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Even after the open enrollment deadline, HealthCare.gov remained a popular destination. (AP)

Federal Health Exchange Stays Busy After Open Enrollment Ends

by Charles Ornstein
Jul 23, 2014 (ProPublica)

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For months, journalists and politicians fixated on the number of people signing up for health insurance through the federal exchange created as part of the Affordable Care Act. It turned out that more than 5 million people signed up using HealthCare.gov by April 19.

But perhaps more surprising is that, according to federal data released Wednesday to ProPublica, there have been nearly 1 million transactions on the exchange since then. People are allowed to sign up and switch plans after certain life events, such as job changes, moves, the birth of a baby, marriages and divorces.

The volume of these transactions was a jolt even for those who have watched the rollout of the ACA most closely.

"That's higher than I would have expected," said Larry Levitt, senior vice president for special initiatives at the Kaiser Family Foundation. "There are a lot of people who qualify for special enrollment, but my assumption has been that few of them would actually sign up."

The impact of the new numbers isn't clear because the Obama administration has not released details of how many consumers failed to pay their premiums and thus were dropped by their health plans. All told, between the federal exchange and 14 state exchanges, more than 8 million people signed up for coverage by April 19. A big question is whether new members will offset attrition.

ProPublica requested data on the number of daily enrollment transactions on the federal exchange last year under the Freedom of Information Act because the Obama administration had declined to release this information, a key barometer of the exchange's performance, to the public. The administration also has not put out any data on the exchange's activity since the open enrollment period ended.

The data show so-called 834 transactions, which insurance companies and the government use to enroll new members, change a member's enrollment status or disenroll members. The data cover the 36 states using the federal exchange, which include Texas, Florida, Illinois, Georgia and Michigan.

When HealthCare.gov rolled out last fall, insurance companies complained that the information in the 834s was replete with errors, creating a crisis at the back-end of the system.

Between April 20 and July 15, the federal government reported sending 960,000 so-called 834 transactions to insurance companies (each report can cover more than one person in the same family). That includes 153,940 for the rest of April, 317,964 in May, 338,017 in June and 150,728 in the first 15 days of July. The daily rate has been fairly stable over this period.

It wasn't immediately clear how many of the records involved plan changes or cancellations and how many were for new enrollments.

An insurance industry official estimated that less than half of the transactions are new enrollments. The rest are changes: When an existing member makes a change to his or her policy, two 834s are created — one terminating the old plan and one opening the new one.

Charles Gaba, who runs the website acasignups.net that tracks enrollment numbers, estimates that between 6,000 and 7,000 people have signed up for coverage each day on the federal exchange after the official enrollment period ended. Gaba's predictions were remarkably accurate during the open enrollment period.

"That doesn't account for attrition. That doesn't mean that they paid," Gaba said. "That's been based on limited data from a half dozen of the smaller exchanges, extrapolated out nationally."

The federal data obtained by ProPublica confirm some other facts about the rollout of HealthCare.gov, which was hobbled initially by technical problems. The slowest day was Oct. 18, when no 834 transactions were sent. That was followed by Oct. 1, the day the website launched, when a grand total of six records were sent to insurers.

By contrast, the busiest day was March 31, which was supposed to be the end of open enrollment, when 202,626 of the so-called 834 reports were sent to insurers. The entire last week in March was busy.

About 86 percent of those who signed up for coverage on the federal exchange were eligible to receive government subsidies to help lower their monthly premiums. Those subsidies are being challenged by lawsuits in federal court contending they aren't allowed by the Affordable Care Act.

Two federal appeals courts came to conflicting decisions Tuesday on the permissibility of the subsidies (one said yes; the other no). They will remain in effect as the cases proceed in the courts, the Obama administration said.

The next time that the general public can sign up for coverage through the exchanges is from November 15 to February 15, 2015.

Click here to download the data released to ProPublica under the Freedom of Information Act.

Read ProPublica's previous coverage of the Affordable Care Act and share your story.

ProPublica is an independent, nonprofit newsroom that produces investigative journalism in the public interest.

Copyright 2014 ProPublica. To see more, visit http://www.propublica.org/.

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Jorge Drexler's new album, Bailar en la Cueva, ventures into new territory for him: dance rhythms. (Courtesy of the artist)

Finding The Anthropology In Latin Dance Music

by Betto Arcos
Jul 23, 2014 (All Things Considered / ProPublica)

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Jorge Drexler's songs have been called introspective and literate. He's been compared to Paul Simon. But a couple years ago, the Uruguayan musician began to wonder what it would take to write dance-oriented music. That's the assignment he gave himself on his latest album, Bailar en la Cueva, or "dancing in the cave."

"I decided to start this record from the feet and from the movement centers in the body," Drexler says. The idea, he explains, was to shift focus "away from what was easy for me, writing from and about emotions, and from and about ideas — and move to the feet."

Drexler broke in to the US market in 2004, after a song he wrote for the movie The Motorcycle Diaries became the first Spanish-language work to win an Oscar for Best Original Song. He says that adding a dance beat doesn't have to mean abandoning the scholarly qualities of his music.

"If I'm going to talk about dancing, I'm going to try to look at a very deep and emotional and anthropological, even biological side, of it," he says. "What it means, music and dancing, for us, as a species."

Drexler is not your ordinary songwriter: He's an ear, nose and throat doctor who didn't launch a music career until he was 30. The awe he felt learning about the laws of science and the natural world still finds its way into tracks like "Todo Cae." In the song, whose title translates to "everything falls," love is so powerful it can defeat gravity and entropy.

"That awe [is what] I try to bring into songs, the awe at the perception and the contemplation of life and existence I feel through basic science," he says. "The only thing that I studied carefully in my life was music and medicine, especially the basic sciences like biology, chemistry and physics. And so I can't help but looking at the world from that point of view."

Drexler's parents were both doctors. His grandparents were German Jews who escaped the Nazis in 1939, taking political asylum at the Bolivian Embassy in Berlin.

"And Bolivia was incredibly brave and generous," Drexler says. "They kept on giving visas to German Jews and they saved a lot of people. So my grandparents, very young, with a 4-year-old boy that was my father, had to leave Berlin and went to live in Oruro."

Josh Kun, a professor at the University of Southern California Annenberg School for communication and journalism, says Drexler represents something rare: a contemporary singer-songwriter in touch with the cultural politics of memory.

"He is somebody who [has] lived and felt and experienced the violences of movement and migration in his own family, and also the power of memory to make sense of the past," Kun says. "And then he has a gift of connecting those personal relationships to memory, to larger, social and cultural memories. And he somehow manages to do that, usually, in a space of a love song, where he can take something very minute and turn it into a much larger commentary about memory that is personal and historical.

For Drexler, history is very much a part of the present, and so is movement. He says people dancing around the fire in a cave, 45,000 years ago, are not that different from people dancing in a 21st-century club.

"There must be something in common in the two situations, the deep reasons why we keep on doing that. We keep on getting together and dancing in closed places," he says. "Every generation thinks that they invented 'party,' and it's actually been with us since we came down from the trees."

As the title track of Bailar en la Cueva says, "We used to make music, long before we knew about agriculture. The idea is eternally new: as night falls, we continue to dance in the cave."

Copyright 2014 NPR. To see more, visit http://www.npr.org/.

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Jorge Drexler's new album, Bailar en la Cueva, ventures into new territory for him: dance rhythms. (Courtesy of the artist)

Confusion With A Chance Of Clarity: Your Weather Questions, Answered

Jul 23, 2014 (All Things Considered / ProPublica)

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Many listeners and readers felt a concise explanation of "a 20 percent chance of rain" was missing from this story, so we followed up with two meteorologists.

From Meterologist Eli Jacks, of the National Oceanic and Atmospheric Administration's National Weather Service:

"There's a 20 percent chance that at least 100th of an inch of rain — and we call that measurable amounts of rain — will fall at any specific point in a forecast area."

From Jason Samenow, chief meteorologist with The Washington Post's Capital Weather Gang:

"It simply means for any locations for which the 20 percent chance of rain applies, measurable rain (more than a trace) would be expected to fall in two of every 10 weather situations like it."

Copyright 2014 NPR. To see more, visit http://www.npr.org/.

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Jorge Drexler's new album, Bailar en la Cueva, ventures into new territory for him: dance rhythms. (Courtesy of the artist)

'Tahrir Harassment' Trials End In Sexual Assault Convictions

Jul 23, 2014 (All Things Considered / ProPublica)

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Sexual assault convictions have been handed down to some Egyptian men, after several women were attacked during celebrations for incoming President Abdel Fattah el-Sisi. Audie Cornish speaks with freelance journalist Nadine Marroushi about the verdicts.

Copyright 2014 NPR. To see more, visit http://www.npr.org/.

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Copyright(c) 2014, NPR
Jorge Drexler's new album, Bailar en la Cueva, ventures into new territory for him: dance rhythms. (Courtesy of the artist)

N.Y. Man's Death Prompts Police Introspection On Use Of Force

Jul 23, 2014 (All Things Considered / ProPublica)

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Funeral services are being held for Eric Garner, a New York City man who died in police custody last week in Staten Island. A video of the incident shows one officer using an apparent chokehold on Garner before he died. The incident is prompting the New York Police Department to rethink how it trains all its officers in the use of force.

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