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Today was a triple blow to the ACA Signups tally...but at least it's more accurate now, so there's some consolation.

First, after discussing the Medicaid conundrum extensively with Caroline Pearson of Avalere Health, I concluded that instead of a solid 7.6 million new enrollee figure, I'm going to have to go with a wide-range model of between 2.4 million - 7.6 million, depending on your POV.

Then, shortly after learning that Paul Krugman used my graph in his Princeton Economics PowerPoint presentation (page 19), I had to modify the exact same graph to subtract over 312,000 Medicaid enrollments from Washington State which, it turns out, were double-counted:

WA Medicaid: This is why I include so many caveats, kids...

Finally, late tonight, I found out that in Wisconsin, only about half of Oct - Dec Private QHP enrollees have paid so far.

I now have solid Paid/Unpaid data for 4 states out of 51 (w/DC): Nevada, Rhode Island, Washington State and Wisconsin. These 4 states combined total about 256,000 QHP enrollees, or around 8% of the total so far. Of that 256K, about 55% are paid in full as of this writing, but it's still not representative enough to come to any conclusions about other states (Rhode Island is at 85% paid, while Wisconsin is only at 50%).

However, we've reached the point where I do feel it's reasonable to start considering the "How many have paid?" factor when considering which enrollments to "count" (at least for enrollees through the end of December, anyway). I'm hoping this data will be included for the other states in the official HHS report to be released this week (I hope!), and will see what it has to say before deciding how to handle the paid/unpaid issue going forward.

Anyway, overall kind of a sucky day all around.

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