Revamp of Census Survey Could Compromise Ability To Assess ACA
A revision to the health insurance questions in the Census Bureau's annual survey could make it difficult for experts to analyze the effect of the Affordable Care Act on uninsured rates, the New York Times reports.
The changes came about after critics said the old survey created flawed results by asking respondents if they had insurance, rather than about their coverage history. Noting that a test of the new questions last year produced lower estimates of the U.S. uninsured rate -- 10.6% compared with 12.5% -- federal officials said the updated survey could make it hard to tell if changes in uninsured rates could be attributed to the ACA or to the survey’s methodology shift.
White House officials reported that 7.5 million individuals signed up for health plans through the ACA's exchanges but have yet to report how many of those people were previously uninsured, had their policies canceled or have paid their first month's premiums. These factors make the true effect of the law and the net increase in coverage unclear, so far, the Times reports.
According to the Times, health policy experts and politicians were relying on the Census Bureau's Current Population Survey to clarify the unknown factors (Pear, New York Times, 4/15).
Republican lawmakers criticized the changes as an attempt by the Obama administration to mask ACA numbers, The Hill's "Healthwatch" reports. Brendan Buck, a spokesperson for House Speaker John Boehner (R-Ohio), said, "This administration seems to always have some excuse for why it can't provide clear data to show, for all the chaos the law caused, how many uninsured people actually gained coverage."
Administration officials argue the changes were not politically motivated, but rather are aimed at fixing issues with the survey that have existed for years (Viebeck, "Healthwatch," The Hill, 4/15).
An internal Census document obtained by the Times stated "it is coincidental and unfortunate timing" that the survey's revisions occurred at the same time as many of the ACA's key provisions were implemented. It noted, "Ideally ... the redesign would have had at least a few years to gather base line and trend date" (New York Times, 4/15).
Meanwhile, a senior administration official noted that the new survey questions will be used to gather data for 2013, the year before the ACA was implemented. This would mean that uninsured rates in 2012 and 2013 would be difficult to compare, but uninsured rates in 2013 and 2014 -- the years before and after the implementation of the ACA -- could be compared (Kliff, Vox, 4/15).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.