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A Closer Look at 2016 Obamacare Enrollment

Mother Jones

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Warning: Lotsa numbers ahead. Sorry about that. If you’re not interested, you can skip down to the last two paragraphs for the bottom line.

A couple of days ago, HHS projected that Obamacare exchange enrollment would reach 10 million by the end of 2016. That’s not much higher than the 9.1 million who are expected to be enrolled at the end of 2015. Has Obamacare enrollment stalled?

Maybe. But keep two things in mind:

This is probably a lowball figure. HHS would rather set a low bar and beat it than set a higher bar and have to explain why they missed it.
Charles Gaba, who has a pretty good track record with this stuff, estimates that 14.7 million people will sign up and 12.2 million will remain by the end of the year.

If Gaba is right, that’s an increase of about one-third from 2015. Not too bad. Still, it’s considerably less than the CBO’s original estimate of 21 million enrollees by 2016. Again, though, keep a couple of things in mind:

The CBO figure is for “average annual enrollment.” Since people drop out as the year progresses, this is probably equivalent to about 19 million by year-end.
CBO had estimated a drop of 8 million people from employer and other insurance plans. However, those numbers appear to have turned out lower than CBO’s estimates. This is a good thing—we’d prefer that people stay on their current coverage instead of being kicked off—but it obviously reduces the market for Obamacare enrollment. We should probably reduce CBO’s estimate by 3 million or so to account for this.

In other words, on an apples-to-apples basis, a best guess suggests that we’ll end up 2016 at 12 million compared to a CBO projection of 16 million. It’s still lower than CBO’s original estimates, but not by a huge amount. This could be due to (a) an overestimate by CBO, (b) weak performance by Obamacare, (c) an improving economy, or (d) nothing more than a difference in how fast Obamacare ramps up.

Bottom line: Because of all this, a more reliable metric of success is to skip all the details of who’s insured via what, and simply count the total number of uninsured. CBO originally estimated that the uninsured population would drop to 8 percent by 2016. That estimate changed after the Supreme Court made Medicare expansion voluntary, and CBO now figures that in 2016 the total number of uninsured will come to about 11 percent. The CDC estimates that in the most recent quarter the number of uninsured dropped to 10.7 percent. If Gaba’s numbers are correct, that will decline to about 10 percent or so by the end of 2016.

In other words, once you clear away all the underbrush it looks like Obamacare is meeting or beating its goals. Some of this might be due to an improving economy, but who cares? If the economy is doing well enough that more people are getting employer coverage and fewer are being forced onto the exchanges, that’s a good thing, not a knock on Obamacare.

POSTSCRIPT: Surveys consistently show that about half of the uninsured say they’re not on Obamacare because it’s too expensive. So for anyone who’s truly concerned that Obamacare isn’t hitting its enrollment targets, there’s an easy answer: increase the federal subsidies for the working poor so that more of them can afford coverage.

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A Closer Look at 2016 Obamacare Enrollment

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How Understanding Randomness Will Give You Mind-Reading Powers

Mother Jones

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In the 1930s, a Duke University botanist named Joseph Banks Rhine was gaining notoriety for focusing a scientific lens on the concept of extrasensory perception, or ESP. His initial research, which he claimed demonstrated the existence of ESP, consisted of case studies of exceptional individuals who seemed to be able to predict which cards a research associate was holding—even when sitting 250 yards away and separated by physical barriers like a wall—with greater accuracy than simple guessing would yield.

But case studies can only take you so far.

One night, Rhine met with Eugene Francis McDonald Jr., the CEO of the Zenith Radio Company. McDonald offered up his technology for what promised to be the largest and most impressive test of ESP yet: a nationwide experiment showing that telepathy is real.

“The idea was that they would have a bunch of people in a radio studio, and they would try to transmit their thoughts to the nationwide radio audience,” explains science writer William Poundstone, author of the book Rock Breaks Scissors, on this week’s Inquiring Minds podcast. “And then people at home could write down what they think they received and send that in, and scientists would look at it and decide if they had shown ESP or not.” The hope, says Poundstone, was that the participation of millions of radio listeners would produce results that were supposedly “much more statistically valid” than earlier ESP studies.

The first few broadcasts were a dramatic success. Most listeners were correct in their guesses of what the “senders” in a radio station in Chicago were thinking. On one episode, writes Poundstone, the thought-senders attempted to use their brains to transmit a series of five Xs and Os—OXXOX—and a majority of the audience members sent in the right answers. “So this seemed very impressive, and the head of Zenith put out big press releases saying that, you know, there’s no way this could be a coincidence,” says Poundstone.

But while it wasn’t a coincidence, a young psychologist named Louis D. Goodfellow figured out that the experiment wasn’t really measuring telepathy. Rather, it was demonstrating something far more interesting about human nature: our inability to behave randomly. It turned out that Goodfellow, who had been hired by Zenith to work on the show, could predict listeners’ guesses even before they had a chance to make them. He started out with the hypothesis that there is no ESP. In that case, the radio audience had to come up with a random sequence themselves. “And he realized that it’s not so easy for a person to make up a random sequence.” says Poundstone. “When people try to do that they fall into certain unconscious patterns, and these patterns are really very similar for everyone.”

In his own laboratory experiments, Goodfellow found that his subjects preferred certain types of sequences when they’re trying to come up with random ones. When he asked people to make up the results of five imaginary coin tosses, for instance, “he found first of all that the most popular first toss was heads,” says Poundstone. How popular? Seventy-eight percent of the study participants selected “heads” as the first result in their supposedly “random” sequences.

What’s more, explains Poundstone, Goodfellow discovered that “people liked sequences that were very well shuffled.” Indeed, the most common sequence chosen by Zenith audiences was heads, heads, tails, heads, tails (or its equivalent in Os and Xs)—they picked it nearly 30 times more frequently than tails, tails, tails, tails, tails. “It’s not too surprising that the least common ones were just five heads in a row, or five tails in a row,” adds Poundstone. “People figured that just wasn’t random.”

So, mystery solved. When the Zenith program transmitted thoughts that matched sequences that were popular with its listeners, “it suddenly looked like the public had a great deal of ESP,” says Poundstone. “But when the sequences were not so popular, then suddenly the telepaths were off their game.”

More recently, psychologists Amos Tversky and Daniel Kahneman proposed the so-called Law of Small Numbers, a theory that accounts for human misunderstandings of randomness. Specifically, we wrongly expect small samples to behave like very large ones. So if you toss a coin five times, you assume that you’ll get some variation of a pattern that includes two or three heads and two or three tails. If your coin lands on tails five times in a row, you tend to believe that it can’t be a coincidence. But in fact, the odds of five tails in a row are 1 in 32—not especially common, but not terribly rare, either. “So we have all these sort of false positives where we figure there must be something wrong with that coin, or maybe the person’s got some magic hot-hand in tossing coins,” Poundstone says.

Understanding these pitfalls can actually help you predict, with accuracy above chance, what someone else is going to do, even when he or she is trying, purposefully, to act randomly. These predictions are at the core of Poundstone’s book, which offers a practical guide to outguessing and outwitting almost anybody—in activities ranging from Rock, Paper, Scissors (men tend to go with rock, so you can beat them with paper) to investing in stocks.

Naturally, the larger the dataset, the more accurately a person—or a computer—can predict behavior. With access to Big Data, large corporations like Target have developed analytics that can predict our behavior with remarkable accuracy, even when we think we’re making decisions in the moment. Siri, your iPhone’s talking app, learns about you and the behavior of all the other iPhone users and uses that information to predict what you’re going to ask her even as you are evaluating your own needs.

And sometimes, the Big Data machine is more observant than even the people closest to us. In his book, Poundstone cites the story of a Minnesota dad (first reported by the New York Times) who complained to a Target manager that his teenage daughter was being encouraged by the company to engage in unprotected sex. The store, he noted, had sent her a mailer littered with photos of cute babies, baby gear, and maternity clothing. As Poundstone writes, the manager apologized and promised that he’d suss out the source of the error. In doing so, he learned that Target analyzes purchases made online and in stores that are predictive of the behavior of an expectant mother. When he called the angry father once again to apologize, he realized just how powerful these algorithms can be. As it turns out, this time the customer was apologetic: Apparently Big Data noticed his daughter’s pregnancy well before he did.

Poundstone draws a direct line between Goodfellow’s debunking of ESP and modern efforts to predict consumer behavior. “It basically demonstrated that a lot of the little everyday decisions we make are incredibly predictable, provided you’ve got a little bit of data to work from,” he says. “And that’s become a very big business today, needless to say.”

But does this predictability apply to everyone? Poundstone knows of at least one person who defies the odds. Computer scientist Claude Shannon built the first computer to predict human behavior. And of all the people tested, he was also the only one who could beat the machine at its own game. When asked how he managed to do this, “he said that he had a very simple secret,” reveals Poundstone. “He essentially mentally emulated the code of the machine and did the algorithm in his head, so he knew what the machine was going to predict, and then he did the opposite.” But Shannon is a special case. “For almost everyone else, mere humans,” says Poundstone, “I think it is pretty easy to predict, at least a good deal of the time.”

Inquiring Minds is a podcast hosted by neuroscientist and musician Indre Viskontas and best-selling author Chris Mooney. To catch future shows right when they are released, subscribe to Inquiring Minds via iTunes or RSS. We are also available on Stitcher. You can follow the show on Twitter at @inquiringshow and like us on Facebook. Inquiring Minds was also recently singled out as one of the “Best of 2013” on iTunes—you can learn more here.

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How Understanding Randomness Will Give You Mind-Reading Powers

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