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January 10, 2014

Sean Trende: Administration's Claimed Figure of Four Million Obamacare Medicaid Enrollments is Slightly Inflated (By a Factor of Ten)

DrewM. mentioned this analysis in the podcast.

[I] haven’t really seen much discussion about the Medicaid figures. The 4 million new beneficiaries seems to be taking on near-canonical status, even being used by the fact checkers at the Washington Post for evaluating GOP claims.

Shocker on that.

This is odd, because after looking carefully at the numbers cited, the Medicaid figures are the weakest of the bunch. It’s a virtual certainty that the number of enrollments attributable to Obamacare is an order of magnitude less than the 4 million sign-ups implied, and the number of people [on Medicaid] who would actually lose their insurance if Obamacare were repealed is probably around 200,000 to 300,000.

The problem is identified in this Ezra Klein column (emphasis mine):

“Meanwhile, in October and November alone, more than 4 million people signed up for Medicaid coverage. This number will be much higher when December’s totals are released. It’s hard to say exactly how many of those Medicaid enrollments Obamacare is responsible for -- the government’s numbers don’t distinguish between people who signed up through Obamacare’s Medicaid expansion and those who entered the program through pre-existing channels. But the fact remains that Medicaid enrolled well over twice as many people as signed up for private insurance through the exchanges."

(Note: Klein has just published more to this effect.)

This is really important stuff. The statistics tell us how many people signed up for Medicaid, period, in October and November. The problem is that people are always signing up for Medicaid. Even without the ACA, we would have had people signing up in October and November. Lots of them, in fact: Medicaid is a program that services 60 million citizens, so the number of monthly enrollments that keep a relatively stable population is pretty substantial.

So, how many of these 4 million sign-ups are attributable to Obamacare, and how many of them are just people who entered the system under the earlier rules?

...

Which brings us back to our number above: 1.9 million total enrollees approved in October or November in states that actually expanded Medicaid. If we are correct in our assumptions above—that is, if 10 percent of these enrollees are due to the Obamacare expansion—then we have an actual estimate for Medicaid enrollment due directly to the ACA’s expansion of Medicaid: 190,000.

That's an analysis of the 1.9 million claimed "Obamacare Medicaid enrollees" in the figures he has; if you double that number (taking account of enrollees through the exchanges) you still only get about 380,000.

That's generous in the Administration's favor. Even with such generous assumptions, the real number is less than ten percent of the claimed number.

And yet the Washington Post uses this figure to "fact check" Republican claims.

Corrected: I got confused about the "four million" enrollees claimed and the 1.9 million Trende has information for and thus could analyze. This resulted in my mistating how off these figures were (by a favor of ten, as opposed to twenty) and general numerical confusion.



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posted by Ace at 02:47 PM

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