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.