Last week, the Centers for Medicare and Medicaid Services released a map showing the number of insurers that are projected to participate in health exchanges in each county next year.
Pretty compelling stuff.
My editor thought it would be a good idea to get the data behind the map. After all, it shows that 47 counties in Missouri, Washington, and Ohio will have no providers, and the number of counties with just one option will again increase. I expected to get a spreadsheet listing each county and the number of providers, something we could analyze and compare to other information CMS provides.
Simple Questions
This is simple, routine stuff, the kind I've done dozens of times as a reporter.
Well, for the past few days I've been trying to get a hold of the data, and my experience has been anything but routine. CMS's position is clear: It's not going to happen.
My first stop was CMS' own site for data about the marketplaces. It includes all sorts of great information -- rates, deductibles, information on where plans are offered and more. But there isn't yet any data about next year.
I moved on.
Usually, when an agency releases a map like this, they'll share the data as well. I assumed they had simply forgotten to include the link. So I shot an email to the media relations office in the department, asking for the data behind the map.
About an hour later I got a response."Not a direct quote, unfortunately we do not have any further information to provide at this time," wrote Shelby Venson-Smith, a public affairs specialist.
Surely, I thought, I caught CMS on a bad day.
The map exists and data were used to make it.
It's not like it was sent mistakenly, either, as the press release that accompanied the map even included a quote from CMS administrator Seema Verma, "This is yet another failing report card for the Exchanges. The American people have fewer insurance choices and in some counties no choice at all. CMS is working with state departments of insurance and issuers to find ways to provide relief and help restore access to healthcare plans, but our actions are by no means a long-term solution to the problems we're seeing with the Insurance Exchanges."
The Old-Fashioned Way
Confused, I tried an old reporting trick: I picked up my phone and tapped out the number for CMS.
For a joyful few minutes, the gentleman who answered the phone put my mind at ease. Of course the data were available, he said; in fact, they had already had several similar requests. If I sent another email specifying that I want the number for every county, he said, I'd get what I was after.
Gleeful, I sent another email to the same address I wrote to last week.
"Hi there," I wrote. "Following up on a call this morning, I'd like to get the data associated with the map released last week for each county. So for every county, I'd like to know the number of insurers projected for next year. Let me know if you have any questions. Thanks!"
Eight minutes later, I got the exact same response I received last week. Again, there was no further information to be had. Again, I was forbidden from quoting the email itself.
I called back. This couldn't be correct, I said. The data must exist, because there is a map. Heck, if I felt like it, I could identify each of the 3,144 counties on the map and make the table myself.
The man who answered the phone (whose name I, sadly, failed to get) agreed. So then why, I asked, wouldn't they share the data?
He didn't give me an answer, but confirmed that the data would not be released. His supervisor, he said, would call me to discuss further.
A short while later, I got another email offering a bit more detail. Again, it was on background, meaning that I can't quote it directly. But the email explained that the map was based on current 2017 issuer participation information supplemented by public statements made by the issuers and public rate filings related to plan year 2018. The information is expected to continue to change, and data will be released in the fall, as usual.
I'm still waiting to hear back from the supervisor.
What's Happening Here?
This is, at best, weird.
At worst, it raises questions about CMS intentions: is the aim to inform the public or to promote the political agenda of the White House, which has been relentless in its criticism of the Affordable Care Act. Journalists, including MedPage Today's Joyce Frieden, have noted the increasingly political tone of communications from CMS.
Few news outlets would be comfortable running a map that they couldn't change to match their own styles, and any reporter's spidey sense should tingle when the government declines to release raw data.
At worst, it preys upon the seediest instincts of our industry, those that lead us to chase page views without caring to make sources justify their claims.
A number of outlets ran the map as is, apparently uninterested in confirming details about what exactly it shows.
I'll chalk this up to disorganization on the part of CMS. Maybe the person who made the map lost the data, or was out sick, or was embarrassed about how she had come to those conclusions. It's OK. I've been there.
But this is not the way it's supposed to work, and we're not going to stop asking for basic competence. Even if it's not fake news this time around, it has all the hallmarks.
We'll keep asking for proof.