ATTENTION L.A. TIMES READERS:
This is actually an older version of the blog post.
I later RE-DID THE WHOLE THING HERE.
IMPORTANT UPDATE 3/27/16 1:30pm: At the suggestion of several people to make the color-coding more distinctive and after re-reviewing a couple of surveys/reports, I've made the following revisions to the chart:
I want to make one thing very clear right off the bat: Some of the numbers in this post are very rough estimates, a combination of hard data and guesstimates extrapolated from the information I have on hand from the Kaiser Family Foundation, the Congressional Budget Office and the HHS Dept.
Having said that, here's a crude table and "stacked area" chart depicting how the U.S. Individual Health Insurance Market has changed over the past 2 1/2 years, from the launch of the ACA exchanges in October 2013 through the end of March 2016.
As you can see, there are 6 columns/sections: Three exchange-based (subsidized QHPs, full price QHPs and Basic Health Plan enrollments) and three OFF-exchange (ACA compliant, "Transitional" and "Grandfathered").
Back in 2013-2014 when I started this project, the most frustrating data to track down was OFF-exchange individual market healthcare policy enrollments. I tried my best to do so, painstakingly verifying around 560,000 across a handful of states, but with the knowledge that there were at least a few million more out there.
While this may sound obvious now, at the time, there were a lot of people who should've damned well known better, like Avik Roy, who actively tried to claim that the off-exchange individual market was nominal at best, documented in this jaw-dropping Tweet from him:
@UriManor@charles_gabaOff-exchange enrollments don’t affect exchange risk pool; usually previously insured. Not a big number either way.
Welcome, fellow Wonks! It's a great honor to be asked to host Health Wonk Review, especially the week of the 6th Anniversary of the Affordable Care Act!
Since this is the first time I've hosted HWR, I'll keep things pretty straightforward:
David Harlow of HealthBlawg addresses the question of "Narrow Networks in California?", pointing out that "Managing cost and quality requires use of narrow networks. A proposal up for consideration in California is deemed “novel” by some. Opponents seem afflicted by the Lake Wobegone Effect."
Now, I'm no fan of Gov. Kasich, but credit where due: Like my own otherwise-destructive governor here in Michigan, Rick Snyder, Gov. Kasich knew a good deal when he saw it and pushed through the ACA's Medicaid expansion program in the Buckeye State, resulting in somewhere between 590,000 - 650,000 additional low-income Ohioans receiving heatlhcare coverage, many for the first time.
I'm aware that aside from my mini-obsession with the Ohio Town Hall incident, my posts have been a bit light the past few weeks, and I've missed out on some important ACA stuff this month.
Part of this is catching up with my day job (which I'm massively backed up on); part is general burnout, and part is due to an unrelated side project that I'm working on (more on that soon).
Anyway, aside from hosting HWR this week, I'm also putting together my final OE3 ASPE/State Breakdown analysis, along with some "ACA at 6" stuff. Look for it over the next few days.
A few days ago, I noted that several Ted Cruz supporters had filled out and submitted the contact form on this site, oblivious to the fact that it has nothing to do with Cruz's campaign.
This morning I received yet another one of these:
I watched your talk this morning on FOX News concering the latest bombing. I take offense to your turning this event into a political issue with your comments on Trump. Whether or not I I am a Trump supporter is of no consequence. I will vote for the GOP candidate that shows the most civil campaign and does no degrade another, but talks more about their policies and ambitions.
Aside from the insanity of suggesting that Donald Trump has run a "civil campaign" which "doesn't degrade others", I'm still flabbergasted that these people are incapable of digesting the voluminous evidence that they're at the wrong website. For once, I decided to address the issue head on by writing this individual back:
Dear XXXXXXX,
I realize that you likely misspelled Sen. Cruz’s name when entering the domain name to visit my website.
There's growing evidence that most of the dramatic gain in the number of Americans with health care coverage is due to President Barack Obama's law, and not the gradual recovery of the nation's economy.
That could pose a political risk for Republicans running against "Obamacare" in the GOP primaries as they shift to the general election later this year.
...Under "Obamacare," the share of Americans without health insurance has dropped to a historic low of about 9 percent, with room to go even lower. But even as the economy has expanded, major government surveys point to a lackluster rebound for employer-based coverage.
Last October, I posted a piece in which I blasted the Heritage Foundation for posting a widely-disseminated article in which they claimed that only 3% of the net increase in 2014 insurance coverage was "due to" private ACA healthcare policies, with the remaining 97% being found via expansion of Medicaid via the ACA.
It's a long, wonky piece, but Heritage's claims fell into two main areas:
First, they, like so many other right-wing organizations, constantly operate under the presumption that Medicaid "doesn't count" for some reason or another.
Apparently people enrolled in Medicaid aren't human beings deserving of healthcare coverage, and can therefore simply be subtracted from the "real people" total. This is the same type of logic which, to this day, has Republicans stating that "Barack Obama only won because so many black people voted for him"...which, even if true, is utterly irrelevant: "So many" black people did vote for him, and their votes count just as much as anyone else's. You could just as easily argue that most other presidents "only won" because so many white people voted for them, and it would have exactly the same relevance to the fact that they were still, you know, elected president.
More to the point, though, the other main claim was this:
Yes, the Heritage Foundation says, the private individual market did increase by about 4.8 million people, however...
Over 4.5 million people who had been covered by employer-sponsored insurance lost or moved off of their plans at the same time, meaning that...
...the net increase in private policy coverage only went up about 260,000 people, which, in their view, means that...
only about 3% of the 9.25 million net increase in covered individuals in 2014 was via private policies, with the remaining 97% being via Medicaid expansion.
I countered by pointing out a whole mess of other reliable sources which collectively concluded that the "4.5 million ESI reduction" was likely way off base for a variety of reasons, including cherry-picking multiple sources, misinterpreting datasets and so forth.
