You are cordially invited to participate in a crowd-sourced research project to determine how many people have gained health care coverage through the Affordable Care Act (ACA). One of the biggest fake news stories all over the internet is “20 million will lose coverage if Obamacare is repealed.” President Obama chose his words carefully and said that since the law was passed, about 20 million more people have insurance. However, sloppy “journalists” have translated this into because the law was passed and even worse, the headline listed above. Over that same period, according to the Bureau of Labor Statistics, about 13 million people gained jobs. Presumably some, if not many, acquired insurance that way. Millions more became eligible for Medicare as the Baby Boom bulge reached retirement age. We need to stick to primary sources for information – no talking heads, no news websites.
Mostly because our government won’t make key pieces of information available, perhaps through our networks we can piece together a reasonably good estimate of the number of people who have acquired health care insurance because of this legislation.
This is a non-trivial exercise because there are many variables that affect who and how people obtain health care coverage.
Let’s assume for this purpose that the 20 million figure is accurate.
Here are other factors contributing to this number:
– As mentioned above, the BLS reports that about 13 million (depending on which months you choose as starting and ending dates) more people are employed. Incidentally, this is the smallest percentage increase in employment coming out of a such a recession. We need an estimate for how many of these people obtained insurance through their employers. I believe the ACA provides that any employer with more than 50 employees must make insurance available, so all of those people who went to work at places with more than 50 employees obtained coverage that way.
– How many people who were not covered became eligible for Medicare simply by aging? This number will be in the millions, but I haven’t explored it yet.
– Apparently, millions of people who were previously eligible for Medicaid but had not enrolled before did enroll during this period, so they wouldn’t have to pay the penalty. This is one of those gray areas, where it is open to interpretation whether or not to credit these enrollments with the passage of the ACA.
– How many people became eligible through the Medicaid expansion provision? This number should be fairly easily obtainable.
– How many people lost coverage because their job was eliminated as a result of the ACA? The CBO first estimated 0, but then were forced to change their estimate to 2.5 million people who lost jobs (although many of these would not have had employer-provided coverage).
– How many people had their individual policies cancelled and were then forced to buy a new policy in the exchange or another individual policy? The number had reached 6 million before the Obama Administration told health insurers to stop reporting the number.
– How many people became covered by extending the age they could stay on their parents’ coverage to 25?
o Of these, how many have the option of employer-provided coverage but stay on their parents’ policy because it is essentially “free” to the young adult?
– How many are fraudulently enrolled? Multiple audits have generally found that 100%, or nearly 100%, of fraudulent applications, including those with subsidies, have been approved by the “system.”
– The number of people who purchased insurance rather than pay the fine. This is an interesting one to count. Of course, it is the responsibility of the ACA that these policies were purchased. Still, these were people who were happy not having insurance and had to purchase it to comply with the law.
If we can get some good estimates for these numbers, we can make the appropriate additions and subtractions and see what we end up with.