Fact Checker: Was it really 35% of young enrolled in health care?
"Thirty-five percent of people who enrolled through the federal marketplace are under the age of 35."-- President Barack Obama, news conference, April 17, 2014
While on break earlier in the month, The Fact Checker managed to pass a TV set that aired images of the president's announcement on April 17 that 8 million people had signed up for health insurance on the Affordable Care Act exchanges. A headline in the TV news ticker amplified the president's message that 35 percent of the enrollees were younger than 35.
Why is that important? The "young invincibles" are considered a key to the health law's success because they are healthier and won't require as much health care as older Americans. If the proportion of young and old enrollees was out of whack, insurance companies might feel compelled to boost premiums, which some analysts feared would lead to a cycle of even fewer younger adults and higher premiums.
But some readers cried foul, saying the president highlighted a misleading number in his news conference. The young invincibles are between the ages of 18 and 34 - and as White House "fact sheet" acknowledged, that figure is 28 percent. The 35 percent figures includes children under the age of 18.
So what's going on here?
Last summer, in background briefings for the media, the administration set an ambitious goal: 40 percent of the enrollees would be between the ages of 18 and 34. That added up to 2.7 million of the anticipated 7 million enrollees.
But the early numbers for Affordable Care Act were a bit grim, as reporters homed in on the percentage of enrollees between 18 and 34. In February, as the percentage edged up from 24 percent to 27 percent, Health and Human Services Secretary Kathleen Sebelius touted what she called a "65 percent rate of growth." (She was counting the increase in the raw number of young-invincible enrollees.) But the percentage stayed stuck at 27 percent in March.
So you can see why there might be some excitement about a figure of 35 percent, as it sounded rather close to the original 40 percent goal. Indeed, the 35 percent figure was first spread a few hours before the president's remarks by state insurance commissioners, who had met privately with the president at the White House.
"They shared the 35 percent under 35, but no details on that number, and they did not disclose the 18-34 (28 percent) figure during the meeting," said an official with the National Association of Insurance Commissioners.
In other words, the stage was set for reporters to zero in on the under-35 number when the president cited it at the start of his news conference.
Here are some media accounts from that day:
Amy Robach, ABC News: "Eight million people have now signed up for Obamacare. That's 1 million more than projected. And 35 percent of the new enrollees are under age 35, and that's just shy of the administration's goal of 40 percent."
Scott Horsely, NPR: "The president said today that of those who signed up on the federal exchange - not the state exchanges, but the federal exchange - 35 percent were under the age of 35."
Ari Melber, MSNBC: "The Kaiser Family Foundation in 2013 estimated that more than a third of the enrollments should be between 18 and 34 years old for these types of plans to succeed. Again today, the president was able to announce, 35 percent of enrollees are under 35."
John Berman, CNN: "Eight million people have now signed up for private health insurance under the affordable care act. Those new White House numbers, 35 percent of those enrolled, the White House says are people under 35."
Now, to be fair, the more relevant number of 28 percent was in the White House fact sheet, and many of the news reports for the Friday print editions eventually got it correct.
Many White House officials also retweeted the news that the 28 percent figure matched the 28.3 percent figure achieved by the Massachusetts health plan (i.e., "Romneycare") in 2007, its first year.
Jon Gruber, an MIT professor who was the source of the Massachusetts figure, said that there is no equivalent 0-18 figure for the Massachusetts plan because it is only for adults. The Massachusetts plan achieved 35 percent in 2008 and 34 percent in 2009, Gruber said.
The White House declined to provide an official response.
The Fact Checker has dealt with White House press operations since the presidency of Ronald Reagan. Every White House likes to have its cake and eat it, too.
In this case, officials were able to put into circulation a really good number, without context, via the state insurance commissioners. That's the number the president highlighted in his news conference. By the time reporters realized that the relevant number was different, the White House highlighted the fact that it was the same as the Massachusetts figure.
Either way, the White House got its spin out. By the time the dust settled, the original 40 percent goal was largely forgotten - as well as the fact that the final 28 percent figure was only slightly better than the 27 percent achieved in March.
That may be a good day's work for press management, but the president should have used the more relevant figure in his remarks.