Medicaid: Roughly 4.5M total, still not sure where 1.24M comes from

OK, the Medicaid situation is, to put it mildly...confusing. For most of the states I simply swapped out whatever numbers were there from the November report for the Dec. 28 total. However, there are easily a dozen states which either have one-time bulk automatic transfers from an existing state-run program (such as the 630,000 transferred from California's LIHP program, which was itself created in preparation for the ACA's Medicaid Expansion program); earlier mass enrollments in Medicaid which were quietly put through via other ACA elements long before the actual Exchanges launched (see DC and Minnesota); "special" cases such as Arkansas' unique "private Medicaid option" program; or simply updated numbers which have been released since 12/28.

Even with all of this, there's still roughly 1.24 million "unspecified" Medicaid/CHIP enrollments which are necessary to make up the other "3.9 million" figure which the HHS Dept. has been touting since around December 20th. I am simply unable to determine exactly what these "unspecified" enrollments are, since the "normal" Exchange-based Medicaid/CHIP numbers only add up to about 1.58 million.

In short, as best as I can figure, it breaks down as:

  • 1.58 Million "normal" Exchange-based Medicaid/CHIP expansion
  • 1.23 Million "one-time transfers" from existing programs
  • 430,000 additional enrollments since 12/28 (although CA's 280,000 portion of this seems awfully high)
  • 1.24 Million Unspecified/Unknown

My guess is that this extra 1.24 million consists of existing Medicaid recipients under the pre-ACA qualification levels...that is, people who were already on "regular" Medicaid who have simply renewed their enrollments. I have no idea why HHS would include these folks in this number, however; it doesn't make much sense politically since the very portion of the population which is most skeptical of the ACA seems to feel that increasing the Medicaid rolls is actually a bad thing; it's only the private QHP enrollments that they're interested in or which they feel "count" anyway. So, either my theory is wrong, or the HHS Dept. has simply been unable to separate out the Medicaid renewals from the new enrollments, which I find hard to believe.

In any event, until I'm able to get a straight answer about that additional 1.24 million Medicaid/CHIP enrollees, I'll leave them under the "Unspecified" row underneath Wyoming.