What Covered California Failed to Track

California should have done a better job collecting and releasing data on those who signed up for health insurance on the state’s open marketplace, advocates for minorities say.

The exchange, run by Covered California, failed to ask enrollees about their gender identity and sexual orientation, and buried questions about race, ethnicity and primary language at the end of the application, the California Pan-Ethnic Health Network said in a letter submitted late last month to the Covered California Board.

The state should have also provided more comprehensive demographic reports to the public, the advocacy group said.

“We recommend that you release the data by numbers of enrolled rather than as a percentage of enrolled since the numbers are volatile and constantly shifting,” Caroline Sanders, director of policy analysis for the Pan-Ethnic Network, said in the May 22 letter.

“Additionally, in order to encourage proper data analysis, each demographic report should incorporate the number of non-respondents and/or ‘decline to state’ so there is a standard denominator from which others may calculate percentages and/or make comparisons.”

About 22 percent of open-exchange enrollees declined to answer the questions about race and ethnicity, which were included in at the end of the application in a section called “Optional Data.”

That’s a high non-response rate, especially compared to similar state applications, Sanders said. For example, only 4.5 percent of applicants to California’s Healthy Families Program, a state insurance program for kids that ended last year, declined to answer race and ethnicity questions.

Streamlining the Covered California questions on race and ethnicity could help improve response rates, allowing advocacy groups and state officials to better track the results of health-care reform, Sanders said.

Similarly, questions about sexual orientation and gender preference should be added to the application so that LGBTQ groups can evaluate that data, the Pan-Ethnic Network said. The state made efforts to reach out to LGBTQ people and enroll them in insurance via the exchange, but it’s now unable to quantify whether those efforts were successful.

“We support advocates for the LGBTQ community in urging that Covered California collect and publicly report this data,” Sanders wrote.

California officials also failed to track whether 24,000 low-income residents were able to find health insurance after the program they were enrolled in ended in December, the Health Report discovered in February.

There were no questions on the Covered California application asking if people had been previously enrolled in the Low Income Health Program, a pre-Obamacare initiative to try to cover those without insurance. Now there is no way to tell whether those 24,000 people statewide found insurance through Covered California or simply slipped through the cracks.

Data itself won’t solve problems, but, as Sanders said in her letter, it can be “extremely helpful in diagnosing problems and strategizing about next steps.”

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