Are Most Customers Previously Uninsured?

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Ezra Klein’s Vox declared Thursday “White House: most enrollees were previously uninsured.” But is this true?

In federally-run Obamacare exchanges, 5.45 million selected plans by April 19 and 5.18 million were required to answer a question about their health insurance coverage, HHS alleged. Of those 5.18 million, 695,011 people — 13 percent — reported that they already had insurance when they applied for an exchange plan.

The Department of Health and Human Services’ claim “suggests a high proportion of people seeking coverage on the exchanges weren’t replacing an old plan, and, instead, they were without health insurance when they signed up,” wrote Vox’s German Lopez. But as it turns out, the White House “cautioned that this data is unreliable.”

There are several problems with the number. First, it includes federally-run marketplaces only, not the entire nation. California has the greatest number of uninsured residents by far — and it’s not included in the data.

California data that is included in the HHS report is concerning at the least. In 2012, 60 percent of the state’s uninsured population was Latino — but according to the HHS report, Latinos account for just 28 percent of California sign-ups. The wide disparity suggests that the long-term uninsured may not be the ones affected, but complete data is necessary to tell for sure.

That’s the second problem with the HHS report — the entire premise is based on incomplete data. The Obama administration is continuing to report sign-ups, not paying customers. The preliminary data concerns only those who selected plans (and applied for subsidies) on federal exchanges — not people who paid their first premiums.

The only public data available on those who have paid their premiums comes from House Republicans, who issued a preliminary report that found that 67 percent of sign-ups had purchased their health plan by April 15, two weeks before the final deadline to pay up.

Manhattan Institute health policy expert Avik Roy made the case earlier this year that the previously uninsured are less likely to end up paying their premiums than those who already had health insurance. Once the Obama administration releases final payment data, its possible that this proportion will drop.

Because HHS didn’t give any details on its basic survey, it’s not clear who the snippet caught.It’s possible that those who were kicked off their insurance policies by Obamacare — whether the plans were canceled in the individual market or terminated by an employer — could be included due to a short lapse in coverage and weren’t perennially uninsured. Again, because the report provides little context for the claim, it’s impossible to know.

Ultimately, Obamacare supporters can’t yet claim victory from a one-paragraph aside that even the White House calls unreliable. HHS’ preliminary findings don’t square with more intensive studies done with data from insurance companies themselves. RAND Corporation’s latest data indicated that 36 percent of exchange customers didn’t have health insurance before signing up. The extensive report took much more into account than the two sentences HHS allotted to the claim.

The Obama administration continues to hold off on releasing more conclusive data.

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