Health and Science

Cat got your tongue, HealthCare.gov? Obamacare's secrets

California's done it, Kentucky's done it, Minnesota's done it, and even Massachusetts somehow manages to do it every day, for goodness' sake.

Yet HealthCare.gov isn't doing it—at least not for now.

A week into open enrollment for Obamacare, that federal exchange serving 37 states has still not revealed how many new customers are selecting health plans for 2015, how many existing customers are renewing and how many applications for eligibility have been completed. While the agency that oversees Obamacare is now promising monthly updates, some advocates want more frequent data disclosures.

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A number of state-run Obamacare exchanges have disclosed just that sort of information, to varying degrees, raising questions of why HealthCare.gov doesn't follow suit.

Those questions became more pressing Thursday when the Obama administration, in an embarrassing admission, confirmed that it had included nearly 400,000 dental insurance plans in tallies of existing Obamacare health plan enrollments nationwide.

The cavity left from extracting those dental enrollments meant that actual Obamacare enrollments have been just below 7 million since September.

That number is significant because then-Health and Human Services Secretary Kathleen Sebelius said in 2013 that success for Obamacare's first open-enrollment season would be signing up 7 million people by April 2014. Ever since, Republican opponents of the Affordable Care Act have repeatedly questioned the accuracy of official Obamacare tallies.

Enrollment data everywhere--except from HealthCare.gov

Technicians and managers monitor the performance of the Massachusetts Health Connector website, the state's health insurance website under the Affordable Care Act, during the open enrollment period in Boston, November 17, 2014.
Brian Snyder | Reuters

On Sunday, current HHS Secretary Sylvia Mathew Burwell said 100,000 people filled out applications for insurance coverage in the first two days of the new open-enrollment season, which began Saturday.

Burwell did not say how many people selected plans.

Nor has HHS disclosed any application, plan selection or plan renewal data since then. That's made it impossible for analysts and the media to track how well open-enrollment efforts have been going in most of the United States.

In contrast, states have disclosed the type of information the federal government has not. Massachusetts has been posting daily updates on its "Open Enrollment 2015 Dashboard."

That dashboard not only details exactly how many people were determined eligible for health coverage, it also gives breakdowns of how many people were found eligible for Obamacare plans, how many of them qualified for federal subsidies to help buy those plans, and how many people are eligible for Massachusetts' Medicaid program. And the dashboard reveals website performance metrics and call center volumes.

The state also is releasing, every Monday, tallies on how many people selected an Obamacare plan.

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Massachusetts' level of disclosure is striking, because the state's exchange was one of the worst-performing during the first open enrollment due to serious technological problems. The old exchange platform was scrapped and replaced with a new one.

Exchange spokesman Jason Lefferts said, "This is just part of our ongoing effort to be as transparent as possible about the system," when he was asked why the marketplace is giving such detailed daily reports.

On Thursday, Covered California, that state's own exchange, released data showing that nearly 36,000 people were deemed eligible for individual coverage as of Tuesday, and that 11,357 people had selected a plan.

California's exchange also revealed that more than 33,330 people had been deemed likely eligible for Medicaid, and disclosed the number of unique visitors on its website in the first four days.

On Monday, Kentucky's exchange, kynect, gave a detailed breakdown of the amount of visitors, new accounts created, applications submitted, new plan selections and old plan renewals, Medicaid enrollments, dental plan enrollments, and calls to the exchange's contact center.

KY, CT release figures, so why not CMS?

Obamacare enrollment mistake
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Obamacare enrollment mistake

The exchange even released the exact number of people who "have visited the new kynect store at Fayette Mall in Lexington" and how many completed applications for new coverage there—1,197 and 173, respectively.

Kynect spokeswoman Jill Midkiff said the exchange's system "was programmed to produce on-demand reports that make enrollment statistics relatively easy to compile."

"All these metrics help us identify when we may need to make adjustments to our system or processes, such as expanding outreach in a particular area of the state, increasing server capacity or adding phone lines at the contact center," Midkiff said.

On Friday, Connecticut's exchange released tallies of how many new Obamacare and Medicaid sign-ups have been handled, as Minnesota's which promised weekly updates from now on. And Vermont exchange officials disclosed Wednesday that 600 new applications had been made on the site, which also had processed more than 3,000 renewals. Colorado's exchange has said it will release enrollment day bi-weekly, and Connecticut is considering doing the same.

As of Friday, however, HealthCare.gov had released no such metrics.

A spokesman for the Centers for Medicare and Medicaid Services, which operates HealthCare.gov, had no immediate comment when asked if CMS will immediately release ongoing open-enrollment statistics as a number of states have done, and why that information has not been released so far.

The spokesman said CMS will be releasing enrollment information on a monthly basis, as it did during the first open enrollment season.

However, even if it does such updates, it's not clear that CMS will be as forthcoming with other information the media has sought about Obamacare data. CMS did not do detailed enrollment updates between April and Novemberthe so-called special enrollment period when people with qualifying life events such as marriages, divorces, job losses, moves out of state, and the births of children are allowed to enroll in insurance plans.

Last week, CNBC and the Wall Street Journal separately asked CMS how many people had enrolled in Obamacare plans during the special enrollment period. CMS told both outlets it would get back to them on that question, but has yet to give an answer. In August, CNBC reported that at least 11 state-run exchanges either released special enrollment tallies on their own or would share that data when asked.

CMS also has failed to release a breakdown of how many people were enrolled in plans sold by each insurer on the exchanges, which could reveal those companies' individual market share.

Charles Gaba, a Michigan-based website developer, last fall launched ACASignups.net, a site that tracks and projects Obamacare enrollments because CMS was not releasing data as often as some states were doing. Gaba's site since has been closely watched by health-care reporters, particularly since his projections have closely mirrored officially released numbers.

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Gaba said CMS should do more frequent updates because of the significance of Obamacare, both politically and in terms of giving uninsured people health coverage.

"It's an important law that impacts a lot of people, and as a supporter I feel it's important to track the first few years," he said.

Gaba said that with nearly a week gone by in this open enrollment season, CMS "should be able . . . to give a number from at least the opening weekend" of how many people selected insurance plans. He also said HealthCare.gov should be releasing a summary of enrollment data each week.

Gaba said that CMS did so, "It would actually put me out of business."