WaPo gives 3 Pinocchios to Medicaid-enrollment claim … and itself

posted at 9:21 am on January 17, 2014 by Ed Morrissey

ObamaCare rolled out in October. In the following two months, 3.9 million people enrolled in Medicaid. How connected are those two facts? The White House, its allies, and some in the media want people to assume a direct causation — and initially, Washington Post factchecker Glenn Kessler did just that. Kessler used the figure to combine up with the 2.1 million who have signed up for ObamaCare to say that Republican claims that more people have lost insurance than gained it were faulty.

Yesterday, however, Kessler began to have second thoughts, based on Sean Trende’s analysis from earlier this month:

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.

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sign-ups implied, and the number of people [on Medicaid] who would actually lose their insurance if Obamacare were repealed is probably around 200,000 to 300,000.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.

In other words, the numbers fail to account for the normal enrollment flow. The question at hand isn’t whether people can sign up for Medicaid at all; it’s the number who would have not otherwise enrolled signed up because of ObamaCare and its expansion of Medicaid. In that sense, the statistics look more like mere correlation:

The above chart tells us that 1.7 million people were determined eligible for Medicaid in November of this year alone. The charts at the end tell us that 780,000 of these enrollees were in states that have undertaken the Obamacare expansion, while 960,000 of them were in states that have not done so.

So, of the November enrollees, 55 percent are in states where the Obamacare expansion of coverage didn’t occur and the ACA is therefore very unlikely to be directly responsible for their coverage. If we look at the October numbers, a little less than half (49.82 percent) were in states that didn’t expand coverage. Therefore, in total, of the 3.9 million individuals newly covered by Medicaid in October or November, only about 1.9 million are from states that expanded Medicaid.**

The next question is: How many of these 1.9 million are eligible directly because of Obamacare’s Medicaid expansion, and how many were just “normal” Medicaid enrollees? As Klein notes, we’d love to have October and November data on enrollment from last year, but unfortunately we don’t.

Kessler issued himself 3 Pinocchios for using this data unquestioningly, and to everyone else who did as well:

Essentially, then, it is ridiculous to suggest, as the @BarackObama tweet does, that the people who have selected a health plan in the exchanges are in anyway equivalent to the 3.9 to 4.2 million who were deemed eligible for Medicaid.

Soon, CMS will release the Medicaid numbers for December. Presumably the new numbers will reveal as little about the impact of the Affordable Care Act as the 3.9 million figure. Reporters need to be very careful about using the new figure in any sentence that includes a reference to the new health-care law.

We’re awarding Three Pinocchios to everyone, including The Fact Checker, who improperly used this number or left the wrong impression about it.

However, there is one more point which Kessler misses. The 2.1 million number for non-Medicaid ObamaCare enrollments which he uses for the other end of his equation is also highly questionable. Those are sign-ups within the exchanges and not confirmed enrollments. As testimony yesterday made clear, the Obama administration actually has no idea how many enrollments have actually taken place — where the insurance company has the correct data, has issued the policy, and where the consumer has paid the premium. The government is supposed to know this, but they haven’t built the back-end systems to track that yet.

What we do know is that between five and six million people lost their health insurance plans in 2013, thanks to the ObamaCare mandates. And what these figures and their context strongly indicate is that we are still far from the break-even point for the lost coverage.


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Ouch

cmsinaz on January 17, 2014 at 9:28 AM

What we do know is that between five and six million people lost their health insurance plans in 2013, thanks to the ObamaCare mandates. And what these figures and their context strongly indicate is that we are still far from the break-even point for the lost coverage.

If there was such a need for Obamacare, why is the rat-eared wonder having so much trouble getting people to sign up? If it delivered what was promised the exchanges would be crashing because of demand not because six people are trying to log on at once.

Happy Nomad on January 17, 2014 at 9:30 AM

Ouch

cmsinaz on January 17, 2014 at 9:28 AM

Kessler (D-WaPo) grades on a curve. If it involves a conservative or conservative claim you have to subtract a full Pinocchio. If it involves a liberal or liberal claim you have to add a full Pinocchio. If it involves Obama you have to add two full Pinocchios.

In short, Kessler is a dishonest weasel and always has been.

Happy Nomad on January 17, 2014 at 9:33 AM

so if medicaid patients haven nothing to do with the insurance companies and way more people have lost their insurance than have signed up, why is it the insurance companies need a bailout? They should be cutting their rates and deductibles and hope the taxpayers don’t tar and feather them.

gracie on January 17, 2014 at 9:33 AM

Indeed HN

cmsinaz on January 17, 2014 at 9:33 AM

This really should be simple to estimate.

How many people signed up for Medicaid in November and December of 2012? 2011? 2010? 2009?

Now just fit that to a line, and project for 2013. Subtract from 3.9 million, and you have a good rough guess of the number of Obamacare Medicaid enrollees.

Give me the data, and I can even do it in Excel(tm) in about 2 minutes.

Chris of Rights on January 17, 2014 at 9:35 AM

As testimony yesterday made clear, the Obama administration actually has no idea how many enrollments have actually taken place — where the insurance company has the correct data, has issued the policy, and where the consumer has paid the premium.

Facts are stubborn things. Details are important. And lies are just lies.

oldroy on January 17, 2014 at 9:43 AM

the Obama administration actually has no idea how many enrollments have actually taken place

But when Obama reads it in the newspaper….
He will be madder then anyone..

Electrongod on January 17, 2014 at 9:44 AM

+1EG

cmsinaz on January 17, 2014 at 9:53 AM

$700 million scheme and no one knows nuthin’ about nuthin’.

Throw some more money at it, the answers will eventually appear.

Bishop on January 17, 2014 at 9:55 AM

Can anyone really be this honestly stupefied?
I think utter chaos IS the plan.

avagreen on January 17, 2014 at 9:56 AM

Why do reports like this sound like a broken record?

HiJack on January 17, 2014 at 9:57 AM

But when Obama reads it in the newspaper….
He will be madder then anyone..

Electrongod on January 17, 2014 at 9:44 AM

…and nobody will be punished.

HiJack on January 17, 2014 at 9:59 AM

This really should be simple to estimate.

How many people signed up for Medicaid in November and December of 2012? 2011? 2010? 2009?

Now just fit that to a line, and project for 2013. Subtract from 3.9 million, and you have a good rough guess of the number of Obamacare Medicaid enrollees.

Give me the data, and I can even do it in Excel(tm) in about 2 minutes.

Chris of Rights on January 17, 2014 at 9:35 AM

Okay, but remember, it’s not how many have been enrolled, but how many have been confirmed.

HiJack on January 17, 2014 at 10:03 AM

Somewhere within all of the lies is a central truth of this administration: They don’t give a damn about anything other than Single Payer.

First, you have to kill off the private health insurance industry.

BigAlSouth on January 17, 2014 at 10:13 AM

It’s amazing that anyone still believes anything this administration says.

GarandFan on January 17, 2014 at 10:29 AM

This is the equivalent of Russia doing a Population Census counting in Sochi during the Winter Olympics.

“The population of Sochi has grown by 850,000 in one year!”

portlandon on January 17, 2014 at 10:39 AM

Give me the data, and I can even do it in Excel(tm) in about 2 minutes.

Chris of Rights on January 17, 2014 at 9:35 AM

You’re more qualified than anyone else working on the System…

Youngs98 on January 17, 2014 at 10:41 AM

However, there is one more point which Kessler misses. The 2.1 million number for non-Medicaid ObamaCare enrollments which he uses for the other end of his equation is also highly questionable. Those are sign-ups within the exchanges and not confirmed enrollments. As testimony yesterday made clear, the Obama administration actually has no idea how many enrollments have actually taken place — where the insurance company has the correct data, has issued the policy, and where the consumer has paid the premium. The government is supposed to know this, but they haven’t built the back-end systems to track that yet.

Surely you don’t mean to suggest …..

Well, maybe I’m just too critical of Obamacare and its websites, and so forth. Let me yield the floor to a less … critical … questioner.

Ed –
You mean the websites aren’t working perfectly on day one two three four five six seven eight nine ten eleven twelve thirteen fourteen fifteen sixteen seventeen eighteen nineteen twenty twenty-one twenty-two twenty-three twenty-four twenty-five twenty-six twenty-seven twenty-eight twenty-nine thirty thirty-one thirty-two thirty-three thirty-four thirty-five thirty-six thirty-seven thirty-eight thirty-nine forty forty-one forty-two forty-three forty-four forty-five forty-six forty-seven forty-eight forty-nine fifty fifty-one fifty-two fifty-three fifty-four fifty-five fifty-six fifty-seven fifty-eight fifty-nine sixty sixty-one sixty-two sixty-three sixty-four sixty-five sixty-six sixty-seven sixty-eight sixty-nine seventy seventy-one seventy-two seventy-three seventy-four seventy-five seventy-six seventy-seven seventy-eight seventy-nine eighty eighty-one eighty-two eighty-three eighty-four eighty-five eighty-six eighty-seven eighty-eight eighty-nine ninety ninety-one ninety-two ninety-three ninety-four ninety-five ninety-six ninety-seven ninety-eight ninety-nine one hundred one hundred one one hundred two one hundred three one hundred four one hundred five one hundred six one hundred seven one hundred eight one hundred nine
verbaluce on October 1, 2013 at 10:18 AM

(H/T NotCoach)

There Goes the Neighborhood on January 17, 2014 at 10:47 AM

But when Obama reads it in the newspaper….
He will be madder then anyone..

Electrongod on January 17, 2014 at 9:44 AM

…and nobody will be punished.

HiJack on January 17, 2014 at 9:59 AM

Now don’t be cynical. He just needs to know whose ass to kick.

There Goes the Neighborhood on January 17, 2014 at 10:50 AM

What we do know is that between five and six million people lost their health insurance plans in 2013, thanks to the ObamaCare mandates.

Ed, I was under the impression that there were 5 or 6 million cancellations that were sent out. At the bare minimum, those cancellations represent an individual – but they likely also represent spouses and children. So the number should be higher – we just don’t know how high.

Hill60 on January 17, 2014 at 10:52 AM

This really should be simple to estimate.

How many people signed up for Medicaid in November and December of 2012? 2011? 2010? 2009?

Now just fit that to a line, and project for 2013. Subtract from 3.9 million, and you have a good rough guess of the number of Obamacare Medicaid enrollees.

Give me the data, and I can even do it in Excel(tm) in about 2 minutes.

Chris of Rights on January 17, 2014 at 9:35 AM

Good idea, except the Government isn’t co-operating.

As Klein notes, we’d love to have October and November data on enrollment from last year, but unfortunately we don’t.

AesopFan on January 17, 2014 at 11:04 AM

the Obama administration actually has no idea how many enrollments have actually taken place

If you believe their testimony, that is.

where the insurance company has the correct data, has issued the policy, and where the consumer has paid the premium. The government is supposed to know this, but they haven’t built the back-end systems to track that yet.

But they know every phone call you made, who you called, when you called, how long the call lasted, and where you were when you made it. It’s just the stuff they’re supposed to know they’re incompetent about.

Right. Got it.

Socratease on January 17, 2014 at 11:45 AM

Liars lie…and this President is the biggest LIAR this nation has had the sorry luck of having as a President!

easyt65 on January 17, 2014 at 1:16 PM

I am a little confused as to why we should be so excited so many millions are signing up for Medicaid at all. Doesn’t that just mean everyone who is not in Medicaid is paying for these “enrollments”?

kclibby on January 17, 2014 at 2:56 PM

So, I went to cms.gov and went to Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/CMS-Statistics-Reference-Booklet/Downloads/CMS_Stats_2013_final.pdf#tablei1

and found the average monthly enrollments for Medicare and Medcaid in the 2013 report, always filed in July:

diff
2000 39.7
2005 42.6 2.9
2009 46.6 4
2010 47.7 1.1
2011 48.9 1.2
2012 50.7 1.8
2013 52.3 1.6

then I took the difference in a popular spreadsheet. It takes about 3 minutes to figure out that in 2012, CMS enrollment changed about 1.8 million people per month, average, over 2011. Further, during August 2012 through July 2013, monthly enrollment increased about 1.6 million people per month. Rough figures, but, two months at the end of the calendar year 2013, October and November, should have produced about 3.2 million new enrollments, ceteris paribus, WITHOUT Obamacare.

Too bad I dint get my edjimikation at Columbia school of journalism, eh?

DublOh7 on January 17, 2014 at 3:02 PM

DublOh7 on January 17, 2014 at 3:02 PM
Yep.

Better watch your mailbox. You may be subject to an IRS audit now.

avagreen on January 17, 2014 at 5:04 PM

so if medicaid patients haven nothing to do with the insurance companies and way more people have lost their insurance than have signed up, why is it the insurance companies need a bailout? They should be cutting their rates and deductibles and hope the taxpayers don’t tar and feather them.

gracie on January 17, 2014 at 9:33 AM

Because the people signing up are the ones the insurers refused to insure before because they were too expensive-pre-existing conditions-high utilizers of health care. The people that lost insurance were healthy people that didn’t use much, so they were profitable even with bare bones coverage. Those people are now going without coverage because the cheapest policies are unaffordable, so the insurers have lost customers and gained only money losers-just as anyone that read the bill would have predicted.

talkingpoints on January 17, 2014 at 5:18 PM