Obamacare

New York Times Exaggerates the Number of Americans Newly Covered by Obamacare Subsidies and Medicaid Expansion

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White House

In a  story about House Budget Committee Chairman Paul Ryan's latest 10-year spending plan, New York Times reporter Jonathan Weisman says the Wisconsin Republican proposes "total repeal of the Affordable Care Act just as millions are reaping the benefits of the law," a juxtaposition that sounds like a Democratic talking point. Later Weisman claims "more than 10 million Americans have gotten health insurance through the law, either through private policies purchased on insurance exchanges, through expanded Medicaid or private policies purchased through brokers but subsidized by the law."

That estimate apparently includes the 7 miillion or so people who have picked out plans on the federal or state exchanges, not all of whom actually have "gotten health insurance," which requires paying the first premium. At this point we do not know how many of the 7 million have taken that step. Furthermore, we do not know how many are newly covered and how many were previously insured but switched to the exchanges, perhaps because their old policies were canceled as a result of Obamacare's minimum coverage requirements. Hence it is quite misleading to say that all 7 million "have gotten health insurance through the law," which implies that they would have been uninsured but for the law.

Weisman would have been aware of these two issues if he kept abreast of my colleague Peter Suderman's insightful Obamacare coverage—or if he had read the work of his own colleagues. In a story on the front page of today's Times, Michael Shear and Robert Pear note:

Several of the most ardent critics of the health care law expressed doubt about the official tally of sign-ups, noting that the White House had not released information about how many people who signed up had paid their initial premiums.

The critics also noted that an unknown number of people who signed up at HealthCare.gov had previously been insured under plans that were canceled. White House officials said they did not yet have a tally of that category.

How big a difference might these two factors make? Pretty big. In a recent Forbes post, Avik Roy cites surveys by McKinsey and the RAND Corporation indicating that between one-quarter and one-third of exchange enrollees were previously uninsured. According to the McKinsey survey, only 53 percent of previously uninsured enrollees had paid their first premiums. Taken together, these findings suggest that the number of previously uninsured people who have obtained coverage through the exchanges may be closer to 1 million than 7 million.

Weisman says he is also counting people who obtained coverage "through expanded Medicaid." According to a recent tally by Los Angeles Times health care reporter Noam Levey, the RAND survey (which has not been published yet) indicates that "at least 4.5 million previously uninsured adults have signed up for state Medicaid programs." Even if all of those people were previously ineligible, we are still more than 4 million shy of Weisman's "more than 10 million" claim.

What about people newly covered by "private policies purchased through brokers but subsidized by the law"? According to RAND's survey, Levey reports, "about 9 million people have bought health plans directly from insurers," but "the vast majority of these people were previously insured." Levey also notes that, according to data from the U.S. Centers for Disease Control and Prevention, "an additional 3 million young adults have gained coverage in recent years through a provision of the law that enables dependent children to remain on their parents' health plans until they turn 26." But Weisman's description of his estimate does not include those people.

Eric Boehlert of Media Matters for America does include the 3 million adults newly covered by their parents' plans but, like Weisman, erroneously counts all 7 million exchange enrollees. Put those two numbers together, Boehlert says, and you can see that "more than 10 million people have used Obamacare to secure health coverage." Well, not quite. CBS News plays it safer, saying "it's possible that more than 10 million people have insurance thanks to Obamacare," counting the changes to Medicaid and family plans as well as insurance bought through exchanges. Levey says "at least 9.5 million previously uninsured people have gained coverage." He assumes that one-third of exchange enrollees were previously uninsured (as indicated by the RAND survey) but does not consider how many have paid their first premiums.

One point none of these estimates seems to consider is that some previously uninsured people would have obtained coverage even without Obamacare. We do not know, for example, how many 25-year-olds would have bought their own health insurance or obtained it through work had they not been covered by their parents' plans. Even some of the people newly eligible for Medicaid might have found jobs with health benefits and therefore obtained medical coverage anyway. If we want to measure Obamacare's impact on the number of uninsured people, we need to have some idea of what would have happened in the absence of the law.

The most striking thing about these numbers is that the exchanges, which were supposed to be the centerpiece of Obamacare, so far have resulted in new coverage for fewer people than either the Medicaid expansion or the mandate that family policies cover children up to age 26. At this point the exchanges look like a needlessly elaborate and inefficient way of providing medical coverage to previously uninsured Americans.

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  1. None of any of this matters as Tony has assured us because at least one more deserving member of the lower classes has something vaguely resembling health care coverage….and isn’t that what is really important here?

    1. Have you ever noticed that when progs talk about the uninsured – when discussing the O’care mandate – they sound more like hardcore Objectivists rather than bleeding hearts?

      1. Yup.

        It was really weird hearing them labor on about personal responsibility.

        1. Even though the fucked a few million people that were being personally responsible into losing their affordable coverage.

  2. I can’t find the quote about the guy reading Soviet propoganda about X million shoes being made and while others thought they exaggerated the numbers, he wondered if they made any shoes at all.

    1. I think that’s from 1984. At least, it appears there.

      1. I thought so too, but Google didn’t find it w/ any search string I tried.

        1. Statistics were just as much a fantasy in their original version as in their rectified version. A great deal of the time you were expected to make them up out of your head. For example, the Ministry of Plenty’s forecast had estimated the output of boots for the quarter at 145 million pairs. The actual output was given as sixty-two millions. Winston, however, in rewriting the forecast, marked the figure down to fifty-seven millions, so as to allow for the usual claim that the quota had been overfulfilled. In any case, sixty-two millions was no nearer the truth than fifty-seven millions, or than 145 millions. Very likely no boots had been produced at all. Likelier still, nobody knew how many had been produced, much less cared. All one knew was that every quarter astronomical numbers of boots were produced on paper,

          1. Boots, not shoes. That was my search problem. Thanks.

            1. How can you stomp on human faces without boots? Another inevitable failure of socialism.

              1. If I recall my Day in the Life correctly, you force the prisoners to select felt boots in the winter for the warmth, confiscate their leather boots, and then stomp on them with those. The system works, once you understand it.

  3. I think it’s double plus good that Obamacare has increased the healthcare ration from two to four. Don’t you agree?

    1. You have it backwards, he increased it from four to two.

      1. Bestest 5 year plan ever.

        1. Better than Straczynski’s?

  4. I think this is exactly right. If the question is “How many people, who previously did not have health insurance, have signed up for health insurance due to the marketplace, whether due to availability, affordability, or coercion?”, the numbers given don’t answer that question. The question they answer is “How many people have signed up for health insurance in the current system?” If the goal is to cover the uninsured, the first question is appropriate; if the goal is to shift people into a government system, the second is appropriate.

    1. I say this because, if a supporter of the law is an honest progressive who believes the point of the law was to cover the uninsured, they should be concerned that this law isn’t achieving what it set out to do. It isn’t even about whether or not you support the law. It’s a viewpoint neutral assessment.

  5. “Gentlemen, we’ve got to get more people on welfare, to protect our phony baloney jobs!”

    1. Harumph, harumph

      1. That guy back there didn’t harumph!

        1. “Give the Governor a harumph!”

  6. Yes, We Can Wait
    …But it was the line photos that we found arresting. And it’s clear McGuinness was advancing a White House line. Press secretary Jay Carney opened his daily briefing yesterday with the following gasconade: “As you can see by the lines around the country this weekend, we are seeing a surge in enrollment.”

    The first thing we thought of when we saw the pictures was the photos we’ve recently seen on Twitter of Venezuelans waiting in bread lines. Waiting in line to purchase necessities is a characteristic not of a prosperous free society but of command economies under repressive regimes. Closer to home, one doubts even the Transportation Security Administration would be so tone-deaf as to advertise long airport lines as an indication it’s doing a great job….

    …”This is like trying to find a parking spot at Wal-Mart on Dec. 23.” Note that Wal-Mart’s marketing emphasizes its “everyday low prices.” The chain doesn’t boast, ? la the White House: “Our prices are so low, people wait in interminable lines to pay them!”…

  7. a juxtaposition that sounds like a Democratic talking point

    Do you guys ever quote Fox News and say “sounds like a Republican talking point”? Maybe you should!

  8. A couple of points I heard on the radio and read on the intertubes today.

    1) Interesting how for so long, they could not come up with any estimates of how many people were signing up, but at the deadline, they came up with a number as precise as 7.1 million.

    2) “Success” was touted based on the number of people signing up on the web site, but there was no mention of how much the plans cost, how high the deductibles were, or how many people lost insurance due to the law. IMO, even if 14 million signed up, the law still causes more harm than good.

    1. Doesn’t matter. We can pick things apart with logic and reason, but the LIVs, Tonys, and the Media don’t care. In ten years, history books will say the Lightbringer gave health care to the poor, filthy peasants.

      1. Isn’t it odd how, if an insurance company drops someone, then it’s the insurance company’s fault, but if they add someone, it’s to the administration’s credit? I’ve actually been pleasantly surprised how little the public has demonized insurance companies, rightfully putting the blame on the administration.

  9. Reposting my take on the numbers, because this is a better place:

    Near as I can tell, here are the numbers on OCare, taking the most favorable approach:

    People who lost insurance due to the mandates: 5mm. (This doesn’t include the part-time workers whose employers no longer offer coverage to them, BTW.)

    People who signed up on the exchanges: 7mm

    People who will actually pay for their exchange policy: 5.5mm

    A net gain of 500K insured, best case scenario. Better than I thought.

    The thinking is that around half of those on the exchanges were previously insured, maybe more. This works out to 3.5mm previously insured who bought exchange policies, leaving 1.5mm who went from having insurance to not.
    What a huge success!

    Note: numbers from Shikha’s article yesterday, which seems solidly sourced, given the environment of lies and misdirection from the administration.

    http://america.aljazeera.com/o…..ealth.html

    1. People who lost insurance due to the mandates: 5mm.

      Source, please. (No wingnut sites)

      http://www.washingtonpost.com/…..are-claim/

      1. I thought you said no wingnut sites?

        1. Here’s another source for the 5mm:

          http://www.forbes.com/sites/sa…..ellations/

          Here’s a better link to Shikha:

          http://america.aljazeera.com/o…..ealth.html

          And you’re posting a Dem report from a partisan blog, which contains the obvious lie that Obama’s attempt to reinstate the cancelled plans had any effect whatsoever. It didn’t and couldn’t, because those plans had to be approved by the states and weren’t.

          1. Sorry, RC, but Forbes and Al Jazeera are now officially considered “wingnut sites.”

            Any site that posts any story that is critical of His Holiness the Lightbringer, Obama the Magnificent is considered “wingnut.” Didn’t you get the memo?

      2. Your source is a liberal quoting a report issued by a Democratic politician.

      3. Bite the pillow shreeky…….

    2. All wrong, I’m afraid. All of the data points toward our having already exceeded the CBO projection for newly-insured in the individual market, and being more than halfway to the CBO projection for newly-insured from expanded medicaid, with 9 months to go and Michigan just starting today. I do mean all of the data, by the way, including the raw data from the McKinsey survey. The laughable 27% “statistic”, of course is not “data”.

      Anyone who wants to learn something can start here:

      http://blogs.marketwatch.com/h…..obamacare/

      …and then re-read http://www.latimes.com/nation/…..2960.story with a less intellectually lazy mindset.

      1. None of the article you linked refutes concerned raised by skeptics of the law.

        The LAT article mentions that about 6 million people who purchased insurance in the marketplace, but only about a third of them were previously uninsured. Some of these people probably made enough money to not qualify for (newly expanded medicaid), meaning they could actually afford insurance of some kind.

        LAT also says the vast majority of the 9 million who purchased plans directly from insurers already had insurance. 3 million “children” are covered, but only until they’re 26.

        There are probably 3,4 million people who are covered now ONLY because of ACA. But as I mentioned, some of them simply chose not to buy insurance and others will be uninsured as soon as they turn 26.

        The ACA’s target audience is heading straight to medicaid. I enrolled just to avoid the penaltax. I, as well as millions of others, won’t pay a diddily cent into the insurance pool. Think about that for a minute.

        1. RAND estimates that there are ~9.5M newly-insured split evenly between the individual market and expanded medicaid.

          Re-read Levey with that in mind. Who was he citing when he put forward the “one-third previously insured”?

          1. And those 4 to 5 million individuals who enrolled in medicaid won’t contribute to the insurance pool. The ACA effectively relieved them of buying any sort of insurance by cancelling cheaper plans. Would you pay premiums for a bronze plan if you could just latch onto medicaid?

            I’m no stranger to local hospitals and free clinics. I’m not under any illusion that there WON’T be overcrowding or serious rise in the cost of healthcare. Keep in mind that lots of people were already “covered” by local programs (like healthy way LA) which is now being transitioned to medicaid.

            If most people simply upgraded to a new plan after their old one was cancelled, then ACA achieved little. We’re looking for the number of people without coverage who are able to afford insurance ONLY because of ACA. That’s why the 9 mil figure is deceptive.

            The LAT articles confirms what we already suspected. Most people who skipped the exchange and went straight to insurers were already covered. Only about a third of the rest had no insurance.

            1. OK – see that I have used ambiguous phrasing. Where I wrote “newly-insured” please read “previously uninsured”. I read the wsj piece as reporting the RAND study as estimating that ~4.75M previously uninsured people enrolled in the public exchanges.

              Levey in the Times says “At least 6 million people have signed up for health coverage on the new marketplaces, about one-third of whom were previously uninsured.” which would appear to be a contradiction except that he is not quoting RAND here. In fact the Times article is a melange of data some sourced, and some not.

              That’s my starting point – RAND never said that only a third of the exchange enrollees were previously uninsured – in fact, they are implicitly saying that most of them were.

      2. Am I supposed to reply to myself here? Sorry about that…

      3. I’m a little embarrassed now – I have (obviously) a burr up my backside about people who have genuine philosphical objections to the ACA substituting instead deluded arguments that the ACA is failing on its own terms. And reason.com, in my view should be the very place (based on old memories) where that real argument – not partisan sniping – that should be happening. But I see none of it – so I came out guns blazing …

  10. 7.1 million…just over the target, when the goalposts stopped shifting. Funny that.

    Remember when unemployment was in the 9 % range, but never ticked into double digits, just never quite went over 10%…funny that.

    Somehow I’m reminded of Obama’s comment about going skeet shooting, which was met with skepticism. Then suddenly a single picture of Obama firing a shotgun appeared. When that obviously staged pic was presented as proof positive that O was a skeet shooter, I knew that no lie was too obvious.

  11. The Obamacare approach to apartment rentals would be to burn down a bunch of homes, and then trumpet the surge in rentals of your new apartments as proof that you are solving homelessness.

  12. “he is also counting people who obtained coverage “through expanded Medicaid… Even if all of those people were previously ineligible, we are still more than 4 million shy of Weisman’s “more than 10 million” claim.”

    A friend who was a healthcare analyst once pointed out that Medicaid only actually provided coverage to about 40-60% of the people who were in fact eligible, such that any ‘expansion’ of it was largely unnecessary if the programs simply ‘automatically’ enrolled those who were *already* eligible.

    meaning, the progs who go off on froth-fests about the dire need for Medicaid expansion don’t actually know what they’re talking about = its already *underutilized*, and for good reason: it sucks

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