Understanding the New Obamacare Numbers

Health and Human Services Secretary Kathleen Sebelius testifies on Capitol Hill in Washington, Wednesday, Oct. 30, 2013, before the House Energy and Commerce Committee hearing on the difficulties plaguing the impleme... Health and Human Services Secretary Kathleen Sebelius testifies on Capitol Hill in Washington, Wednesday, Oct. 30, 2013, before the House Energy and Commerce Committee hearing on the difficulties plaguing the implementation of the Affordable Care Act. The Obama Administration claims the botched rollout was the result of contractors failing to live up to expectations – not bad management at HHS. As the public face of President Barack Obama's signature health care program, Sec. Sebelius has become the target for attacks over its botched rollout with Republicans, and even some Democrats, calling for her to resign. (AP Photo/J. Scott Applewhite) MORE LESS
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For months we’ve been getting various different metrics purporting to show the success or failure of Obamacare. There are a bunch of different numbers, different reporting methods by state, an orchard of apples and oranges. And behind all these uncertainties you have the question of how many of the people who’ve gotten coverage under some flavor of Obamacare are actually newly covered – as opposed to people who simply traded one kind of insurance for another. The 7.1 million private sector sign ups number got all the attention this week. But getting less attention have been a series of new reports using distinct, though internally consistent approaching to quantifying just how many more people have coverage today than did before Obamacare.

If you try to line them up on something like an apples to apples basis, they’re broadly consistent: upwards of ten million people have coverage now who lacked it in the past. The first was a Rand study which the LA Times filled out with other publicly available data and their own reporting. They came to a total number of 9.5 million people who newly have coverage.

That was followed by a study by the Urban Institute which came up with 5.4 million newly covered people. But they notably did not include what is estimated to be roughly 3 million young adults who are now covered under parents’ plans. Add that and you get 8.4 million, which is lower but in the same ballpark as Rand/LAT. Urban Institute notes that their study likely did not capture a lot of the late March surge. And LAT/Rand seems to have gotten more of that.

Now today, the administration itself has made its first attempt to get at the contentious issue of how many of the more than ten million Medicaid sign ups since Oct. 1 are actually people who are newly covered. The raw number of sign ups is 11.7 million. But the administration notes that the actual net increase in people covered by Medicaid is about 3 million people. So conservative critics had a decent point noting that the big number gave an unrealistic sense of the impact of Obamacare.

Now, to map these studies against each other, Rand/LAT pegged the new Medicaid number at 4.5 million, as opposed to 3 million – a really big difference. But it’s also important to note that the administration computation does not include Medicaid enrollments in March. So this may explain some of the discrepancy.

Of course, all of this would be a lot easier if there was a national database of who has insurance and who doesn’t. But of course nothing remotely like that exists and you actually have 50 different insurance microcosms. So each of these studies are using pretty significantly different methodologies to capture what is not only an elusive picture but one that remains in motion. Indeed, the Rand/LAT number, which appears to be the ‘latest’ of the three, went with the 6 million private sector sign ups number. In other words, their tally doesn’t include the big bump in signups that came in the final days of March and nudged the number to 7.1 million.

What stands out most to me is that each study comes up with broadly similar results. And these are the first attempts to get at this critical question of the real impact of Obamacare on lower the number of uninsured people – as opposed to applying partisan hopes onto aggregate numbers. Put them all together, add in that none is actually up to date as of the beginning of April, it appears we can conservatively estimate that a good 9 million people now have new care.

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