Recommendation: The Secretary of HHS should establish numeric enrollment targets for healthcare.gov, to ensure it can monitor its performance with respect to its objectives. (Recommendation 2)

Agency: Department of Health and Human Services
Status: Open

Comments: HHS does not concur with this recommendation. In October 2018, the agency noted that there are numerous external factors, such as the state of the economy and plan premiums, that may affect the number of people who decide to enroll in coverage. HHS also stated that it does not believe that numeric enrollment targets are relevant to assess the performance of objectives related to a successful open enrollment period. We continue to believe that the development of numeric enrollment targets is important for effective monitoring of the program and management of its resources. As of September 2019, HHS had not provided any additional information about steps to implement this recommendation. The status of this recommendation will be reconsidered once relevant action is taken.

Recommendation: Should the agency continue to focus on enhancing the consumer experience as a goal for the program, the Secretary of HHS should assess other aspects of the consumer experience, such as those it previously identified as key, to ensure it has quality information to achieve its goal. (Recommendation 3)

Agency: Department of Health and Human Services
Status: Open

Comments: HHS concurs with this recommendation, and in October 2018, stated that as it is looking for ways to improve the consumer experience, it will consider focusing its assessment on other aspects of the consumer experience as needed. As of September 2019, HHS had not provided evidence of any additional steps it had taken to improve the consumer experience. The status of this recommendation will be reconsidered once relevant action is taken.

Recommendation: To assist in determining whether to require USPS and PRC to report on delivery performance for rural and non-rural areas, Congress should direct USPS to provide cost estimates related to providing this information.

Agency: Congress
Status: Open

Comments: As of March 2020, Congress has not taken any action to direct USPS to provide cost estimates related to reporting on delivery performance for rural and non-rural areas

Recommendation: Congress should consider strengthening the current consumer privacy framework to reflect the effects of changes in technology and the marketplace--particularly in relation to consumer data used for marketing purposes--while also ensuring that any limitations on data collection and sharing do not unduly inhibit the economic and other benefits to industry and consumers that data sharing can accord. Among the issues that should be considered are: (1) the adequacy of consumers' ability to access, correct, and control their personal information in circumstances beyond those currently accorded under FCRA; (2) whether there should be additional controls on the types of personal or sensitive information that may or may not be collected and shared; (3) changes needed, if any, in the permitted sources and methods for data collection; and (4) privacy controls related to new technologies, such as web tracking and mobile devices.

Agency: Congress
Status: Open

Comments: As of July 2020, Congress has not taken action on this matter.

Recommendation: To help improve the effectiveness of the Bureau's outreach and enumeration efforts, especially for HTC populations, should they be used again in the 2020 Census, and improve the Bureau's marketing/outreach efforts, the Secretary of Commerce should require the Under Secretary for Economic Affairs as well as the Director of the U.S. Census Bureau to develop mechanisms to increase coordination and communication between the partnership and local census office staff. Possible actions include offering more opportunities for joint training, establishing protocols for coordination, and more effectively leveraging the partnership contact database to better align partnership outreach activities with local needs.

Agency: Department of Commerce
Status: Open
Priority recommendation

Comments: The Department generally agreed with this recommendation. In 2011, the Bureau reported on the agency's assessment of the partnership program. In September 2014, the Bureau's Path to the 2020 Census, identified the Partnership Program as one of the best methods for communicating the importance of response and states its intent to map out details about the Partnership Program in early 2016. As of March 2018, Bureau officials said they were developing coordination mechanisms between partnership and Area Census Office staff for the 2020 Census. For example, the Bureau updated a form it had used during the 2010 Census to track partnership outreach activities to help facilitate information sharing within the Bureau and said it plans to make additional updates. In March 2019, the Bureau informed us that it is assigning at least one partnership specialist to each census office manager to help address this recommendation. As we reported in May 2020, the Bureau had not put in place expectations for how Partnership staff should support area census office staff. We also reported that pluralities of area census office managers we surveyed in March 2020 were dissatsified with the level of clarity of roles and responsibilities of Partnership staff, as well as the level of communication and coordination between Partnership and office staff. To fully implement this recommendation, the Bureau will need to take such steps as documenting for partnership specialists and their area census office manager how they are expected to work together and other significant mechanisms that would increase effectiveness of coordination and communication between partnership and local field office staff.

Recommendation: To help improve the effectiveness of the Bureau's outreach and enumeration efforts, especially for HTC populations, should they be used again in the 2020 Census, and to improve some of the Bureau's key efforts to enumerate HTC populations, the Secretary of Commerce should require the Under Secretary for Economic Affairs as well as the Director of the U.S. Census Bureau to determine the factors that led to the staffing issues observed during SBE and take corrective actions to ensure more efficient SBE staffing levels in 2020.

Agency: Department of Commerce
Status: Open

Comments: The Department generally agreed with this recommendation. In September 2012, the Bureau issued its assessment of the Service Based Enumeration Program. The assessment reported on the number of individuals counted and the complexities of this special enumeration activity. The assessment did not address the Bureau's approach to staffing this special enumeration activity. In its 2020 Census Operational Plan, issued in October 2017, the Bureau provided a high level overview of reengineered field operations plans but did not provide details on special enumeration efforts. In April 2018, the Bureau provided us with its planned staffing ratios for its Service-Based Enumeration activity for the 2020 Census in comparison to those used in the 2010 Census, as well as results of its 2016 Census Test of SBE activity. As of August 2020 we have ongoing work that will be examining implementation of peak field operations and providing updates to this recommendation. In order to fully implement this recommendation, the Bureau needs to demonstrate that its planning for how it will determine staffing levels for SBE takes into account the factors that led to inefficient staffing allocation previously.

Recommendation: To help improve the effectiveness of the Bureau's outreach and enumeration efforts, especially for HTC populations, should they be used again in the 2020 Census, and to improve some of the Bureau's key efforts to enumerate HTC populations, the Secretary of Commerce should require the Under Secretary for Economic Affairs as well as the Director of the U.S. Census Bureau to evaluate the extent to which each special enumeration activity improved the count of traditionally hard-to-enumerate groups and use the results to help inform decision making on spending for these programs in 2020.

Agency: Department of Commerce
Status: Open
Priority recommendation

Comments: The Department generally agreed with this recommendation. In 2012, the Bureau reported on assessments of many 2010 special enumeration activities such as the Service-Based Enumeration and the Be Counted/Questionnaire Assistance Center Programs. These assessments revealed the number of persons counted and spending for the special enumeration activities. Separately, the Bureau issued results of the 2010 Census Coverage Measurement Program that described the level of coverage of various hard-to-enumerate populations generally without attributing coverage to specific enumeration activities. Since 2015, the Bureau has issued annual updates of its 2020 Census Operational Plans, which have not provided details of plans for various special enumeration activities. In April 2017 Bureau officials provided us with evaluation results of its 2010 communication efforts and other documents related to ongoing efforts to reduce errors in the census. As of August 2020, we are in communication with Bureau officials about steps they are taking to implement this recommendation. To fully implement this recommendation, the Bureau needs to demonstrate how it is relying on data about how various special enumeration activities of historically hard-to-enumerate groups contributed to census coverage in 2010 to inform its design for the 2020 Census.