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April 25, 2006


Hilzoy, I really think that you should reduce the stress on yourself and only document the instances when the Bush admin has told the truth about something. You can then use your copious free time for house posts.

As far as the projected enrollments for the year go, it's really too soon to say -- facilitated enrollments have just started (for moderately low-income beneficiaries), and the late enrollment penalty doesn't kick in until the summer. Which is not to say that their press release isn't misleading, however.

BTW, it is indeed "creditable" coverage and not "credible" coverage, although the latter is a common mistake.

Re the discrepancies in the MA vs MA-PD numbers, Feb 2006 isn't a good reference point, since by then a large number of MA members had already gone to an MA-PD (in fact many were automatically rolled over into an MA-PD -- they would have had to take positive action to opt out. This is another fact which is glossed over in the press release, along with the fact that a good chunk of that population already had drug coverage through their MA plan). The real reference point you want is the MA membership in December 2005 or prior.

kenB: Yes, I saw the credible/creditable thingo. 'Credible' is from the HHS press release. In the official enrollment stats, however, it's 'creditable' (but I think you have to download the Excel file to see it.)

I think the late enrollment penalty kicks in as of May 15, which is, horrifying to say, just 3 weeks away. So I'd expect a surge of people between now and then, and a lot fewer thereafter. However, I think it's unlikely that that surge will give us nearly ten million new beneficiaries.

Re "creditable", yes, I wasn't correcting you, just confirming which one was correct. 80% of the people in the biz, whether at CMS or in the health industry, say "credible" instead -- apparently it's just too much work putting that fourth syllable in the middle, nevermind that "credible" doesn't really make sense in that context.

Anecdotally, I've talked to several (healthy) seniors who've been putting off their decision as long as possible, until there were nontrivial negative consequences to waiting. The penalty works out to 32 cents extra per month times the number of months the member delayed enrolling (at least for this year, probably comparable in future years), so it's possible that different people will have different thresholds for what's too much to pay in perpetuity. Whether there are 10 million people out there waiting for just the right moment or not, I have no idea. I also have no idea how many Medicare benes are even aware of the penalty.

As for when the penalty starts, I remember from last year that there was some talk about that not kicking in until August, but I haven't heard anything more about it recently. Also, I don't remember if it was just the extra charge that was going to be started in August or that they'd be pushing back the actual reference date for determining the penalty. Probably just the former -- the pushback was probably due to the schedule for the required systems changes, not to any desire to give seniors a break.

I'm just trying to figure out what (if anything) to suggest to my parents. So far have come up very blank indeed.

There is a political party's website that covers the same topic on which Hilzoy has done so much work; that other site is here.
We remember what the administration did during three years preceding the attempted rollout of "private social security accounts", suppressing Richard Foster's actuarial work which revealed the weaknesses of the bookkeeping involved in that proposed law; here is an article written about that debacle two years ago, mentioning his ultimately getting fired.
Ostensibly, if the accounting is the difficulty here, as Hilzoy has highlighted, all that might be needed, once again, would be to locate, suppress, and then fire the actuarial people who examine the bookkeeping; that might be do-able in the next three weeks, to meet the target date.
Credible is the byword of this administration; as are elided syllables. Yet, to be fair, I work with many people with advanced degrees, some of them with a similar kind of neo-vernacularization of words, as contributors here discussed. It might be appropriate to say this administration has a creditability problem in healthcare matters, though, usually the criticism would be of its credibility.

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