Report: Census survey changes will prevent analysis of Obamacare effects

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The Census Bureau will make significant changes to its annual survey that it will make it difficult to measure Obamacare’s effects, The New York Times reports.

The Current Population Survey, the questionnaire used during interviews with tens of thousands of households, will undergo a “total revision to health insurance questions” this fall, according to internal Census documents. The changes will make the new findings incomparable to census data from years before the health care law went into effect and will cause a break in continuous data that will cause next year’s Census data to show fewer uninsured Americans post-Obamacare, whether that’s true or not.

Officials say the changes are intended to improve the census survey’s accuracy. Internal Census documents alleged that the timing wasn’t purposely intended to cloud clear analysis of Obamacare’s effects.

“It is coincidental and unfortunate timing” to modify the health insurance interview questions just after the health-care law became law, according to one internal paper. “Ideally, the redesign would have had at least a few years to gather base line and trend data.”

Several of the new questions were requested by the the Department of Health and Human Services, which administers Obamacare, and the White House Council of Economic Advisers. The White House Office of Management and Budget, currently headed by Sylvia Mathews Burwell, approved all of the revisions.

Burwell has been nominated to replace Kathleen Sebelius at HHS.

While the survey previously asked Americans whether they had health insurance at any time in the previous year, the modified version will ask if they have insurance at the time of the interview, which will be in February, March or April, and will employ follow-up questions to determine when the coverage began and for what months it was in effect. The goal is to create a monthly history of health coverage.

During a test run last year, the revised questions yielded lower estimates of the uninsured population in the U.S. than the previous method did. In 2013, the standard questionnaire found that 12.5 percent of Americans were uninsured; using the new version, just 10.6 percent of Americans were without health coverage.

On top of that, the survey changes also affect the totals of those with private insurance, as opposed to public health coverage. “The percentage of people with private coverage was statistically higher” when the Census Bureau tested the new survey last year, according to the document.

The changes seem geared toward producing census results that are more favorable to Obamacare. It will make it difficult to determine whether any drop in the uninsured rate has to do with the law or other factors, like changes in the survey methods. Census officials do expect to see fewer people uninsured.

The new survey will also ask Americans whether they have insurance through an exchange, if their plan has premiums, and whether the premiums are subsidized.

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

Given the changes, “it is likely that the Census Bureau will decide that there is a break in series for the health insurance estimates,” according to an internal Census Bureau document, which concluded that the break may stifle efforts to determine whether the health-care law is effective.

While the changes may prevent the White House from entirely attributing a decrease in the uninsured population to the health-care law, it will take away experts’ opportunity to see whether the health-care law has actually improved health insurance coverage in the U.S.

O’Hara told the Times that the bureau will not release coverage data from early 2014, which would include Obamacare coverage, in its next report, but will wait to analyze the reliability of the new monthly data before releasing it to the public.

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