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McKinsey Health Insurance Survey Raises Ruckus, Questions

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The influential consulting firm McKinsey & Company caused quite a stir when it published an article last week predicting that nearly a third of employers "will definitely or probably stop offering" health insurance to their workers after 2014.

Republicans, including some presidential candidates, seized upon the piece as evidence that President Obama was wrong when he vowed that people who liked their health coverage could keep it after a federal health overhaul took effect.

But just how accurate is the McKinsey study?

While some news organizations (not including this one) accepted the study at face value, others, including Time, Talking Points Memo, and the Washington Post's Plum Line blog, started raising questions fairly early on. The biggest one: Why did McKinsey refuse to release the methodology by which it surveyed the 1,300 employers the article said it queried?

We asked McKinsey for details. The firm declined to comment.

So we turned to the American Association for Public Opinion Research for help figuring it out. They referred us to Scott Keeter, director of survey research for the Pew Research Center. "We're not the polling police," he said. "But I'm suspicious of research if people won't tell me how they did it."

Another thing that raised eyebrows: The McKinsey findings were so out of line with studies done by other outfits, the Mercer consulting group, the Urban Institute and the Rand Corporation. All those studies found the impact on employer-provided insurance likely to be much smaller.

Speculation aside, there's the real-life example of Massachusetts, where the requirement for most individuals to have health insurance has been in reality since 2007.

And there, access to employer coverage has increased, rather than gone down. According to a study released in April by the Blue Cross Blue Shield of Massachusetts Foundation, "There has been no evidence of subsidized coverage 'crowding out' employer-sponsored insurance, and employer offer rates have grown from 70 percent to 76 percent since implementation of reform."

All of which prompted irritated Democrats to lash out at McKinsey. "Honest public discourse requires a standard level of transparency — one McKinsey simply has not met," said Senate Finance Committee Chairman Max Baucus in a letter Thursday to McKinsey's Managing Director Dominic Barton asked the firm release the study's methodology.

Nine leading House Democrats, led by Energy and Commerce ranking member Henry Waxman, sent Barton a similar letter late Thursday.

"We are concerned that, if the survey based its conclusions on a questionable instrument and potentially biased methodology, McKinsey may have provided the American public with invalid information about the impact of the Affordable Care Act," the House members wrote.

Backed into a corner, McKinsey may be ready to comply. Unofficial word is the methodology will soon be forthcoming.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

Julie Rovner is a health policy correspondent for NPR specializing in the politics of health care.Reporting on all aspects of health policy and politics, Rovner covers the White House, Capitol Hill, the Department of Health and Human Services in addition to issues around the country. She served as NPR's lead correspondent covering the passage and implementation of the 2010 health overhaul bill, the Patient Protection and Affordable Care Act.