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Cross-posted at
Yes, this is self-serving and smug of me. I really don't care at the moment:
Enrollment in Medicaid spiked in December, aided by Obamacare exchanges and an expansion of the government-run health coverage program for the poor in 25 states...

By the end of December, more than 6.3 million people were determined to be eligible for Medicaid or CHIP, the program covering children, through state-run agencies and state-based Obamacare exchanges, according to a Centers for Medicare & Medicaid Services report released Wednesday.

That tally does not include the 750,000 or so people who were determined eligible in Medicaid through the federally-run Obamacare exchange

Adding the two enrollment numbers together equals more than 7 million Medicaid-eligible determinations. But some of the determinations made by may be duplicative of state-based decisions.

As it happens, if you look at the Medicaid/CHIP spreadsheet, I deliberately left out about 620,000 Medicaid enrollees from the total because I suspected they would otherwise be double-counted.

I particularly like this part later on:

Health care analyst Timothy Jost, a professor at the Washington and Lee University School of Law, said that high percentage is "the key number" and suggests that a big chunk of the Medicaid sign-up reported Wednesday are due to new enrollees.

But how big a chunk is difficult, if not impossible, to figure out from the CMS data, Jost said.

"The numbers are just so confusing," he said.

Took the words right out of my mouth.
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Comment Preferences

  •  Could have sworn they got the numbers from you (5+ / 0-)

    and not CMS: they were that close!

    Shall we go? Yes, let's go.

    by whenwego on Wed Jan 22, 2014 at 04:40:51 PM PST

    •  I love your spreadsheet and look almost daily (10+ / 0-)

      The work you do is so important and vital.  It gives me very effective ammunition to straighten out the right-wingers like my sister who says a friend of hers assured her that "nobody is signing up."

      The state numbers are fascinating.  The private signups in Georgia and Alabama have really taken off in a very encouraging way.  Oregon and Maryland of course are a disaster.

      Brace yourself.  A lot of people do not want these numbers to be available because it threatens their desire to discredit the Affordable Care Act.  Many news outlets for example were reporting the ACA signups in early January as 1.1 million instead of 2.1 million.  When they started using your spreadsheet, suddenly they started reporting the correct 2.1 million number.  Kaiser has recently had a slew of misleading articles. My sister was not at all happy to see the numbers and that yes, people were signing up.  I think you will get a lot of pressure to quit providing a factual basis for assessing what is actually happening.

      Your spreadsheet is extremely valuable, and of course fascinating for anyone who takes the time to run down the individual states.

      Bless you for doing this!

    •  Actually, CMS got their numbers from Charles Gaba. (2+ / 0-)
      Recommended by:
      Brainwrap, whenwego

      “The meaning of life is to find it.”

      by ArcticStones on Thu Jan 23, 2014 at 03:15:33 AM PST

      [ Parent ]

  •  I like the effort you have put in...but... (1+ / 0-)
    Recommended by:

    Considering we don't know how many of the Medicaid eligibles are simply people who already had Medicaid...the Medicaid number is pretty worthless

    And now considering there is no push back from the WH on the insurance poll that the overwhelming number of private signups are people who already had insurance...that number is not very meaningful

    Considering we are all just guessing right now, maybe you should give yourself a break as you have been stressing out over it

    Let some intern in the WH worry about this mess

    •  Actually, you're only partially correct. (9+ / 0-)

      Washington State separates out renewals from new enrollees, and is even kind enough to specify how many of those new enrollees are due to Expansion.

      Medicaid Newly Eligible Adults: 134,700

      Medicaid Previously Eligible but not Enrolled: 63,070

      Medicaid Redeterminations (Previously Covered)  183,141

      So, out of 381,000 people, over 35% are directly due to the ACA expansion and another 17% are probably (mostly?) due to it...these are people who were already qualified but most likely never realized it until all the media attention to the ACA and the exchanges kicked in.

      Unfortunately, I don't now how representative WA is of the country at large, but if it is, that suggests that roughly half of the 6.3M are thanks to the ACA.

      •  The other number that we cannot discern is how (7+ / 0-)

        many people had no insurance because of pre-existing conditions and are now available to purchase it. I think here in CA at lot of folks were like us - had insurance but could not move due to pre-existing (small business, group policy). Ditched Anthem the minute we could and we now have an individual policy for the hubbie and I.  

        if a habitat is flooded, the improvement for target fishes increases by an infinite percentage...because a habitat suitability index that is even a tiny fraction of 1 is still infinitely higher than zero, which is the suitability of dry land to fishes.

        by mrsgoo on Wed Jan 22, 2014 at 06:38:19 PM PST

        [ Parent ]

  •  Things Are Looking Really Good (5+ / 0-)

    The ACA really seems to be moving now.  Unfortunately, there is always some ambiguity when you are accumulating massive amounts of data from multiple sources and the Republicans will use that to try to totally twist the data to somehow portray the ACA as a total failure.  This is a common Republican tactic and the only way you can combat it is by continuing to hit the Conservative propaganda machine with actual facts and figures until the data become so indisputable and so overwhelming that the Republican Party ultimately crumbles under its own pile or misinformation and lies.  

    •  Not so sure (0+ / 0-)

      There is a lot of ambiguity, but also there are indications the numbers just are pretty bad.  

      The CEO of US Healthcare said yesterday, that they were finding only 11% of the people signing up for their policies through the websites had previously been uninsured.  

      He also said that while USH was submitting prices in May for 2015, depending upon the makeup of the policies they were selling they might consider exiting the ACA market entirely.  

      Vague obviously, but still unsettling.

      The other problem is we'll shortly be able to learn how many of those policies were actually paid for and are in place.  Another wildcard.

      As for the 6 million medicaid/chip number, if it includes people renewing prior policies and people who would have qualified pre-expansion the number seemingly is of no value.  I think a lot of us incorrectly believed that number was entirely driven by the expansion and that is incorrect.  So we'll have to wait for post 3/31 to determine whether the medicaid expansion has been a success.

      I've got nothing but respect for what Brainwrap has attempted here, but if the underlying data is so ambiguous I don't see how we can draw any conclusions from his efforts.

      •  Your concern is duly noted. (0+ / 0-)

        if a habitat is flooded, the improvement for target fishes increases by an infinite percentage...because a habitat suitability index that is even a tiny fraction of 1 is still infinitely higher than zero, which is the suitability of dry land to fishes.

        by mrsgoo on Wed Jan 22, 2014 at 06:44:19 PM PST

        [ Parent ]

      •  The Medi-Cal numbers from California (2+ / 0-)
        Recommended by:
        Vatexia, ArcticStones

        are new enrollees, according to a report released yesterday by Covered California. It says 405,000 Medi-Cal applicants in December were found likely eligible for coverage - "far more than the 108,000 during November. For the three-month period October-December, a total of 584,000 applicants were determined to be likely eligible for Medi-Cal through the enrollment portal."  This means that the Medi-Cal applicants found eligible from Oct.1-Dec. 31 came through the exchange ("the enrollment portal") and were not renewals.

        You can also find much information about Medicaid numbers state by state here.

        The spirit of liberty is the spirit which is not too sure that it is right. -- Judge Learned Hand, May 21, 1944

        by ybruti on Wed Jan 22, 2014 at 07:16:48 PM PST

        [ Parent ]

        •  Got it, but.. (0+ / 0-)

          Understand that the 584k came through the portal, but how many are eligible under the prior rules & how many additional are going to receive insurance because of the expansion?

          That seems like the key measure of how things are going on the medicaid side of the equation.

          •  On Jan. 1 of this year (1+ / 0-)
            Recommended by:

            630,000 non-elderly childless adults without disabilities were added to Medi-Cal. Not eligible for Medicaid under the rules before 2014, these adults were enrolled previously in an ACA-funded program (The Low Income Health Program) set up in 2010 as "early Medicaid Expansion" in several states.  You can see a reference to these adults in the first paragraph of yesterday's California report. The director of Medi-Cal is quoted later in the report:  

            the former members of the LIHP program and members now newly eligible because of the Affordable Care Act’s Medicaid expansion will receive high-quality care from Medi-Cal managed care health plans. The selection of health plans varies by county and includes many of the health plans offered to those who purchase coverage through Covered California.

            The spirit of liberty is the spirit which is not too sure that it is right. -- Judge Learned Hand, May 21, 1944

            by ybruti on Wed Jan 22, 2014 at 08:01:25 PM PST

            [ Parent ]

            •  See also this article about the low income health (0+ / 0-)

              program: "This Program Was Bigger Than Covered California. Why Did We Ignore It?"

              The program was conceived as part of the state's "Bridge to Reform," an initiative made possible with a Section 1115 waiver from CMS in November 2010, and began enrolling eligible California residents in July 2011. (Enrollees essentially had to make too much money to qualify for "traditional" Medicaid, but no more than about 138% of the federal poverty level.) Each county was offered an opportunity to create its own LIHP and some initially demurred, citing concerns about the ACA's legality or their own liability.
              Ultimately, about 20 different LIHPs were created; the state transitioned about 630,000 enrollees into Medi-Cal on Jan. 1, when the program expired. (An additional 24,000 enrollees were steered toward Covered California.)
              The LIHP wasn't alone in structure or ambition. Six other states made similar moves to expand their Medicaid programs ahead of the formal launch date, although their programs ended up being a fraction of the scope.

              The spirit of liberty is the spirit which is not too sure that it is right. -- Judge Learned Hand, May 21, 1944

              by ybruti on Thu Jan 23, 2014 at 09:49:43 AM PST

              [ Parent ]

  •  Analyses Like These Always Complicated (4+ / 0-)

    Making these types of analyses is always complicated so I have tremendous respect for the people compiling and analyzing these figures here.  I am an engineer with multiple advanced degrees and decades of experience and it is exceedingly common to have to make conclusions from incomplete or sometimes contradictory data which is why this type of work can be very difficult.  However, this doesn't mean that you just throw up your hands and don't do it.  

    Data in the real world is always incomplete to some degree and if you wait till every conceivable piece of data has been acquired and everything is totally unambiguous you will never conclude anything because there is always something else you need to check out or clarify.  There is always to some degree some uncertainty in any conclusion.  

    I think you guys are doing an incredible job and I feel as more and more data become available we will ultimately converge on a reality very close to that discussed here. If you do not do this work then the Republicans will unilaterally create some fantasy world to support their rather perverse and distorted view of the real world.  There clearly has got to be some forum in which we can counter this perpetual wave of propaganda being advanced by the far right.  And you can't wait for three years until all the data has been neatly compiled and reviewed in 15 peer reviewed journals before you do this or the Republicans will already have shaped public opinion and won the political war with their flagrant misrepresentation of the facts.  

  •  What? (0+ / 0-)

    I just read a diary on Daily Kos in the last few days that the combined total (fed exchange, state exchanges plus Medicaid) totaled $11.9 MILLION sign ups.

    Which is it?

  •  Visit and see for yourself (1+ / 0-)
    Recommended by:

    Private QHPs (private health plans): 2.53 million
    Sub26ers (covered by parents’ plans): 3.1 million
    Medicaid/CHIP (discussed in this post): 6.32 million

    Grand total of people covered: 11.95 million people

    So, as you see, both 6.32 million and 11.95 million are correct.
    However, they refer to different things. :)

    “The meaning of life is to find it.”

    by ArcticStones on Thu Jan 23, 2014 at 03:29:04 AM PST

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