Kevin Griffis, a spokesman for the U.S. Health and Human Services Department, said he didn't have a comment yet, hours after being asked for one.

The administration had supplied information about dental plans separately in earlier disclosures. In May, the government reported that 8 million were signed up for health plans and 1.1 million were in dental coverage.

Less transparent

Then in September, the numbers became less transparent. The Medicare agency's administrator, Marilyn Tavenner, released a new enrollment figure, obtained from insurance companies participating in the exchanges: 7.3 million people were "enrolled in the health insurance marketplace coverage," she said at a hearing by the Republican-led Oversight committee.

Tavenner didn't elaborate or break out dental plans. Reporters asked a spokesman for her agency, Aaron Albright, for more detail about the number after the hearing: He said he had no additional information about it.

"After touting 8 million initial sign-ups for medical plans, four months later they engaged in a concerted effort to obscure a heavy drop-out rate of perhaps a million or more enrollees by quietly adding in dental plan sign-ups to exchange numbers," Republican Darrell Issa of California, chairman of the Oversight committee, said in an e-mail from a spokeswoman.

'FANTASTIC' to 'appalled'

Charles Gaba, a Bloomfield Hills, Michigan-based blogger who backs the Patient Protection and Affordable Care Act and has accurately forecast enrollment, was among those who found Tavenner's announcement encouraging. He had predicted enrollment would suffer attrition of about 3 percent per month; Tavenner's figure suggested the rate was lower, only about 2 percent.

"This is FANTASTIC news," he wrote at the time.

He said yesterday that he is "appalled" to find out dental plans were included in the figure.

"I really don't see what the point would be of being misleading about that number," he said in a phone interview. "Even if it had been 6.9 million, I don't see that as being a terrible thing."

The CBO, which forecasts enrollment under the Affordable Care Act, projected in 2013 that 7 million people would be signed up in 2014 before lowering the estimate by 1 million early this year.

Raw data

The Obama administration has said that enrollment would erode from the 8 million figure. Some customers never paid their premiums or stopped paying. Some may have found alternative coverage, such as through a new job; others may have decided the program wasn't worth the price.

"Instead of offering the public an accurate accounting, the administration engaged in an effort to obscure and downplay the number of dropouts," Issa said.

The success of the Affordable Care Act should be measured by one "fundamental number," the U.S. uninsured rate, U.S. health secretary Sylvia Mathews Burwell has said. That number is down about four percentage points this year to 13.4 percent, according to Gallup Inc.

After Tavenner's announcement, aides to the Oversight committee demanded the Medicare agency's raw data. Weeks of negotiations yielded 289 password-protected Excel spreadsheets, each representing enrollment in a single insurance company's Affordable Care Act health plans.

$60 premiums

In addition to enrollment, the spreadsheets include information such as premium revenue each plan received and the amount of tax credits it was paid by the government, to discount premiums. Dividing total premium revenue by enrollment in the plans, the committee aides noticed that some plans had premiums of less than $60 a month.

The low-priced plans also received little in the way of tax credits. Dental coverage sold under PPACA isn't eligible for the credits, unless it's combined with a health plan. In that case, the credit first subsidizes the premium for medical coverage, and anything left over goes to the dental plan.

Analysts at HealthPocket Inc., a research firm based in Sunnyvale, California, that maintains data on Affordable Care Act insurers, verified that 243 of 299 plans that Issa's staff singled out, with enrollment of more than 399,000 people, were for dental care. Without them, enrollment in medical plans fell from 7.37 million to 6.97 million as of Aug. 15.

Kevin Coleman, head of research and data at HealthPocket, said he wasn't able to verify the remaining 56 plans as dental. Some of their ID numbers are in "close sequence" to confirmed dental plans, suggesting they too cover only dental care, he said in an e-mail.

Important threshold?

Gaba said he couldn't see why the administration didn't just say it had 6.97 million enrollments, since that rounds up to 7 million anyway.

"If this is true and accurate, they were embellishing a number they didn't need to," he said.

The 7 million threshold appears to be important for the administration, said Douglas Holtz-Eakin, president of the American Action Forum, a Washington advocacy group aligned with Republicans that has opposed the health law.

"It's a little weird," Holtz-Eakin, a former CBO director, said. "Usually, the goal is for the forecast to hit the reality, but here the reality is being massaged to hit the forecast."

'Effectuated enrollment'

The dental-plan data may add to a growing credibility problem for the Obama administration, Holtz-Eakin said. Recently, the administration has rebutted remarks by a former adviser, Massachusetts Institute of Technology economics professor Jonathan Gruber, suggesting that Democrats deceived the public when the law was passed in 2010.

"The No. 1 most effective message against the Affordable Care Act is: they lied to you to get it through," Holtz-Eakin said in a phone interview. "People believe that years now after its passage. The distrust is already there, and they're doing nothing but exacerbate it."

The figure Tavenner announced in September, known as "effectuated enrollment" because it reflects people who have paid their insurance premiums, is probably lower now. Burwell, the health secretary, recently reported total PPACA enrollment as 7.1 million in October, 200,000 less than in August, again without breaking out dental plans.

"That's the number of people currently enrolled and paying in the marketplace," Burwell said Nov. 10 at an event hosted by the Democratic-aligned Center for American Progress.

She reported the number after Ted Strickland, the former Democratic governor of Ohio who moderated the event, asked her to respond to critics who say the Obama administration has not been transparent about enrollment or premiums under the Affordable Care Act.

"In terms of this transparency issue, what we're trying to do is make sure we're clear," Burwell said. "What we try and do is give you information when we have it that's accurate."

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