Bloomberg News
For several months now, whenever the topic of enrollment in the Affordable Care Act came up, I've been saying that it was too soon to tell its ultimate effects. We don't know how many people have paid for their new insurance policies, or how many of those who bought policies were previously uninsured. For that, I said, we will have to wait for Census Bureau data, which offer the best assessment of the insurance status of the whole population. Other surveys are available, but the samples are smaller, so they're not as good; the census is the gold standard. Unfortunately, as I invariably noted, these data won't be available until 2015.
I stand corrected: These data won't be available at all. Ever.
No, I'm not kidding. I wish I was. The New York Times reports that the Obama administration has changed the survey so that we cannot directly compare the numbers on the uninsured over time.
I'm speechless. Shocked. Stunned. Horrified. Befuddled. Aghast, appalled, thunderstruck, perplexed, baffled, bewildered and dumbfounded. It's not that I am opposed to the changes: Everyone understands that the census reports probably overstate the true number of the uninsured, because the number they report is supposed to be "people who lacked insurance for the entire previous year," but people tend to answer with their insurance status right now.
But why, dear God, oh, why, would you change it in the one year in the entire history of the republic that it is most important for policymakers, researchers and voters to be able to compare the number of uninsured to those in prior years? The answers would seem to range from "total incompetence on the part of every level of this administration" to something worse.
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. Quick: On what day did you last get your oil changed? What month was the wedding you attended last summer? If it was in the last few months, you probably know. If it was someone you're not that close to . well, the summer months kind of blend into each other now that you're a grownup, don't they?