[kenberg]

Winston,

I would like to seriously make sense of some of the numbers that I am seeing. Let's start simple.

This 2.8 percent and 0.8 percent. One possibility would be that the 2.8 breaks down into some number who have gotten private insurance off the exchange and some number that are on the expanded Medicaid plan. That could be a starting point for explaining why the numbers are so different. But maybe that isn't what is happening. Do you (or anyone) know if this is possible? Also: The 8 million that we hear about. Is that 8 million including new Medicaids?

These numbers just get tossed out without, as near as I can see, much care about what it is that they are actually measuring. When I look at them, I often have a great deal of difficulty understanding what they are counting. This has nothing to do with being for or against anything, it is simply a matter of liking some clarity in exposition.

I think it is very important that this be straightened out before the fall elections. I have seen way too many debates where each side, of possibly several sides, comes in with their own numbers that they just toss out on the table,and refuse to discuss any details. Bbf might well be able to do better. I for one would like it if we do.

Actually let me put it ieven simpler. I would like to see the following numbers:

In January of 2013 there were x number of people under 65 who had insurance coverage, not including Medicaid.
In April of 20134 there were y number of people under 65 who had insurance coverage, not including Medicaid.
In January of 2013 there were u number of people under 65 on Medicaid.
In April of 2014 there were v number of people under 65 on Medicaid.

A am not fussy about whether April or January or whatever is the chosen month.
It seems to me that with all of the data gathering that is being done, it should be possible to attach numbers to x,y,u,v.
Of course the population has changed in the last year, but that probably is not a big deal. Still, those numbers should be calculated also.

To put it differently, if these very basic numbers are too difficult to compute, why on earth should we believe other, more complex, numbers?

[Winstonm]

kenberg, on 2014-April-29, 10:40, said:

Winston,

I would like to seriously make sense of some of the numbers that I am seeing. Let's start simple.

This 2.8 percent and 0.8 percent. One possibility would be that the 2.8 breaks down into some number who have gotten private insurance off the exchange and some number that are on the expanded Medicaid plan. That could be a starting point for explaining why the numbers are so different. But maybe that isn't what is happening. Do you (or anyone) know if this is possible? Also: The 8 million that we hear about. Is that 8 million including new Medicaids?

These numbers just get tossed out without, as near as I can see, much care about what it is that they are actually measuring. When I look at them, I often have a great deal of difficulty understanding what they are counting. This has nothing to do with being for or against anything, it is simply a matter of liking some clarity in exposition.

I think it is very important that this be straightened out before the fall elections. I have seen way too many debates where each side, of possibly several sides, comes in with their own numbers that they just toss out on the table,and refuse to discuss any details. Bbf might well be able to do better. I for one would like it if we do.

Actually let me put it ieven simpler. I would like to see the following numbers:

In January of 2013 there were x number of people under 65 who had insurance coverage, not including Medicaid.
In April of 20134 there were y number of people under 65 who had insurance coverage, not including Medicaid.
In January of 2013 there were u number of people under 65 on Medicaid.
In April of 2014 there were v number of people under 65 on Medicaid.

A am not fussy about whether April or January or whatever is the chosen month.
It seems to me that with all of the data gathering that is being done, it should be possible to attach numbers to x,y,u,v.
Of course the population has changed in the last year, but that probably is not a big deal. Still, those numbers should be calculated also.

To put it differently, if these very basic numbers are too difficult to compute, why on earth should we believe other, more complex, numbers?

Ken,

Good points. I'll see if I can find more clear information. Thanks.

Here is the Gallup Poll article link.

Quote

While a majority of Americans continue to disapprove of the Affordable Care Act, also known as "Obamacare," the uninsured rate appears to be declining, as the law intended. In turn, the states (including the District of Columbia) that have implemented two of the law's core mechanisms -- Medicaid expansion and state health insurance exchanges -- are realizing a rate of decline that is substantively greater than what is found among the remaining states that have not done so. Consequently, the gap that previously existed between the two groups has now expanded.

[kenberg]

Here is part of the aricle:

Quote

Nationally, 17.3% of U.S. adults reported being without health insurance in 2013, a rate that had slowly increased from 14.8% in 2008. The uninsured rate peaked at 18.0% in the third quarter of 2013 -- the three months immediately preceding the opening of the healthcare exchanges -- and has since declined to 15.6%.

Now if we subtract 15.6 from 18.0 we get 2.4, and 2.4% of 330 is 7.92. Perhaps this is where the 8 million figure comes from. Or perhaps not. It would be good to know..

One of the earlier graphs that showed this 18.0 figure also made it clear that it was anomalous. that is reason enough to take a closer look at it.

I see Medicaid expansion and the Health Exchange as related but really rather different enterprises. The costs of Medicaid, at least as I understand it, are mostly borne by the taxpayer. Individual policies purchased on the Exchange, again as I understand it, are sometimes subsidized but perhaps largely to be paid for by the insured. Surely we will be having vigorous political debate over these changes as we head into the fall elections, and I am hoping that at least some of the debate will have something to do with actual facts. Probably naive of me, I know.

The easiest figure for the governemnt to come by, I would think, is the number of Medicare enrollees and the cost. It's a goverment program, surely they must have figures that say how many were and how many are enrolled.

I fear that what will happen is that the administration will lack the courage of its convictions. that they will try to keep it all as just one number. They should say: Here is what we have done. We have increased the number of Medicare enrollees by this much, the number of subsidized individual polices by so much, the number of unsubsidized individual polices by this other number. We have done this and now we will explain why wwe believe that this is good. I think that might well work for them. Bobbing and weaving, maybe not.

[Winstonm]

Ken,

Just for clarification purposes, there are three distinct methods to obtain healthcare via the ACA. First, for the really poor the Medicaid expansion was offered, which would be paid for initially by the federal government. Second, state-run healthcare exchanges, where private insurance could be purchased and where any tax credit could be used to help offset the monthly cost. And third, a federal healthcare exchange, where those who lived in states that declined to initiate state-run exchanges.

Medicare has always been separate from any of the calculations as far as I can make out. ACA applies to those who are not eligible for medicare.
I understand the 8 million figure is estimated, not based on an exact count.

I think the discrepancies between the 2.4 and the 0.8 has to do with the extremely poor who neither receive any tax credits to help offset the cost of private insurance yet who live in states that refused to expand their Medicaid programs to give these poor coverage.

[awm]

There is pretty complete info at acasignups.net

The 8 million number is sign ups for plans on the online exchanges. This does not count any of: 1. Medicaid 2. Offline sign ups 3. Kids added to parents plan.

However it can sort of over count because a number of people had plans canceled, then signed up for new plans on the exchange (so they are not "newly insured").

Anyway all the stats are at the web page given (click navigation to get spreadsheets).

[kenberg]

Certainly the 8 million is an estimate. But calculated how?
As mentioned, if we subtract 15.6 from 18.0 we get 2.4, and 2.4% of 330 is 7.92. That's approx 8. Is that it?

But there is still this very basic question that I don't ever see explained: Does the 8 million newly insured include new Medicare sign-ups? I get the idea that it does, but I am uncertain. I don't see how anyone can even begin to make sense of the data until we get at least that much straight.

Now would it make sense to get the 8 million as (.180-.156)X 330,000,000 = 8,000,000? Maybe. Just conjecturing, suppose the 8 million includes Medicare as I think that it does. Now Gallup does its poll, it reaches a woman with 3 kids, no husband, and she says she is on Medicaid. They record this as how many people on insurance? The mother is 1, the mother and family is 4. In my sample calculation I multiply by 330 million, the full population. So it would be good if the Gallup folks included the children. Did they? Who knows? And maybe that isn't where the 8 million figure comes from anyway.

Dems are going to be attacked on the ACA, this is news to no one. How to respond? I am suggesting that they seriously examine their numbers and present them in a manner that will withstand scrutiny. My general experience with people that argue with statistics is that each side has its own numbers, neither side will give an honest accounting of what the numbers actually mean, and quite often they have no clue at all how the numbers were arrived at. They just pick whatever numbers sound best for their side.

Right now I have no idea of what any of the numbers are based on.

An old tennis adage is that the answer to power is spin the answer to spin is power. Updated to politics, it seems to read that the answer to everything is spin.

[Winstonm]

kenberg, on 2014-April-29, 16:38, said:

Certainly the 8 million is an estimate. But calculated how?
As mentioned, if we subtract 15.6 from 18.0 we get 2.4, and 2.4% of 330 is 7.92. That's approx 8. Is that it?

But there is still this very basic question that I don't ever see explained: Does the 8 million newly insured include new Medicare sign-ups? I get the idea that it does, but I am uncertain. I don't see how anyone can even begin to make sense of the data until we get at least that much straight.

Now would it make sense to get the 8 million as (.180-.156)X 330,000,000 = 8,000,000? Maybe. Just conjecturing, suppose the 8 million includes Medicare as I think that it does. Now Gallup does its poll, it reaches a woman with 3 kids, no husband, and she says she is on Medicaid. They record this as how many people on insurance? The mother is 1, the mother and family is 4. In my sample calculation I multiply by 330 million, the full population. So it would be good if the Gallup folks included the children. Did they? Who knows? And maybe that isn't where the 8 million figure comes from anyway.

Dems are going to be attacked on the ACA, this is news to no one. How to respond? I am suggesting that they seriously examine their numbers and present them in a manner that will withstand scrutiny. My general experience with people that argue with statistics is that each side has its own numbers, neither side will give an honest accounting of what the numbers actually mean, and quite often they have no clue at all how the numbers were arrived at. They just pick whatever numbers sound best for their side.

Right now I have no idea of what any of the numbers are based on.

An old tennis adage is that the answer to power is spin the answer to spin is power. Updated to politics, it seems to read that the answer to everything is spin.

Ken,

Good questions; no easy answers found.

[kenberg]

Winstonm, on 2014-April-29, 17:18, said:

Ken,

Good questions; no easy answers found.

Hey. We agree!


Some of the answers should be reasonably Eastwood . Not all.

The ACA has obviously changed things. Exactly what and exactly how is not clear (to me). I expect a strong approach would go something like this: We need to really see what has been done. It is not going to be undone. I think generally people accept that as fact. But it may need some serious looking after, and that starts with honest assessment. For example, I have a lingering suspicion that the accomplishment so far has been much more in the direction of expanded Medicaid coverage than in the individual policies. This might be wrong, I simply don't know. I don't really much trust anyone on this issue right now. Which could be a real opportunity for the one who can come in and tell it straight.

[y66]

German Lopez at Vox is tracking estimates from the Obama Administration, CBO, Urban Institute, LA Times, RAND and Gallup here.

re: The administration's 8 million estimate:

Quote

Who it counts: The White House's number covers how many people signed up for Obamacare's marketplaces, which you probably know as HealthCare.gov.

This includes people who have paid their first month's premium and those who haven't. It also includes some people who were previously insured, as well as those buying coverage for the first time. The White House has not published a breakdown of how many of these people have paid or how many are newly insured.

Who it doesn't count:

1) Medicaid enrollees, including those who gained coverage through Obamacare's expansion of Medicaid.

2) Many young adults who, due to Obamacare, can now stay on their parents' health plans until they turn 26. Many in this group were insured before open enrollment began on October 2013, since the health-care law allowed them to enroll on their parents' plans starting in 2010.

Same as posted above by awm.

[awm]

The numbers are acquired as follows.

The federal government runs a website called healthcare.gov which allows people to sign up for qualified health plans. Some state governments have their own websites, others just direct people to the federal one. Since this is all done online, it is straightforward code to count the number of people who have completely signed up. These numbers are periodically released by states and/or the federal government, and should be 100% accurate as of the time of release. Note that these are not guesses or produced statistically by survey. However, the numbers are released sporadically so we don't have totally updated results at all times. The current breakdown looks like:

Released signups for qualified health plans via online websites: 5,593,526
Estimated additional signups prior to 3/31 from states which have not released numbers from this date or later: 1,510,000
Estimated additional signups from April: 1,035,000

Estimated total signups via online websites: 8,138,526

Note this is excluding Medicaid expansion, offline signups, etc.

Estimated offline signups for qualified health plans maybe as high as 5,000,000 more. However, note that all these numbers include people who were previously insured and canceled their plan (either voluntarily because a better plan was available, or canceled by the insurer because it didn't meet Obamacare minimum standards, or canceled by the insurer for some other reason). So not all these people are folks who previously had no health insurance.

New Medicaid signups can be computed from the Center for Medicaid Services (CMS) and Department of Health and Human Services (HHS) reports. These are estimated at 10,838,786. However, many of these are people who would've been eligible for medicaid prior to the expansion, and are signing up now either because of the publicity surrounding Obamacare or for other reasons. The estimate for Obamacare Medicaid expansion only is 3,820,218.

All these numbers are from acasignups.net. While this is the work of a small number of individuals, it's based on publicly available reports from US Government sources, and has been cited in a wide range of reputable publications.

[kenberg]

Adam,

This is absolutely great. I am not surprised that if anyone had this data it would be you. As I noted, I think it is particularly useful to distinguish between signups for the qualified medical plans, via the exchanges or otherwise, and the signups for Medicaid. Over 10m new signups for Medicaid? I had no idea of this, no idea at all.

This will take some digesting, but I am delighted to find that the numbers exist. I couldn't really see why they would not exist, at least in some form wiht some reasonable estimates on accuracy, but somehow these sources seem to be not usually quoted. It's the first time that I have seen them at any rate.

Mucho gracias.

[Winstonm]

kenberg, on 2014-April-30, 05:36, said:

Adam,

This is absolutely great. I am not surprised that if anyone had this data it would be you. As I noted, I think it is particularly useeful to distinguish between signups for the qualified medical plans, via exchange or otherwise, and the signups for Medicaid. Over 10m new signups for Medicaid? I had no idea of this, no idea at all.

This will take some digesting, but I am delighted to find that the numbers exist. I couldn't really see why they woould not exist, at least in some form wiht some reasoanble estimates on accuracy, but somehow these sources seem tobe not usually quoted. It's the first time that I have seen them at any rate.

Mucho gracias.

Ditto.

[Winstonm]

This is pretty disgusting if shown to be accurate.

Quote

Virginia Republicans are being accused of bribing off a Democratic state senator by offering him and his daughter prestigious jobs in exchange for his resignation – giving the GOP control of the chamber and the ability to strike down Medicaid expansion through the Affordable Care Act

[mike777]

Winstonm, on 2014-June-09, 10:25, said:

This is pretty disgusting if shown to be accurate.

yet another example that so many prefer to ignore.


Give a few, tiny few economic and political power in a few and same hands and this sort of thing happens often.

I have predicted for years that this is what will happen

[ArtK78]

One thing I will never understand is why it is the official position of the Republican Party, and the position advocated by Republican politicians almost uniformly, to be so mean-spirited towards the less affluant in our society.

It is as if they were saying, "I have mine, and I will do whatever I can do within my power to keep you from getting yours."

[Winstonm]

ArtK78, on 2014-June-10, 08:38, said:

One thing I will never understand is why it is the official position of the Republican Party, and the position advocated by Republican politicians almost uniformly, to be so mean-spirited towards the less affluant in our society.

It is as if they were saying, "I have mine, and I will do whatever I can do within my power to keep you from getting yours."

It is curious why the GOP followers spend so much time jousting low-income windmills. I think a large part is collusive prejudice and bigotry hiding behind a mask of economic policy.

[y66]

Meanwhile, on the health care front

Quote

You still encounter people claiming that Obamacare has been a disaster, that more people have lost insurance than gained it, etc., etc. But the reality is that it has already made a big dent in the number of uninsured; and the quality of insurance has gone up, too, because canceled policies were canceled because they offered little real protection.

[blackshoe]

I'm not inclined to accept at face value that article about "buying the Virginia Senate". I suspect there's a lot more to it than is in the article. But if somebody did buy off this Democratic Senator, that means the Senate, or at least the Senator, is apparently for sale. What does that say about Democrats?

[Winstonm]

blackshoe, on 2014-June-11, 14:15, said:

I'm not inclined to accept at face value that article about "buying the Virginia Senate". I suspect there's a lot more to it than is in the article. But if somebody did buy off this Democratic Senator, that means the Senate, or at least the Senator, is apparently for sale. What does that say about Democrats?

Exactly. To me the most offensive action is the self-serving Democrat's who placed his individual well-being above his constituents' well being.

[mike777]

y66, on 2014-June-10, 11:23, said:

Meanwhile, on the health care front

You raise to key points but don't really explore them.

1) Is the cost of insuring them too great in terms of money and regulations that inhibit innovation.
2) Quality of care may be worse, not better, but in any event has the cost been too great.

This issue keeps coming back to the govt will not allow for failure and competition. Instead the reward as in the case of the VA more money, more employees, more power to a few a very few in Washington.

If you do bad you don't fail, you get more money, billions more. You get more power concentrated in a tiny few hands.