Health and Science

Is Obamacare signing up the uninsured? It's a tough call

The main goal of President Barack Obama's Affordable Care Act is to give uninsured Americans access to health insurance. Yet, the Obama administration has refused to reveal how many people who've signed up were, in fact, previously uninsured.

It turns out, it's not necessarily that the officials don't want to. It's that they can't—because they're not asking applicants the question.

A man enrolls in a health insurance plan under the Affordable Care Act in Miami.
Getty Images

Enrollees on the federal marketplace and most of the 15 state exchanges are never asked about their current or previous insurance status.

All applicants who are seeking subsidies must answer questions about future access to insurance, but they are not asked about prior or current coverage.

Of the 12 state exchanges that answered CNBC's request for information, only Kentucky and New York require enrollees to disclose whether they were previously insured. California, Colorado and Connecticut make the question optional, but did not have information on how many respond.

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"A lot of people could have anticipated this is a question everyone would be asking," said Rachel Garfield, a senior researcher at the Kaiser Family Foundation. But, "the application is really designed to get people into coverage. The question people are asking is more of a research and evaluation question. If I had to guess, I'd say they were just focused on what do we absolutely need to know to get people signed up."

According to the Census Bureau, 48 million Americans were uninsured in 2012. So, will the government ever be able to tell us how many of them obtained insurance in this first enrollment period, which ends in 10 days?

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"We are a looking at a range of data sources to determine how many marketplace enrollees previously had coverage," federal CMS spokesman Aaron Albright told CNBC. "The marketplace application asks applicants only if they are looking to apply for coverage, not whether the consumer currently has coverage. Previous insurance coverage is an important metric, and we hope to have additional information in the future."

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Those sources likely include Census Bureau and Centers for Disease Control and Prevention data, which are collected every year. Garfield said much of the data likely won't be available until winter 2015.

In the meantime, public and private entities are conducting their own surveys to get an idea of who's signing up. Garfield said this is a valid way of getting reliable numbers, but it's challenging because most of the general population is not experiencing changes in coverage through the law right now.

Of course, only the government and insurance companies have access to lists of people who have signed up and are the only ones able to limit a survey to that group.

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About 5 million people overall had enrolled in ACA plans as of March 17, according to the Centers for Medicare and Medicaid Services (CMS).

Critics have suggested most of them had insurance before, but had to buy new plans because their old ones were not compliant with the new law.

The Obama administration has touted a recent Gallup poll that found the rate of uninsured Americans dropping to 15.2 percent in Februarythe lowest rate since 2008.

But McKinsey, a leading management consulting firm, polled about 2,100 exchange-eligible Americans in February, and found only 27 percent of people who had picked a plan were previously uninsured. Only 53 percent of them had paid their first premium, compared with 86 percent of the previously insured. With 5 million total enrollments, that would be about 715,500 previously uninsured Americans who had chosen and paid for new insurance.

It's also been hard to get a handle on how many previously uninsured people have gained coverage through Medicaid expansion in the states that chose to offer it.

The House Energy and Commerce Committee has held numerous hearings on the Obamacare implementation. Chairman Fred Upton has been a vocal critic.

"It's bad enough that the administration has repeatedly moved the goalposts and attempted to redefine what success means for the president's health care law. But the fact that they are deliberately avoiding the threshold measurement of how many of the law's new enrollees were previously uninsured begs the question: what was the goal?" the Michigan Republican said in a statement to CNBC.

By CNBC's Jodi Gralnick. Follow her on Twitter @jodigralnick.