Skip to main content

The context you need, when you need it

When news breaks, you need to understand what actually matters — and what to do about it. At Vox, our mission to help you make sense of the world has never been more vital. But we can’t do it on our own.

We rely on readers like you to fund our journalism. Will you support our work and become a Vox Member today?

Join now

How the Obamacare agency will address its enrollment number screw-up

Chip Somodevilla/Getty Images

In the wake of news that the Obama administration wrongly overcounted Obamacare enrollment numbers, Health and Human Services Secretary Sylvia Burwell has sent her senior staff an email calling the incident an “unacceptable mistake” and directing them to convene a series of meetings on how to increase transparency at the agency.

“I am asking each of you to schedule a staff meeting to ask for suggestions to strengthen this culture of increased transparency, ownership, and accountability, and for those suggestions to be reported back to me,” Burwell wrote in a Sunday night email, provided by a source at Health and Human Services who asked for anonymity to share internal communications. “I will convene a senior leadership meeting to hear and discuss those suggestions.”

You can read the full email below. HHS spokesperson Kevin Griffis says that the agency is still "in the process of finding out precisely what happened" with the wrong count. Jonathan Cohn published Thursday what is the most detailed account the Obama administration has given of how it thinks the error — in which 400,000 dental plans were wrongly included in the total enrollment figure — happened:

Administration officials told me that, during the spring, they used an internal system for tracking how many people were shopping and selecting new insurance plans. That system distinguished between health and dental policies, and didn’t count the latter towards the sign-up totals. But, as you may recall, that data didn’t provide a critical piece of information: How many people were actually paying for their plans. To get that information, HHS got information directly from insurers and used it to produce the autumn numbers. When they did so, they didn’t think to break out dental plans—and ended up including them accidentally.

Not everyone believes this story; House Republicans charge that the Obama administration intentionally included the dental numbers so they would stay above 7 million sign-ups, the Congressional Budget Office projection for enrollment in 2014.

Those arguments will likely get a fuller hearing on December 9, when the House Committee on Government Reform and Oversight has asked Medicare Administrator Marilyn Tavenner to testify about the issue at a hearing that will focus on Obamacare and transparency.

Here’s Burwell’s full email:

Colleagues,

As you know, our Department made a mistake in the way it reported effectuated enrollment numbers in the Health Insurance Marketplace. Individuals with both Marketplace medical and dental coverage were erroneously counted. Those with stand-alone dental plans should not have been included.

The work we are doing around the Affordable Care Act is about helping more Americans obtain the security and peace-of-mind of quality, affordable health coverage. That is our focus and what the American people want us to do.

Let me be clear: this mistake was unacceptable. One of our most important obligations to the American people is to report information and data accurately. We are working quickly to understand what happened and to improve our processes in order to prevent similar mistakes from occurring again.

I believe strongly that a hallmark of effective leadership and management is instilling a culture of transparency, ownership and accountability. As leaders, we all must have a sense of urgency in promoting these cultural values.

As an initial step, I am asking each of you to schedule a staff meeting to ask for suggestions to strengthen this culture of increased transparency, ownership, and accountability, and for those suggestions to be reported back to me. I will convene a senior leadership meeting to hear and discuss those suggestions.

As public servants, we must constantly work to earn the trust of those we serve. That trust is built on our commitment to transparency, ownership, accountability, and accuracy, and being forthcoming about where we can do better.

I appreciate all the hard work going on every day across the Department. Every day this Department delivers impact for the American people, and every day we are going to work together to be better at doing that.

Thank you for your continued commitment to our effort and to our work together. I look forward to hearing from you and following up on these issues.

Sincerely,

Sylvia M. Burwell

More in Health Care

Good Medicine
The alcohol crisis quietly hitting high-stress, “high-status” workersThe alcohol crisis quietly hitting high-stress, “high-status” workers
Good Medicine

What The Pitt can teach us about addiction.

By Dylan Scott
The End of HIV
The 45-year fight against HIV is one of humanity’s greatest victories. It’s also in danger.The 45-year fight against HIV is one of humanity’s greatest victories. It’s also in danger.
The End of HIV

We have the tools to end the virus. The question is whether we’ll abandon them.

By Bryan Walsh
The Highlight
The elder care solution that everyone with aging parents should know aboutThe elder care solution that everyone with aging parents should know about
The Highlight

As baby boomers age, caregivers are often squeezed caring for parents and children at the same time. They need help.

By Courtney E. Martin
Good Medicine
The cocaine comeback, explainedThe cocaine comeback, explained
Good Medicine

The next phase of America’s drug crisis is here.

By Dylan Scott
Future Perfect
The world’s deadliest infectious disease is on the rise in the USThe world’s deadliest infectious disease is on the rise in the US
Future Perfect

We discovered its cause 144 years ago. It’s still a massive problem.

By Shayna Korol
Good Medicine
How to talk to your doctor about moneyHow to talk to your doctor about money
Good Medicine

Health care in America is too expensive. But you can make your physician your ally.

By Dylan Scott