The Graph, Updated w/MAJOR New Category Addition (and a drop to an existing one)

Until today, I had The Graph broken into 7 distinct categories:

  1. Exchange-Based Individual QHPs (Paid or To Be Paid Soon)
  2. Exchange-Based Individual QHPs (Unpaid or May Not Pay)
  3. OFF-Exchange Individual QHPs
  4. Exchange-Based SHOP (Sm. Biz) QHPs
  5. Medicaid/CHIP (Strict Expansion)
  6. Medicaid/CHIP (Woodworkers)
  7. Sub26ers (Low Est. / High Est.)

Yesterday, however, the release of the RAND Corp. Survey made me realize that I was handling the 3rd category (OFF-Exchange Individual QHPs) the wrong way.

You see, in the rare cases where I had access to the off-exchange enrollments for a particular company, I mushed their individual and group policies together. The numbers weren't huge--only about 34,000 people--but the potential numbers, as the RAND survey indicated, could potentially be massive.

As a result, I've made several significant changes. The Graph itself is only modified slightly (the new "Off-Exchange SHOP QHPs" category is so tiny you literally can't even see it depicted), but I've added a second "NOT SHOWN" note to the text box, noting that there could potentially be up to 7.17 million more off-exchange business enrollments added which haven't been documented:

A study released Tuesday blows the door wide open in the never-ending parlor game to estimate how many uninsured Americans have gotten health coverage under Obamacare, suggesting that the number might be bigger than previously thought.

But at this point, nobody is quite sure what to make of it.

RAND Corp, a non-profit think tank, released the survey. Its eye-opening finding: 7.2 million previously uninsured people have gained health coverage through their employer since mid-September. That's on top of those people who have purchased private coverage on Obamacare's insurance marketplaces or enrolled in Medicaid or young adults who signed up through their parents' plan.

Those three groups were the only people that many previous estimates of Obamacare's impact had accounted for.

In other words, if you take the earlier estimates of 8.3 million to 9.5 million uninsured people who had gotten covered by marketplace plans, Medicaid and their parents' policies -- and then add some of the millions more who RAND found had gotten insured through their employer -- then Obamacare could be responsible for reducing America's uninsured ranks much more than the earlier estimates suggested.

"I think that’s fair," Larry Levitt, vice president of the non-profit, non-partisan Kaiser Family Foundation, told TPM when asked if that was one of the study's implications. "Some of it could be improvements in the economy, which might have happened regardless of the Affordable Care Act.

"But it could also be tied to the individual mandate as people who previously turned down employer coverage signed up to avoid getting penalized. How big an effect the mandate is having is possibly one of the biggest unknowns right now."

It's important to note that as with the individual off-exchange QHPs, until I have documentation of these (which will likely never happen), I'm not going to add them to the actual graph itself, although I am still listing them as part of the high-end range of potential ACA-specific policy additions.

Thus, the complete potential range is now anywhere from 13.7 million up to a whopping 32.8 million.

Now, obviously not all of those off-exchange business enrollments are due to the ACA; in many cases it may simply be the improving economy causing this, but as long as I don't include them on the graph itself and make sure the low end range is limited to documented numbers, I think I'm on safe ground here in at least including them as potential numbers.

On the other hand, perhaps I should remove both of the larger numbers from the "high end range" completely for now (although I'll be damned if I'm gonna remove any reference to them at all!)

Thoughts welcome.

On a related note, there's one other significant change: Until today everyone seemed to think that the RAND study suggested up to 9 million individual off-exchange QHPs; however, the study itself seems to indicate the high-end range of this is about 1.2M lower, down to 7.8M. I've therefore reduced that "not shown" potential number accordingly.