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Chart showing enrollment data in both Medicaid/SCHIP in states, comparing states that fully embraced Obamacare with states that did so partially and not at all.
The Republican assault on Obamacare has gone far, far beyond just repeal votes in the House of Representatives. The most effective efforts have been in the states, if by effective you mean undermining the law by keeping people uninsured. Republicans are really good at keeping people uninsured. How good? The above chart from Talking Points Memo shows the discrepancy in enrollments in both Medicaid/SCHIP and private insurance between the states that embraced the law fully, partially, and not at all.

That comes from enrollment data compiled by Theda Skocpol, professor of government and sociology at Harvard University. States that fully embraced the law by creating and marketing their own exchanges and expanding Medicaid, like California and New York, have enrolled about 43 percent of people eligible for Medicaid in these first few months, and 37 percent with private enrollments. Compare that to the states like Texas and Florida which have refused to participate. That refusal hasn't just kept people in the Medicaid gap, it's suppressed private insurance enrollments. Just 1.5 percent of eligible Medicaid recipients have been enrolled, and just 5.6 percent of people in private enrollments. Skocpol discussed the data with TPM.

"You go back to how the law was designed, for better or worse, it gave states a lot of responsibility," Skocpol told TPM. "The states that have actually done things the way the law envisaged are the ones that are, at this early stage, doing the most toward those goals."

"But the 'Just Say No' states are putting all their lower income residents at risk," she continued, "not just by refusing to expand Medicaid but also, in many cases, by failing to help people get subsidized private coverage through the exchange."

This is early data, as there will be a lot more sign-ups in the next three months of open enrollment. [Update: The data from states using the federal exchange includes information just through November, so revised numbers could be significantly better, since the site has been fixed since then.] But there's still the very real possibility that millions of people—those in the Medicaid gap and more—could remain uninsured because of Republican obstruction. That's exactly what Republicans intended all along, of course. But it's very much worth reiterating that it's not just the very low-income potential Medicaid recipients that are being left out here.

Originally posted to Joan McCarter on Tue Jan 07, 2014 at 08:39 AM PST.

Also republished by Daily Kos.

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Comment Preferences

  •  Tip Jar (29+ / 0-)

    "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

    by Joan McCarter on Tue Jan 07, 2014 at 08:39:03 AM PST

  •  Nullified in Over Half the States. nt (12+ / 0-)

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Tue Jan 07, 2014 at 08:51:07 AM PST

    •  I wonder if at any point the insurance companies (6+ / 0-)

      will start putting pressure on the Repug leaders of those states obstructing Obamacare exchange enrollments.  Because the bottom line is those Repugs are costing them customers/money.  And if there's anything Repugs respond to its pressure from massive corporations.

      •  Business won't buy them over. (2+ / 0-)
        Recommended by:
        Sylv, Dodgerdog1

        The business community pressured Boehner to avert a shutdown, but he refused to budge. The Chamber of Commerce has lost control over the Frankenstein it helped create.

        •  Depends on which biz behemoth (1+ / 0-)
          Recommended by:
          Mr MadAsHell

          The insurance industry is only a fifth of the economy.

          The Koch brothers and other right wing billionaires are paying for a quarter of the medicaid expansion with a small tax of a percent or two on unearned income - it applies to all those who earn more than $250,000 in trong>UNearned income annually, so not on salaries or earned income, just the interest on their billions - that's gotta mount up.

          The Kochs alone spent $25 million fighting Obamacare.

          Obamacare will save me $3,000 in 2014, thank you Pelosi House Democrats

          by sotiredofusernames on Tue Jan 07, 2014 at 10:43:02 AM PST

          [ Parent ]

      •  The insurance and health care industries (1+ / 0-)
        Recommended by:
        Scott in Tampa

        have been pressuring Republican Governors and Legislatures since before the ACA was passed. They were entirely down with mandatory Medicaid expansion in the states, except for certain ideological wackos and criminals in management like Rick Scott. Insurance companies reportedly plan to invest half a billion dollars in advertising to sign people up to their ObamaReallyTrulyDoesCare policies. Because if you like them, you can keep them, and become customers of that company for life, or until we get to single payer. We're talking about 47 million uninsured here, or in other words real money.

        But they are up against the Tea Party money and organization, which they do not know how to counter, any more than Wall Street does. You can't get Republicans to show up at town hall meetings to demand Medicaid expansion. That would make them RINOs, or worse.

        Shutting down the government was too much for business Republicans, but anything less than that, particularly harshing on the poor and other riff-raff, still feels like Republicanism to too many on the Right, even when helping them is good for business. Because without the base, there is no Republican Party.

        Naturally, insurance and health care companies don't want to ally themselves with Democrats who still want to regulate them, and still less with the Loony Left that demonizes them, including a few Kossacks. (Pointing out immoral business practices in insurance and health care is not demonization. Claiming that the only purpose of ObamaCare is to enrich corporate CEOs is.)

        This is going to take years. Remember, the scariest words in the English language are, "I'm from the Republican Party, and I'm here to help." For example, by explaining how cutting unemployment benefits and refusing to provide health care is good for you, indeed it is the very reason why you should vote Republican. No?

        Ceterem censeo, gerrymandra delenda est

        by Mokurai on Tue Jan 07, 2014 at 11:41:03 AM PST

        [ Parent ]

    •  Nobody Could Have Predicted (0+ / 0-)

      that teahadist governors and state legislatures would try to torpedo the Kendonesian Muslim Socialist's signature legislative accomplishment, using the very responsibility given them by said legislative accomplishment.

      Just like nobody could have predicted that Republican senators would use the filibuster to block stuff.  Certainly nobody who had been watching what they had been doing since 2007.

      If only there had been some single federal program already in existence that could just have been expanded to cover more people......

      "A standing military force, with an overgrown Executive will not long be safe companions to liberty. The means of defence agst. foreign danger, have been always the instruments of tyranny at home." - James Madison

      by gharlane on Wed Jan 08, 2014 at 04:01:42 PM PST

      [ Parent ]

  •  This is a stunning argument AGAINST (19+ / 0-)

    block grants and other forms of "federal money, state administration".

    The Republicans have given us all the ammunition we need to show that leaving critical programs up to the states is not necessarily a good thing.

    I'm on a mission! Testing the new site rules.

    by blue aardvark on Tue Jan 07, 2014 at 08:59:40 AM PST

  •  While that's a nice chart, it won't change (9+ / 0-)

    many Republican minds.  If you look at it like a Republican, what it says is:  States that accepted Obamacare made millions more people dependent on the government.  Those states that didn't are keeping people free.

    We've got a large segment that believes that the government helping people is a bad thing.  This chart won't change that view.

    "Harass us, because we really do pay attention. Look at who's on the ballot, and vote for the candidate you agree with the most. The next time, you get better choices." - Barney Frank

    by anonevent on Tue Jan 07, 2014 at 09:30:41 AM PST

    •  Charlie Christ will win Floriduh when he campaigns (6+ / 0-)

      to allow Obamacare into the state

      "You can't think and surf at the same time" Yogi Surfdog

      by surfdog on Tue Jan 07, 2014 at 09:48:07 AM PST

      [ Parent ]

      •  Even if he does, he won't expand Obamacare. (1+ / 0-)
        Recommended by:
        Scott in Tampa

        The state legislature will likely remain in GOP hands, and it will not allow him to budge from rejecting Obamacare. Rick Scott tried to make them at least accept Medicaid, and they said no.

        •  The chart above shows that states that (1+ / 0-)
          Recommended by:

          cooperate with the Federal exchanges are doing much better than those that refuse.

          We must find out whether Florida could follow the example of Ohio, where Gov. John Kasich expanded Medicaid without any help from the Legislature. Republicans sued to prevent it, but lost.

          Ohio Supreme Court Upholds Medicaid Expansion

          And then there is always the next election, when we will be able to debate the reality of ObamaDoesCare, and they won't be able to get away with mere supposition. They will still lie, of course, but there are ways to get the facts out and show them up.

          Ceterem censeo, gerrymandra delenda est

          by Mokurai on Tue Jan 07, 2014 at 11:52:41 AM PST

          [ Parent ]

    •  When you did into many of the pols it appears (3+ / 0-)

      that only 20% of the population has been brainwashed to accept that premise.  The rest of the population is just to smart to believe the BS the Cons put out.

      The danger we face today is that so much of the media is owned by the few who want to push false memes.  That's the real fight. To bring back a Free Press.

      Congressional elections have consequences!

      by Cordyc on Tue Jan 07, 2014 at 10:01:20 AM PST

      [ Parent ]

    •  Fortunately, it is not Republicans whom we (0+ / 0-)

      have to convince. It is mostly swing voters, including millions of the children of Republicans who don't buy the old hatreds anymore. How can you keep them down on the farm now that they have seen the Internet?

      It wouldn't hurt to convince Democratic non-voters to come out to the polls, too. There are a lot more of us than of them.

      Obama's commanding lead—among non-voters

      As the taxi driver might have said if you asked him whether he knew the way to the White House,


      Ceterem censeo, gerrymandra delenda est

      by Mokurai on Tue Jan 07, 2014 at 11:47:08 AM PST

      [ Parent ]

  •  Chart looks off to me (3+ / 0-)
    Recommended by:
    RabbleON, Brainwrap, Sylv

    Going by the spreadsheet at, it looks like there are around 1.85 million Medicaid signups that haven't been allocated among the States yet, due to the once-a-month release of statistics.  Perhaps the chart will look a lot different after the data to be released around Jan. 11 is added in.  I'm sure that there will still be a big gap, but I'd like to think that the sabotage efforts ultimately will be fruitless.

  •  News networks will be all over this horror story (4+ / 0-)
    Recommended by:
    earicicle, Cordyc, VPofKarma, Sylv

    I'm quite sure.

    You know I actually can't even take small pleasure in wising off about this, because it's so fucking pathetic.  The GOP slime at least has some 'philosophical' excuse for their actions.

    What's the media's excuse?

    Someone gets 'cancelled' and we hear about it 24-7.  

    Millions are blocked by the actions of their own states?  Crickets and tumbleweeds.

    •  You might find brainwrap's new page (0+ / 0-)

      at ACA Signups helpful. In the News started yesterday with 16 solid links to mainstream news outlets (print, TV, and Web) linking to and even naming brainwrap/Charles Gaba, and I send him an update late last night with several more.

      That isn't anywhere near enough reality-based reporting, but it is way better than what there was without us.

      Even has had to take note of our work and our numbers, and admit that ObamaCaresAboutUs has a chance of working. Which they then pooh-pooh, of course.

      You can argue whether this means that the glass is half empty or half full, as long as we agree that the glass does not belong to the 1%.

      Ceterem censeo, gerrymandra delenda est

      by Mokurai on Tue Jan 07, 2014 at 12:06:11 PM PST

      [ Parent ]

  •  They're the ones who wanted state control. (5+ / 0-)

    The House-passed Obamacare bill created a national exchange, but conservatives insisted on 50-state based exchanges, arguing that local control is best. So what do the GOP-controlled states do? Well, they refuse to establish the exchanges and they turn it over to the federal government.

  •  I don't know if I'm insured (3+ / 0-)
    Recommended by:
    surfdog, Cordyc, Leftleaner

    I'm disabled, in Massachusetts.  I had been on the Commonwealth Care program, which was due to terminate on 12/31/2013.  We were required to re-enroll by 12/23/2013, except there was no way to enroll.  No plans were available.  The computer system stinks, so I printed out the enrollment forms and filled them out and mailed them in manually.  Now I'm told I can continue the specific plan I had (BMC HealthNet) by following the notification instruction in the new guide that was to be mailed to me in 2013.  It has not yet arrived.  Moreover, it said thgat to continue in that plan  I was NOT to re-enroll, which previously I had been told was mandatory, and which I sent in the manual form for.  In the meantime, I have no idea whether I have coverage after 12/31/2013.

    I know there will be those here who will try to give me a pol.itical answer.  I NEED to know if I have health coverage damnit!  I have two appointments booked for 1/15, and I have no idea whether I have insurance or not, and I have yet to receive the guide the state was supposedly going to send me last month!  I'm supposed to have a blood test this week, should I expect to have to pay for this myself?

    I haven't done anything wrong.  I've gone out of my way to attempt to comply with ever changing rules and requirements.  And I don't know if I'm covered.  THERE ARE NO REPUBLICANS INVOLVED.  Somewhere, whether at the state or federal level, Democrat are screwing up and basically terminating insurance of the disabled without making provision for replacement, and leaving us to twist in the wind with time passing.  Medical conditions don't stop for holidays or bureaucratic SNAFUs.  And somehow this is all my fault?  I'm not buying that, however good it mnay make a party hack to assert it.  It DOES matter that I have insurance, and the Commonwealth is deliberately obscuring whether or not I do.

    "Power concedes nothing without a demand. It never did and it never will." ~Frederick Douglass

    by ActivistGuy on Tue Jan 07, 2014 at 09:48:41 AM PST

    •  Have you called? (0+ / 0-)

      I've gotten my card from the private insurance corp here in CA but I'm still getting misinformation sent to me by Blue Shield.  For us the problem is in the private insurance corporation not being ready to handle all the new business.

      I've called a few times to get verification when I get misleading letters.  Now I have my card but have no need to use it.  We'll see what happens the first time I use it.

      Congressional elections have consequences!

      by Cordyc on Tue Jan 07, 2014 at 10:05:40 AM PST

      [ Parent ]

    •  Call your doctor's office (2+ / 0-)
      Recommended by:
      VPofKarma, Cardinal Fang

      and ask to talk to the person who handles billing and insurance issues, and see if they can break through the logjam for you. If you have a caseworker, call them. If that doesn't work, call the Mass Health number.

      My guess is that you have been automatically switched over to a new plan (Medicaid expansion?), since it would make no sense for Massachusetts to dump you through the cracks when you're clearly eligible for coverage.

      I doubt very much that anyone in Mass. is deliberately concealing information or holding up your coverage. It's much more likely that they have been swamped, and your situation isn't the usual set of questions and people are giving out conflicting information -- lack of coordination, inadequate training, whatever.

      This will all get sorted out. Don't panic, and definitely don't cancel your appointments.


    •  Take a deep breath and go to appointments (1+ / 0-)
      Recommended by:
      Cardinal Fang

      There is a lot of churn as we switch over. I doubt old or new insurers are in any position to give us a hard time.

      Worst case scenario you have a bill from the caregiver that won't get allocated to the correct insurer in time, and there will be a few calls over the first few months of adjustment.

      All this will pass. So glad you are safe now. I can't tell you what a relief it is for me knowing my disabled adult child is finally safe from the impermanence of coverage or eligibility pre ACA.

      Obamacare will save me $3,000 in 2014, thank you Pelosi House Democrats

      by sotiredofusernames on Tue Jan 07, 2014 at 10:52:01 AM PST

      [ Parent ]

  •  well of course... (2+ / 0-)
    Recommended by:
    a2nite, VPofKarma

    '(t)hat's exactly what Republicans intended all along."
    as far as they're concerned, the poors aren't worthy of health insurance.

    "The only thing that ever changed the conservative mind was the Union army." –Driftglass

    by mellowjohn on Tue Jan 07, 2014 at 09:50:17 AM PST

  •  Better to decrease the surplus population? (2+ / 0-)
    Recommended by:
    a2nite, VPofKarma

    Remember that lack of health insurance has been killing 45,000 Americans annually. The GOP is clearly determined keep this number rolling along.

    Ho'oponopono. To make things right; restore harmony; heal.

    by earicicle on Tue Jan 07, 2014 at 09:54:39 AM PST

  •  wow..23 states are refusing Obamacare?! (1+ / 0-)
    Recommended by:

    I did not know it was that many!

    "You can't think and surf at the same time" Yogi Surfdog

    by surfdog on Tue Jan 07, 2014 at 10:00:41 AM PST

  •  yea but (1+ / 0-)
    Recommended by:

    what about the proportion of the population that resides in those states that decided to participate?  don't they hold over 75% of the u.s. population?

  •  Percentages of what number? (0+ / 0-)

    As I understand it, all these percentages aren't measuring against the total number of uninsured as of Oct. 1. They're only measuring against the artificial target set by the CBO, which is much lower.

    Here in RI, the uninsured # was about 120,000. The CBO target (private + Medicaid) was 12,000, or only 10%. We're well on track to exceed that, possibly even as of 1/1/14 (they haven't released the 12/31/13 numbers yet).

    But that is only a small fraction of the uninsured. It will likely take a couple of years (judging by the Massachusetts experience) to get the percentage of uninsured down under 5%. And in communities with large numbers of immigrants without documents, or people cycling through the prison system, it will be hard ever to get there.

    That's millions of people still suffering and anxious, with the mechanism for helping them there, but just outside their grasp.

  •  A campaign vs. GOP "These guys are costing you $" (0+ / 0-)

    might go a long way to tipping the tables.

  •  The Republicans have already lost the war (0+ / 0-)

    The states that have fully embraced the ACA will provide a demonstration effect to the other states and health care will become a galvanizing election issue at the state and local level.  The only thing the GOP has to hold its anti-everything coalition together is Barack Obama.  As the President's numbers improve, as the economy improves and as the election season proceeds, the GOP will be hard pressed to maintain this level of intransigence without paying a political consequence.  I think Democrats will make incremental to solid gains in red states/regions in 2014 and will make bigger gains in 2016 and 2018.

    Global Shakedown - Alternative rock with something to say. Check out their latest release, "A Time to Recognize": Available on iTunes, Amazon, Google Play, Spotify and other major online music sites. Visit

    by khyber900 on Tue Jan 07, 2014 at 11:29:42 AM PST

  •  Obama Care will be unimportant (0+ / 0-)

    If the GOP and the Far Right continue as they have been, obstructing job creation, stimulus and if they are successful (as they have been so far) at chipping away at the social safety net, we won't be touting the success of Health Insurance Reform because the fallacy of Private Insurance as a method of serving anything but profits will be more obvious than any improvement in the wellbeing of THE PEOPLE. IT is like passing a comprehensive Equal pay for women bill or even the Lilly Ledbetter act when there simply are no jobs anyway. I remember when Australia tried a sham bunch of unemployment insurance fixes - back in the late 60's and early 70's. A person was not unemployed officially unless he or she was collecting unemployment insurance. TO collect one had to go to the storefront for the unemployment commission and the one assigned to you would ALWAYS be 25 or more miles away, off the otherwise great public transportation routes and would have very limited hours. Once there - you didn't qualify because you were obviously capable of work since you actually made it there. Poof- near zero unemployment. If everyone who wanted to work in the US was collecting unemployment insurance, we would find out the rate is not 7+% nor 14% but 22% or higher - the same rate as the 1930-35 averages. In other words we are in a really bad way with really great PR convincing us we are doing OK because Banks and Wall St are happy as clams. In the last year of Obama these facts will finally surface and the reaction will be a GOP House, Senate and President. THEN watch us crash. Obama Care will cease being a thought let alone an issue.

  •  aswed (0+ / 0-)

    my buddy's step-aunt makes $82/hr on the computer. She has been out of work for 10 months but last month her paycheck was $18010 just working on the computer for a few hours. read this….

  •  We Need a Poster... (0+ / 0-)

    ...that the low-information voters in the non-participating red states can understand.

    Before next November's elections, it needs to be demonstrated, loud and clear, in as few words as possible (no big discussions, no fancy charts) that the citizens of CA and NY are enjoying the benefits of the ACA as they were envisioned.

    It needs to be pointed out, loud and clear, how many people in NY and CA (and the others) are getting Medicaid.  And how the citizens of TX et al are not getting the assistance for which they qualify.  Only because their elected officials don't want them to have it.

    The responsibility for any failure of the ACA in TX, LA, and the like, has to be placed squarely on the heads of the GOP elected officials.  When will those citizens declare that "Enough is enough"?

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