Census Bureau To Change Annual Health Care Survey To Make it IMPOSSIBLE to Determine Impact of Obamacare

April 15th, 2014

I’m not sure how I should react to this story in the Times that the Census Bureau is changing the manner in which data about uninsured people is collected. As a result, it will be impossible to measure the number of people who gained insurance before Obamacare. On the one hand, it seems like a good move, in that more detailed data will be gathered. But, on the other hand, my cynical side is piqued.

Nearly every aspect of the implementation of this law in Treasury and HHS has been politicized from the top down. Is the Census Bureau exempt? I want to say yes, but I can’t. This is the distrust that disregarding the rule of law engenders. Something as mundane as a survey about levels of uninsured is now subject to manipulation by the Administration.

The articles tries to discount that this change was political in nature

Another Census Bureau paper said “it is coincidental and unfortunate timing” that the survey was overhauled just before major provisions of the health care law took effect. “Ideally,” it said, “the redesign would have had at least a few years to gather base line and trend data.” …  But the decision to make fundamental changes in the survey was driven by technical experts at the Census Bureau, and members of Congress have not focused on it or suggested political motives. The new survey was conceived, in part, to reduce a kind of bias or confusion in the old survey. When asked about their insurance arrangements in the prior year, people tended to give answers about their coverage at the time of the interview — forgetting, for example, if they had Medicaid for a few months early in the prior year.

But we also know that this new questionnaire came from the White House.

The White House is always looking for evidence to show the benefits of the health law, which is an issue in many of this year’s midterm elections. TheDepartment of Health and Human Services and the White House Council of Economic Advisers requested several of the new questions, and the White House Office of Management and Budget approved the new questionnaire.

Plus, this new survey will yield lower levels of uninsured.

An internal Census Bureau document said that the new questionnaire included a “total revision to health insurance questions” and, in a test last year, produced lower estimates of the uninsured. Thus, officials said, it will be difficult to say how much of any change is attributable to the Affordable Care Act and how much to the use of a new survey instrument.

“We are expecting much lower numbers just because of the questions and how they are asked,” said Brett J. O’Hara, chief of the health statistics branch at the Census Bureau.

With the new questions, “it is likely that the Census Bureau will decide that there is a break in series for the health insurance estimates,” says another agency document describing the changes. This “break in trend” will complicate efforts to trace the impact of the Affordable Care Act, it said.

So there we have it. In the era of Obamacare, it is now impossible to ascertain how many people actually gained coverage. And I wondered why Sebelius was dodging this question. I’m sure this change was known before the 7 million number came out.

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