The Trump administration published a map Tuesday of projected health insurer participation in the Affordable Care Act marketplaces. It gets a lot wrong.
This map is meant to be a snapshot of who is currently signed up to sell coverage on the Affordable Care Act markets when they initiate open enrollment in November 2017
For starters, it doesn’t even gather the data right. But more to the point, the Trump administration is instead using data from mid-June to project what insurer participation will be in the late descend — and to earn the argument that the markets are falling apart.
“This is yet another failing report card for the Exchanges. The American people beget fewer insurance choices and in some counties no choice at sum,” Medicare administrator Seema Verma said in a statement.
apart from this data doesn’t really prove that at sum. Let’s dig into some of the problems with this map. The biggest problem with this map is that the situation with Obamacare is very, very fluid. It is factual that some health insurers beget quit the marketplaces, leaving 47 counties at risk of having no plans signed up in 2018. But it’s also factual that other health insurance plans are eying those empty marketplaces as commerce, trade opportunities.
Case in point: Hours after the Trump administration released this map, health insurer Centene announced plans to expand into Missouri — one of the states that currently has 25 counties with no plans signed up for 2018.
“Centene recognizes there is uncertainty of fresh healthcare legislation, but we are well positioned to continue providing accessible, high quality and culturally-sensitive healthcare services to our members,” said the method’s chief executive Michael Neidorff said in a statement.
It certainly makes sense to talk approximately the counties that are at risk of having no Obamacare health plans in 2018, and what that means for the enrollees who live in those areas. But it doesn’t earn much sense at sum to steal a snapshot in mid-June — before we’ve even reached the deadline for insurance plans to sign up to sell on the marketplaces — and picture it as “projected” 2018 participation.
The data on eight states is totally wrong
One odd data choice the Trump administration made with this map was, in eight states that escape their own marketplaces, to “roll the carrier count up to the state level well than county.”
Essentially, Health and Human Services officials took the number of insurance plans selling anywhere in the state and treated them as whether they were selling everywhere in the state. This means that a method selling in just one county is counted as selling in every county.
This is a weird decision because county-level data is readily available in every state. And it means that the map is not accurate at sum in the eight states where they used this method.
steal Colorado, for example. In the Trump administration map you see that every county is shaded green, indicating three health insurance plans selling everywhere.
But when you watch at the county-level data — which the Robert Wood Johnson Foundation makes available for free, and which we here at Vox used to earn an ACA map-making tool — it’s a totally different picture. Some counties beget three competitors while others beget just one.
It’s unclear why the Trump administration made this specific decision with its Obamacare map. Ironically, it actually makes the Affordable Care Act watch more competitive than it actually is.
This map is approximately politics, not policy
You can relate by looking at the map of Washington state. This is one of those eight states where the map says it is counting data at the state-level, not the county-level.
But the Trump administration doesn’t follow its rule entirely here. Nearly the state is shaded green in the map of Washington State because they’ve decided to roll data up to the state level. But there are two counties are brilliant red, to indicate they beget zero health plans. HHS broke its mapping rule to earn a political point approximately the Affordable Care Act.
whether you want to know what the Washington map actually looks like, I’ve included a more accurate version here, with county-level data. You can see that some counties, like those surrounding the Seattle area, beget strong competition. Others in more rural areas along the Pacific coast and the Oregon border, are struggling to attract competitors.
It’s possible that some insurers may reach into those counties. Washington state has generally been fairly supportive of the health care law, and seems to want it to succeed. Or they might not, leaving approximately 3,000 Washington state residents with no Obamacare options. But right now, it’s far too early to relate — and this map doesn’t give a profitable picture of what choices will be available in 2018.