future.