The U.S. Census Bureau set of a mild firestorm in the health policy field on Tuesday after revealing to The New York Times that it was planning to execute a complete overhaul of the way that it measures health insurance coverage in the U.S.
The new version of the decades-old survey is designed to get a better read on the number of uninsured people in the country, and is expected to produce results showing the rate as lower, in general, than the old report. The Times reported that the bureau was changing the survey so dramatically, “that it will be difficult to measure the effects of President Obama’s health care law in the next report, due this fall.”
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The combination of lower rates of uninsured people and the inability to compare numbers before and after the implementation of Obamacare set off an immediate reaction, not just from the administration’s political opponents, but from health policy researchers and reporters who see the Census data as vital to understanding the impact of the Affordable Care Act.
The National Republican Congressional Committee took to Twitter to ask whether the administration was “politicizing the Census Bureau to protect Democrats.” Influential Republican commentators piled on, pointing out that the agency was basically admitting that it had been overstating the number of uninsured for years while Democrats pushed for healthcare reform, and would suddenly start using a more accurate measure once the Democrats’ plan had been implemented.
Even people normally sympathetic to the administration were upset by the move. Economist Justin Wolfers, a senior fellow at the Brookings Institution, wrote, “Creating a series break is always a bad idea, and creating one in health insurance data right now is dumb."
However, additional reporting later indicated that the impact of the survey change might not be quite as large as the Times report originally suggested.
According to Vox.com, a “senior administration official” confirmed that the change will be in effect when the survey is conducted this month. However, this month’s survey is meant to measure the years 2013. That means the new survey will contain data for one year prior to the implementation of the ACA. Hardly ideal, as even the Census Bureau recognizes, according to a document obtained by The Times. It says, “Ideally, the redesign would have had at least a few years to gather base line and trend data.”
The changes will limit the data’s usefulness for long-term historical comparisons, but at least there will be a one-year apples-to-apples comparison of life before and after the ACA’s implementation.
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