POLITICO Pro Administration admits Obamacare enrollment numbers error

The Obama administration has admitted that it inflated Obamacare enrollment numbers twice this year — including in testimony to Congress — thanks to an error in the way health insurance numbers were conflated with dental insurance figures.

The exaggeration, which HHS Secretary Sylvia Mathews Burwell said was an “unacceptable” mistake, inflated the reported number enrolled in Obamacare by 400,000. House Republicans first spotted the issue, and say that blaming the bad numbers on mistaken data “strains credulity.” If you take the dental insurance customers out of the latest administration Obamacare report, the enrollment number is closer 6.7 million now.


Burwell and HHS officials did not publicly explain how the mistake happened. But one administration official told POLITICO a topline number for paid enrollment — different data than HHS usually uses in its enrollment reports — was used for Medicare chief Marilyn Tavenner’s testimony on the Hill in September. She said at the time that 7.3 million people were covered as of mid-August.

The problem was uncovered by House Oversight Republicans after receiving more detailed information from HHS this month.

Burwell pledged to take steps so that “this kind of mistake does not occur again after we understand why it happened.”

Several top Republicans saw it as far more than an error, though. House Oversight Chairman Darrell Issa insisted “HHS must provide a clear and detailed account of who knew about this decision and when they knew it.” House Majority Leader Kevin McCarthy tweeted, “Administration double counts #Obamacare enrollees to reach enrollment goal” of 7 million.

The controversy follows the stream of unflattering news about former administration health care adviser Jonathan Gruber, the MIT economist who denigrated American’s “stupidity” on a series of videos to explain how the health law got passed. That has overshadowed the otherwise smooth rollout of Obamacare’s second open enrollment season, one that made good on Burwell’s promises to avoid a repeat of the debacle of HealthCare.gov’s debut last fall.

The hearing in which Tavenner used the 7.3 million figure was called by Republicans to explore HealthCare.gov’s online security. The number wasn’t part of Tavenner’s written testimony, and no detailed data was released. When pressed by reporters afterward for more details, HHS aides stressed that it was a figure gathered from insurers.

Administration testimony — particularly to the highly controversial House Oversight Committee — typically goes through rounds of review inside HHS.

The source told POLITICO the figure Tavenner drew on for paid health plan enrollment is different than the data compiled by a separate division of HHS that utilizes health plan selection, meaning before payment. Those are the numbers that appeared in HHS’s detailed monthly accounts of 2014 enrollment, which broke out the dental plans clearly. The last of those reports was released in May, a few weeks after the sign-up season ended.

No updates occurred until Tavenner testified before Congress in September and provided the ill-fated 7.3 million figure. On Nov. 10, CMS again released another overall update but few other specifics.

Distinguishing between medical and dental plans “isn’t magic. It’s just tedious work,” said Kev Coleman, head of research and data at HealthPocket Inc., who reviewed plan identification numbers from enrollment files that federal officials released to the House Oversight Committee. “I was surprised that HHS could be confused, because it’s not like it’s overly complicated.”

Coleman added, “One would assume there’s going to be a post-mortem at HHS that identifies how this information got comingled when it wasn’t before.”

The administration source said those full files weren’t used to calculate the figure in Tavenner’s testimony; Issa’s office said they were made available to the committee on Nov. 6, two days after the midterm election.

The issue poses a challenge to Burwell’s credibility. Since becoming secretary in June, she has generally been well received by lawmakers on both sides of the aisle and praised for her transparency.

She responded swiftly and strongly Thursday. “This mistake was unacceptable,” Burwell wrote on Facebook. “I will be communicating that clearly throughout the department. While we understand some will be skeptical, our clarity that this is a mistake and the fact that we have quickly corrected the numbers should give people confidence.”

Shortly after the data discrepancy, reported first by Bloomberg News, became public on Thursday, HHS scheduled a conference call with Democratic allies on Capitol Hill.

Both supporters and detractors of the law agree it that the discrepancy increases skepticism at a critical time.

“The problem isn’t the numbers — whether they hit a target or not — the real problem is that this fosters a belief that [administration officials] are playing fast and loose with the facts, that they are not being upfront with the American people,” said Tevi Troy, a former HHS official under President George W. Bush and the president of the American Health Policy Institute. He added that “the Gruber story cemented that.”

Dan Mendelson, the CEO of Avalere Health who served in the Clinton administration, called it a self-inflicted wound.

“It feeds into the Gruber mania,” he said. “It defines the narrative of misleading the public. And that’s the problem with it.”

Burwell herself cited the Oct. 15 figure of 7.1 million during a Center for American Progress event earlier this month. In her speech there, she defended the administration’s efforts to be transparent on key ACA metrics. “With regard to the numbers … we want it to be accurate, we want it to be analytically based, and we want to move it as quickly as we can,” she said.

CMS reiterated Thursday that it stands by its goal of getting 9.1 million people in medical coverage next year.

In Troy’s view, partisans on both sides of Obamacare have had a misplaced obsession with hitting enrollment targets. “Getting over an artificial number doesn’t get you anything,” he said. “If nobody finds out, it doesn’t help that much, and if they do, it’s a disaster.”

Ron Pollack, executive director of Families USA, a close ally of the administration, labeled the latest controversy “the issue du jour” and said that Burwell and her management team “are truly committed to being as transparent as possible. I think we are going to be seeing more data than we’ve seen before.”

But Pollack also predicted ongoing efforts to shake public confidence in the law and the people who are implementing it.

“We’ll be talking about something different a month from now,” he said. “It will be designed to undermine the honesty and efficiency of the process. In the long run, I don’t think it will have much effect.”