Parsing the Obamacare Debate

Are companies warming to the state exchanges?
A change in Census data will provide a different picture of Americans' heath insurance. Photographer: Joe Raedle/Getty Images

Today, the biggest news about the Affordable Care Act probably is a Politico story that says insurance companies are becoming exchange optimists. It's too early to predict, but it looks as though both large and smaller insurers are going to be more likely to jump into state exchanges than to leave them. That's huge. The whole idea of the exchanges is to deliver the advantages of market mechanisms that were largely unavailable pre-reform. If this pans out, it would help bring down prices and encourage better insurance products.

Meanwhile, a lot of buzz is being generated by aCensus Bureau plan to change the way it conducts its survey on health insurance, a change that will make it harder to make pre- and post-Obamacare comparisons. Sarah Kliff has more. And Jonathan Cohn explains the Census's move in the context of all the ways the government assesses who has health care and who doesn't (the change affects only one of those methods, so we should be careful not to overstate its importance). My favorite take on this is Kevin Drum's conclusion that the Census change is likely to give plenty of grist for Fox News conspiracy theorists:

It doesn't matter if it's almost certainly bureaucratic inertia at work here, not political skullduggery. The Fox News set is going to have a field day with this. The feds are unskewing their own numbers! Probably on direct orders from the White House! I expect Darrell Issa to commence hearings next week.

Nonetheless, the first item on the Census story over at National Review's The Corneris factual and level-headed. So who knows? The first rule of Fox "scandals" is that their relationship to facts is irrelevant. The biggest problem with Fox (and, more seriously, with the clown show being put on by House Oversight Committee Chairman Darrell Issa ) is that real Obama administration malfeasance may well be going unexplored because those stories don't fit their purposes.

Good measurement, including before-and-after data, is important not just for political gamesmanship, but more critically to get the policy right. Even so, if the old numbers were worthless (or of limited value), then perhaps the switch is the least-bad choice. Or maybe not; only real expertise could provide the answer.

In any case, while the Census numbers are important, insurer behavior is going to be the biggest test of the exchanges.

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