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shifting the goalposts
Now We'll Never Know Whether Obamacare Worked

As if it weren’t hard enough to assess the health of Obamacare, the Census Bureau has just muddied the waters still further. The law stands or falls politically on whether it reduces the number of uninsured, and the annual census is the best source we have for that data. As the NYT reported yesterday, the 2013 census will ask very different questions about insurance that will yield a lower number of uninsured. Under the previous system, a person is “uninsured” if he or she has lacked coverage for a year or longer. But many tend to respond that they are “uninsured” even if they recently had insurance or expect to get it again soon. The new survey will ask more detailed questions that track the respondent’s insured status over the course of several months.

So starting with the 2013 census we’ll see a drop in the uninsured that has nothing to do with any reform measures—only with how these census questions have changed. We therefore won’t be able to accurately compare new data to that of previous years.

At first glance it looks like the changes amount to cooking the books to make Obamacare appear more successful. But 2013 was the year before the Affordable Care Act’s insurance expansion took place, so there will at least be some kind of pre-Obamacare baseline to compare the 2014 census data to when it comes out in 2015.

That doesn’t entirely clear things up, however. An accurate picture of the law’s impact would require data from multiple years, as Megan McArdle points out:

Sarah Kliff of Vox says we shouldn’t freak out, because these are the numbers that the census collects for 2013, so the change is actually giving us a good baseline. But I’m afraid I’m not so sanguine. As Aaron Carroll says: “It’s actually helpful to have a trend to measure, not a pre-post 2013/2014. This still sucks.”

The new numbers will suffer, to some extent, from the same bias that the old questions suffered from: People are better at remembering recent events than later ones. […]

And what has been happening in the most recent months? A whole lot of change! Policies were canceled, benefits changed, people shifted around their coverage in anticipation of the new law. That doesn’t make for a very good baseline. It will be a very good measure of who has insurance right now, in 2014, but it’s not where I’d want to start my 2013 baseline for our new law. That’s why they should have done this for 2012 — or waited until 2016 — to give us actual comparable data for the transition period.

Without holding the census questions constant from 2012 to 2015, it will be nearly impossible to measure the overall effect of the law on the uninsured population. Whether intentionally or not, the Obama administration has graduated from delaying various mandates in order push a reckoning over Obamacare past the midterms. It has now found a way to push back that reckoning indefinitely.

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  • mesquito


    • Jim__L


      • Curious Mayhem

        Of course.

  • gabrielsyme

    Whether intentionally or not, the Obama administration has graduated
    from delaying various mandates in order push a reckoning over Obamacare
    past the midterms.

    The Obama administration may be incompetant about many things, but few have ever accused them of being less than exceptional at tampering with the rules for political gain. A more dishonest White House has not been seen since at least Nixon.

    • Pete

      Richard Nixon was a saint compared to B. Hussein Obama. Fact.

      • Andrew Allison

        Pete,my fist thought was you were overstating the case, but then I realized that Nixon lied about Watergate whilst Obama lies about almost everything. His support of Sharpton was the final straw for me. The man’s racist, and there’s all there is to it.

  • Curious Mayhem

    It’s not “shifting the goal posts.” It’s “removing the goal posts altogether and making sure no one can put any in.”

    Watch the complicity of the hack news media, formerly known as “reporters” and “journalists.”

  • Andrew Allison

    If there’s still an adult present, pease point out to the kiddy-winks that it’s 2014. Given what we know about the gross politicization of the Administrative Branch, under the Obama maladministration, just how is the latest fudging on the part of the Census Bureau newsworthy. The effect of the ACA can be measured rather simply: the cost to the insured for their coverage and the cost to the taxpayer for the difference.

  • Andrew Allison

    Yes we will. However our current maladministration manipulates the the numbers, at the end of the day it’s about the net increase in those insured, the cost of their insurance, and the cost to the taxpayer of the difference.

    • mgoodfel

      Three possible ACA criteria 1) does it improve health. 2) does it cut costs. 3) do people like it?

      1) no, because expensive high-tech health care doesn’t have much effect on longevity. It’s the cheaper stuff like public health measures, prenatal care, primary care, and of course lifestyle that matter.

      2) no, because the government would have to say “no” to the entire health care system and all the dependent taxpayers. We’ll see if small provider networks and high deductibles last. I doubt it. See the “Doc Fix”.

      3) no, because it will be crappy care, high deductible bills, limited choice of doctors, and lots of waiting for the doctors available. The British NHS experience, but twice as expensive.

      The web site fiasco got all the attention, but it was never important.

  • qet

    This is just the latest example in a long list demonstrating that the idea of “evidence-based” policy making, which phrase is regularly incanted as a mantra by self-proclaimed wonks and even by people who ought to know better, is unsound, to be charitable. All of the so-called evidence is unreliable. The change in Census technique; the inability of people and institutions simply to count the number of ACA enrollees; the constant significant inaccuracy of government cost projections for its policies; outright fraud in reporting certain statistics near an election. People in this country–people who ought to know better–constantly confuse valid reasoning with sound reasoning. The former is merely a method, while the latter depends on true premises. The reasoning of all our policy wonks and mavens is unsound because the premises are almost never correct, and we have no reliable means for determining which premises are correct. And yet many of us still go around crowing that we are for evidence-based policy. We should not wonder at the sorry state we are in.

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