![\"Obamacare](\"https:\/\/i0.wp.com\/www.dougsbriefcase.com\/blog\/wp-content\/uploads\/2014\/03\/Credit-CNN-Money.jpg\")
<\/a>Oba\u00admacare sup\u00adport\u00aders are great\u00adly inflat\u00ading esti\u00admates of the num\u00adber of pre\u00advi\u00adous\u00adly unin\u00adsured peo\u00adple that have gained cov\u00ader\u00adage because of the new law. Here\u2019s sen\u00adsi\u00adble look at the num\u00adbers. [Cred\u00adit: CNN<\/span>\/Money]<\/p><\/div>Near\u00adly 13 mil\u00adlion Amer\u00adi\u00adcans now have health insur\u00adance thanks to Oba\u00admacare. Tell Repub\u00adli\u00adcans to stop vot\u00ading to take their cov\u00ader\u00adage away.<\/em> \u2013 Demo\u00adc\u00adra\u00adt\u00adic Leg\u00adisla\u00adtive Cam\u00adpaign Com\u00admit\u00adtee<\/a> peti\u00adtion drive\n Hyper\u00adbole over how many peo\u00adple have pre\u00adsum\u00adably gained health cov\u00ader\u00adage as the result of Oba\u00admacare won\u2019t sub\u00adside any\u00adtime soon. At its cur\u00adrent pace, we seem des\u00adtined to reach the point where the num\u00adber of peo\u00adple who are alleged to have gained cov\u00ader\u00adage because of Oba\u00admacare sur\u00adpass\u00ades the num\u00adber that lacked cov\u00ader\u00adage in the first place.<\/p>\n Last month, Sen\u00ada\u00adtor Richard Durbin (R\u2011IL<\/span>) put the num\u00adber of new\u00adly insured at 10 mil\u00adlion<\/a>. This month, advo\u00adcates are seek\u00ading sig\u00adna\u00adtures on online peti\u00adtions to pro\u00adtect 13 mil\u00adlion peo\u00adple \u201cwho now have health insur\u00adance thanks to Oba\u00admacare\u201d from the malef\u00adic schemes of the Repub\u00adli\u00adcan party.<\/p>\n In this two-part series, I\u2019ve tried to push past the hype and take a care\u00adful look at the data the gov\u00adern\u00adment have released so far on new enroll\u00adments. My pre\u00advi\u00adous post<\/a> exam\u00adined data on enroll\u00adment in pri\u00advate health insur\u00adance poli\u00adcies sold through exchanges. This one deals with new Med\u00adic\u00adaid determinations.<\/p>\n But first, how did we move from the bogus 10 mil\u00adlion fig\u00adure to the even loop\u00adi\u00ader 13 mil\u00adlion fig\u00adure? Easy. After Sen\u00ada\u00adtor Durbin pro\u00adpound\u00aded his 10 mil\u00adlion exag\u00adger\u00ada\u00adtion, the gov\u00adern\u00adment released new data on Med\u00adic\u00adaid deter\u00admi\u00adna\u00adtions through the end of Jan\u00adu\u00adary and also issued a press release updat\u00ading exchange enroll\u00adment through late Feb\u00adru\u00adary. Our on-line peti\u00adtion friends used these new fig\u00adures, adding the num\u00adber of peo\u00adple who had select\u00aded plans through late Feb\u00adru\u00adary (4 mil\u00adlion<\/a>) to the num\u00adber of new Med\u00adic\u00adaid deter\u00admi\u00adna\u00adtions from Octo\u00adber 2013 through Jan\u00adu\u00adary 2014 (8.9 mil\u00adlion<\/a>), to arrive at their high\u00adly mis\u00adlead\u00ading 12.9 mil\u00adlion, or \u201cnear\u00adly 13 million.\u201d<\/p>\n Before exam\u00adin\u00ading the Med\u00adic\u00adaid num\u00adbers more close\u00adly, it is impor\u00adtant to lay out a few facts about the pro\u00adgram. Many think of Med\u00adic\u00adaid as gov\u00adern\u00adment insur\u00adance for the very poor. That\u2019s only half right. Mil\u00adlions of low-income peo\u00adple have nev\u00ader been eli\u00adgi\u00adble for Med\u00adic\u00adaid cov\u00ader\u00adage because pover\u00adty alone wasn\u2019t enough. In addi\u00adtion to being poor, you had to be:<\/p>\n With few excep\u00adtions in some states, non-aged, non-dis\u00adabled, child\u00adless adults have been shut out of Med\u00adic\u00adaid no mat\u00adter how low their income. Oba\u00admacare changed that, allow\u00ading an indi\u00advid\u00adual to qual\u00adi\u00adfy for Med\u00adic\u00adaid based on income alone. It required states to cov\u00ader every\u00adone earn\u00ading less than 133 per\u00adcent of the fed\u00ader\u00adal pover\u00adty lev\u00adel ($15,521 for an indi\u00advid\u00adual; $31,720 for a fam\u00adi\u00adly of 4), irre\u00adspec\u00adtive of their life cir\u00adcum\u00adstances. Med\u00adic\u00adaid became what many peo\u00adple thought it had been all along \u2014 gov\u00adern\u00adment health cov\u00ader\u00adage for the very poor.<\/p>\n The law the Pres\u00adi\u00addent signed man\u00addat\u00aded that every state expand its Med\u00adic\u00adaid pro\u00adgram. But the Supreme Court found that pro\u00advi\u00adsion uncon\u00adsti\u00adtu\u00adtion\u00adal, requir\u00ading that states be allowed to decide for them\u00adselves whether to expand their pro\u00adgrams. As of the begin\u00adning of this year, 25 states and the Dis\u00adtrict of Colum\u00adbia had done so. The rest had not.<\/p>\n While only half the states have expand\u00aded Med\u00adic\u00adaid to new pop\u00adu\u00adla\u00adtions, every state oper\u00adates a Med\u00adic\u00adaid pro\u00adgram. That is a crit\u00adi\u00adcal dif\u00adfer\u00adence between exchanges, which opened for busi\u00adness last Octo\u00adber, and Med\u00adic\u00adaid, which has been around for 50 years. Peo\u00adple are deter\u00admined eli\u00adgi\u00adble for Med\u00adic\u00adaid every day in every state \u2013 seniors, peo\u00adple with devel\u00adop\u00admen\u00adtal dis\u00adabil\u00adi\u00adties, preg\u00adnant women, chil\u00addren under 18, low-income par\u00adents \u2013 and there is no way to infer from gov\u00adern\u00adment reports which peo\u00adple added to the Med\u00adic\u00adaid rolls are new\u00adly eli\u00adgi\u00adble thanks to Oba\u00admacare and which would have been eli\u00adgi\u00adble even if Oba\u00admacare had nev\u00ader become law.<\/p>\n The chart below presents the num\u00adber of peo\u00adple deter\u00admined eli\u00adgi\u00adble for Med\u00adic\u00adaid by state agen\u00adcies between Octo\u00adber 1 of last year and Jan\u00adu\u00adary 31.<\/p>\n The blue bars show how many of the 8.9 mil\u00adlion deter\u00admi\u00adna\u00adtions were made by states that opened their pro\u00adgrams to peo\u00adple who were pre\u00advi\u00adous\u00adly inel\u00adi\u00adgi\u00adble for the pro\u00adgram (\u201cexpan\u00adsion states\u201d); the red bars rep\u00adre\u00adsent deter\u00admi\u00adna\u00adtions by states that retained the old rules (\u201cnon-expan\u00adsion states\u201d).<\/p>\n More than 4.2 mil\u00adlion \u2013 or 47 per\u00adcent \u2013 of those deter\u00admined eli\u00adgi\u00adble over that peri\u00adod lived in states that did not<\/strong> expand their Med\u00adic\u00adaid pro\u00adgrams. By def\u00adi\u00adn\u00adi\u00adtion, those 4.2 mil\u00adlion peo\u00adple could not have become eli\u00adgi\u00adble for Med\u00adic\u00adaid because of Obamacare.<\/p>\n What about the 4.7 mil\u00adlion who live in expan\u00adsion states? Weren\u2019t they added to the rolls only because of the changes made by Oba\u00admacare? No. Most were almost cer\u00adtain\u00adly eli\u00adgi\u00adble under the old rules. Med\u00adic\u00adaid is a huge pro\u00adgram. Congress\u2019s advi\u00adso\u00adry com\u00admit\u00adtee on the pro\u00adgram reports<\/a> that there were more than 63 mil\u00adlion enrollees in 2010, includ\u00ading more than 30 mil\u00adlion chil\u00addren. All of these groups con\u00adtin\u00adue to be eli\u00adgi\u00adble today and like\u00adly con\u00adsti\u00adtute the vast major\u00adi\u00adty of those deter\u00admined eli\u00adgi\u00adble even in expan\u00adsion states.<\/p>\n That is espe\u00adcial\u00adly true since Med\u00adic\u00adaid has a large shad\u00adow pop\u00adu\u00adla\u00adtion, mil\u00adlions of peo\u00adple who are eli\u00adgi\u00adble for cov\u00ader\u00adage but have not enrolled. How many is a mat\u00adter of con\u00adsid\u00ader\u00adable dis\u00adpute. But con\u00adsid\u00ader this: CBO<\/span> esti\u00admates that even years from now, after Oba\u00admacare is ful\u00adly imple\u00adment\u00aded, more than 6 mil\u00adlion<\/a> Med\u00adic\u00adaid-eli\u00adgi\u00adble peo\u00adple will remain unin\u00adsured. It seems like\u00adly that some unin\u00adsured peo\u00adple who were eli\u00adgi\u00adble for Med\u00adic\u00adaid were moti\u00advat\u00aded to apply for cov\u00ader\u00adage by inten\u00adsive enroll\u00adment cam\u00adpaigns. Though that is a knock-on effect of Oba\u00admacare pro\u00admo\u00adtion\u00adal efforts, it is not accu\u00adrate to say that these indi\u00advid\u00adu\u00adals gained Med\u00adic\u00adaid cov\u00ader\u00adage because of the new law.<\/p>\n It should also be borne in mind that many of the \u201cexpan\u00adsion\u201d states were cov\u00ader\u00ading adults with incomes of 133 per\u00adcent of the fed\u00ader\u00adal pover\u00adty lev\u00adel even before the Oba\u00admacare Med\u00adic\u00adaid expan\u00adsion took effect this year. As of Jan\u00adu\u00adary 2013, accord\u00ading to the Kaiser Fam\u00adi\u00adly Foun\u00adda\u00adtion<\/a>,<\/span> 10 \u201cexpan\u00adsion\u201d states (DC<\/span>, HI<\/span>, IL<\/span>, ME<\/span>, MA<\/span>, MN<\/span>, NJ<\/span>, NY<\/span>, RI<\/span>, and VT<\/span>) were cov\u00ader\u00ading adults with depen\u00addent chil\u00addren with incomes of 133 per\u00adcent of the pover\u00adty lev\u00adel, and 3 (DC<\/span>, HI<\/span> and VT<\/span>) had extend\u00aded cov\u00ader\u00adage to child\u00adless adults to that income lev\u00adel. Anoth\u00ader 5 (IA<\/span>, MA<\/span>, MN<\/span>, NM<\/span>, WA<\/span>) were cov\u00ader\u00ading unem\u00adployed child\u00adless adults above those lev\u00adels. As a result, many adults deter\u00admined eli\u00adgi\u00adble for Med\u00adic\u00adaid in those expan\u00adsion states this year would have qual\u00adi\u00adfied for cov\u00ader\u00adage even with\u00adout the health care law.<\/p>\n Then there is the addi\u00adtion\u00adal com\u00adpli\u00adca\u00adtion that Med\u00adic\u00adaid data are noto\u00adri\u00adous\u00adly faulty and incom\u00adplete. CMS<\/span> bases its fig\u00adures on state reports, which are spot\u00adty and defi\u00adcient. A num\u00adber of states have anti\u00adquat\u00aded data sys\u00adtems<\/a> and most are still in the process of imple\u00adment\u00ading new fed\u00ader\u00adal rules for mak\u00ading income eli\u00adgi\u00adbil\u00adi\u00adty deter\u00admi\u00adna\u00adtions. Some still haven\u2019t report\u00aded their Jan\u00adu\u00adary num\u00adbers. Oth\u00aders dou\u00adble-count<\/a> enroll\u00adments, since an indi\u00advid\u00adual may have more than one eli\u00adgi\u00adbil\u00adi\u00adty deter\u00admi\u00adna\u00adtion. And 13 states<\/a> don\u2019t dis\u00adtin\u00adguish a new eli\u00adgi\u00adbil\u00adi\u00adty deter\u00admi\u00adna\u00adtion from a rede\u00adter\u00admi\u00adna\u00adtion \u2013 the process by which a state agency decides whether an indi\u00advid\u00adual already receiv\u00ading Med\u00adic\u00adaid can con\u00adtin\u00adue receiv\u00ading it.<\/p>\n This com\u00adbi\u00adna\u00adtion of fac\u00adtors thor\u00adough\u00adly dis\u00adcred\u00adits the notion that there are 9.3 mil\u00adlion few\u00ader unin\u00adsured peo\u00adple as the result of Obamacare\u2019s Med\u00adic\u00adaid expan\u00adsion. Indeed, it is vir\u00adtu\u00adal\u00adly impos\u00adsi\u00adble to deter\u00admine how many peo\u00adple have gained cov\u00ader\u00adage so far due to this expansion.<\/p>\n The health con\u00adsul\u00adtan\u00adcy Avalere<\/a> has tak\u00aden a crack at it, esti\u00admat\u00ading that 1.7 to 2.7 mil\u00adlion pre\u00advi\u00adous\u00adly unin\u00adsured peo\u00adple liv\u00ading in expan\u00adsion states had been deter\u00admined eli\u00adgi\u00adble for Med\u00adic\u00adaid through the end of Jan\u00adu\u00adary. [Avalere esti\u00admates that some peo\u00adple liv\u00ading in non-expan\u00adsion states also had gained cov\u00ader\u00adage due to the law, although offi\u00adcials in some of these states have strong\u00adly dis\u00adput\u00aded the esti\u00admates<\/a>.] The Avalere esti\u00admates include \u201cthose who were pre\u00advi\u00adous\u00adly eli\u00adgi\u00adble<\/em> [for Med\u00adic\u00adaid] but new\u00adly enrolled due to greater aware\u00adness of cov\u00ader\u00adage options\u201d [empha\u00adsis added<\/em>]. Such esti\u00admates are high\u00adly ques\u00adtion\u00adable. How, exact\u00adly, does one quan\u00adti\u00adfy \u201cgreater aware\u00adness?\u201d In any event, if peo\u00adple were \u201cpre\u00advi\u00adous\u00adly eli\u00adgi\u00adble\u201d for Med\u00adic\u00adaid, Oba\u00admacare did not make them eli\u00adgi\u00adble for Med\u00adic\u00adaid. As a result, I would argue that the actu\u00adal num\u00adber of pre\u00advi\u00adous\u00adly unin\u00adsured peo\u00adple who today have cov\u00ader\u00adage due to the Oba\u00admacare Med\u00adic\u00adaid expan\u00adsion must fall some\u00adwhere below the 1.7 \u2014 2.7 mil\u00adlion range, though I think the data are too mud\u00addled to say much more than that.<\/p>\n Things should become clear\u00ader as the year pro\u00adgress\u00ades, but the impor\u00adtant thing to bear in mind is how lit\u00adtle get\u00adting an accu\u00adrate Med\u00adic\u00adaid count mat\u00adters. From the ben\u00ade\u00adfi\u00adcia\u00adry per\u00adspec\u00adtive, there is no dead\u00adline to sign up for Med\u00adic\u00adaid. Unlike the exchanges, where peo\u00adple must enroll by the end of this month, some\u00adone eli\u00adgi\u00adble for Med\u00adic\u00adaid can show up in an emer\u00adgency room or com\u00admu\u00adni\u00adty health cen\u00adter any day of the year and sign up on the spot. The Med\u00adic\u00adaid enroll\u00adment num\u00adbers will con\u00adtin\u00adue to mount over time. There is no March 31 cut-off.<\/p>\n From the per\u00adspec\u00adtive of insur\u00adance com\u00adpa\u00adnies, the health, age and num\u00adber of new Med\u00adic\u00adaid recip\u00adi\u00adents doesn\u2019t mat\u00adter. Unlike exchange-based insur\u00adance cov\u00ader\u00adage, pay\u00ading claims for a pool com\u00adpris\u00ading unusu\u00adal\u00adly old or unhealthy peo\u00adple cre\u00adates no finan\u00adcial risk. Claims aren\u2019t paid out of pre\u00admi\u00adums, since Med\u00adic\u00adaid recip\u00adi\u00adents pay no pre\u00admi\u00adums. The cost of their cov\u00ader\u00adage is borne entire\u00adly by the gov\u00adern\u00adment, which will finance their care out of tax\u00ades and new debt, no mat\u00adter the cost.<\/p>\n Indeed, there is real\u00adly lit\u00adtle rea\u00adson for Oba\u00admacare back\u00aders to play games with enroll\u00adment num\u00adbers, whether for Med\u00adic\u00adaid or pri\u00advate cov\u00ader\u00adage sold through exchanges. CBO<\/span> expects the law to reduce the num\u00adber of unin\u00adsured by rough\u00adly 45% over the next 10 years at a cost of a lit\u00adtle more than $2 tril\u00adlion. But that will take time. Data on the first four months of the first open sea\u00adson sug\u00adgest that a lot of unin\u00adsured peo\u00adple already have obtained cov\u00ader\u00adage. That num\u00adber will cer\u00adtain\u00adly amount to mil\u00adlions over the course of this year and mil\u00adlions more in the years to come.<\/p>\n That it is too soon to know just how many peo\u00adple have so far ben\u00ade\u00adfit\u00aded from the law should not detract from the fact that the num\u00adber of unin\u00adsured peo\u00adple in 2014 will be con\u00adsid\u00ader\u00adably less than last year\u2019s num\u00adber and that the 2015 num\u00adber will like\u00adly be low\u00ader still.<\/p>\n That is an achieve\u00adment that requires no exag\u00adger\u00ada\u00adtion or hyper\u00adbole. The law\u2019s pro\u00adpo\u00adnents should drop the num\u00adbers game and cel\u00ade\u00adbrate the fact that the law is reduc\u00ading the ranks of the uninsured.<\/p>\n","protected":false},"excerpt":{"rendered":" Near\u00adly 13 mil\u00adlion Amer\u00adi\u00adcans now have health insur\u00adance thanks to Oba\u00admacare. Tell Repub\u00adli\u00adcans to stop vot\u00ading to take their cov\u00ader\u00adage away. \u2013 Demo\u00adc\u00adra\u00adt\u00adic Leg\u00adisla\u00adtive Cam\u00adpaign Com\u00admit\u00adtee peti\u00adtion dri\u00adve Hyper\u00adbole over how many peo\u00adple have pre\u00adsum\u00adably gained health cov\u00ader\u00adage as the result of \u2026 Con\u00adtin\u00adue read\u00ading \n
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