Tag: Obamacare coverage estimates

More Flaws in CBO Estimate History


Last week I pointed out clear flaws in the way the Congressional Budget Office analyzed the effect of the Better Care Reconciliation Act, otherwise known as the Senate bill to repeal and replace the Patient Protection and Affordable Care Act. In analyzing three of the most recent legislative efforts to repeal and replace the ACA (otherwise known as Obamacare), the CBO has come out with estimates that are difficult to fathom considering the vast differences in assumptions each estimate makes.

There is apparently another plan that has come out that is really no better than the other plans from what I am hearing from Senator Rand Paul’s objections on the news, and no doubt, the CBO will get around to weighing in on that one too. Why bother though? I don’t doubt that the agency will pick a number, any number, somewhere between 22 and 24 million as their estimate on how many people will “lose” coverage if that particular Senate bill were to pass.

Then that “dire” number will be trumpeted all over the media as those who will be “losing” coverage as a result of that bill. As Avik Roy pointed out in the Forbes article to which I referred in my last blog post, approximately 15 million of those people are not “losing” their insurance, but REJECTING their insurance. The sad aspect of that is, there will still be no insurance to which they can flee, because the only plans allowed will still be Obamacare-type plans. The Senate rejected Senator Ted Cruz’s Consumer Freedom Amendment – more about that in a future blog post.

I would like to once again, demonstrate how faulty the CBO estimates are concerning any issue of coverage or non-coverage whether Obamacare is in effect or not.

Let’s start with the CBO’s estimates in a 2012 report of how many people it predicted would sign up for Obamacare in advance of the sign-ups.

Here is a quote from that March 2012 report by the CBO entitled, “Updated Estimates for The Insurance Coverage Provisions of the Affordable Care Act,” (1) regarding how many people would gain coverage through the Obamacare exchanges.

“According to the current estimates, from 2016 on, between 20 million and 23 million people will receive coverage through the new insurance exchanges and 16 million to 17 million people will be enrolled in Medicaid and CHIP.”

So let’s look at how the numbers have actually shaken out so far.

An editorial in The Hill (2) about an early 2017 meeting of the House Budget Committee regarding the failures of Obamacare, says that Ed Haislmaier, senior research fellow with the Heritage Foundation, estimated that only 14 million people gained insurance through the Obamacare exchanges between 2014 and 2015. He added that early estimates of those receiving health insurance through the individual market for 2016 were another 842,028.

Other figures Haislmaier reported were as follows:

  • A decline of 1,128,597 individuals enrolled in fully insured employer health insurance plans.
  • Enrollment in self-insured employer plans increased by 776,780 people.
  • Individuals enrolled in Medicaid and CHIP (Children’s Health Insurance Program) increased by 2,044,809.

So, according to this editorial in The Hill, the approximated number of people that actually gained some form of health coverage in 2016 was 16.5. This number does not even come close to the 20 million to 23 million people the CBO estimated would gain “insurance” through the exchanges.

Clearly, there are no totals for 2017 yet as we are in the middle of the year. However, if the CBO did such a woeful job so far of predicting how many people would be covered from 2016 on, how can we possibly expect that office to provide any believable estimates for how many people might “lose” their insurance as the result of an Obamacare repeal with or without a replacement? Don’t forget that in its estimations of the people that would “lose” their insurance are an approximate 15 million who would not be losing it, but canceling it of their own free will and saying “Good riddance!”

My theory: the numbers that the CBO has been putting out regarding the number of people who would be without “coverage” are merely something the Democrat left and Republicans in Name Only (RINOS) can use as scare tactics – nothing more, just a useful propaganda tool.

Sources for further reading:

  1. http://www.cbo.gov/sites/default/files/cbofiles/attachments/03-13-Coverage%20Estimates.pdf
  2. http://thehill.com/blogs/pundits-blog/healthcare/320969-debunking-the-20-million-obamacare-myth


How Numbers Are Manipulated in the Obamacare Debate


Ah … numbers are enough to drive one crazy unless you’re a math fanatic. I’m definitely NOT!

So Why Did I Undertake Research on Obamacare Numbers?

I was inspired by a tweet from Gerard Gianoli, M.D., one of the doctors I follow on Twitter, to look into the number of people who had their health insurance plans canceled as the Obamacare exchanges opened in the fall of 2013, and people started to sign up (or in many cases, TRIED to sign up) for one of the Obamacare-compliant plans with all the bells and whistles. Then there have been cancellations for other reasons as well.

I had originally responded to an editorial in The Hill that Dr. Gianoli had posted, “Debunking the 20-million Obamacare Myth,” written by opinion contributors Justin Haskins and Michael Hamilton. The article showed how all the numbers that were used to make Obamacare look like a big success over the last three years were very fungible. And indeed they are.

My Foray Into Numbers – Ouch!

I’m not going to put you to sleep with a whole array of numbers here because frankly they make my head spin, but the basic premise of this editorial was that the oft-cited number of 20 million people in the United States who have gained health insurance coverage via the Affordable Care Act since it became effective in 2014 is closer to 16.5 million than 20 million. However, that estimate is not limited to those who gained commercial insurance through the ACA; it includes approximately 2,044,809 of those new “enrollees” being signed up for Medicaid and the Children’s Heath Insurance Program (CHIP) primarily because of the Medicaid expansion in many states, which offered “coverage” to able-bodied low-income people and was almost completely subsidized by government.

Dr. Gianoli brought up the point about the many people who lost insurance because of the ACA. I suppose that number could include those with individual insurance policies prior to 2014 who had them canceled because they did not meet the coverage mandates required by the ACA. It could also include those who lost insurance for a plethora of other reasons such as employers cutting employee hours so they didn’t have to provide benefits, etc. So I set out to do a little bit of internet research. Here is what I found, and the results of my research were dizzying.

According to the website FactCheck.org, the Associated Press had cited a number of people whose insurance policies had been cancelled because of non-compliance with ACA mandates to be 4.7 million. However, according to FactCheck.org, an article published on the journal Health Affairs’ website estimated that number to be more like 2.6 million. Apparently that estimate was based on the work of two researchers with the Urban Institute, which has been a known cheering section for Obamacare.

In an online editorial in Forbes entitled “How Many People Has Obamacare Really Insured” by Scott Gottlieb, he cites two different studies of the actual numbers that Obamacare can be credited with insuring – one by Goldman Sachs and one by the Rand Corporation.

According to Gottlieb, the Goldman Sachs study estimated that total insurance coverage as the result of the ACA increased by between 13 and 14 million in 2014 with a possible 4 million people being added to that number in the first five months of 2015, for a grand total of 17 to 18 million people “newly” covered in that period.

The Rand Corporation estimated that a total of 22.8 million people gained coverage under the ACA, and yet it also calculated that 5.9 million people lost coverage as the result of the law, which brings the estimate of actual covered lives as a result of the ACA to 16.9 million, which is really not far, in either direction, from the estimates of the Goldman Sachs study or the estimates in the The Hill editorial.

It is interesting to note that the Forbes article did not state the reasons an estimated 5.9 million people lost health insurance as the result of Obamacare. That may include those who lost it because their plans prior to 2014 did not meet the Obamacare compliance standards as well as those who lost coverage because of insurance carriers withdrawing from the Obamacare exchanges when they found they were experiencing too much in the way of losses. Who knows? That estimated number could even include those who decided the Obamacare plans were worthless and concluded that they would be better off not having insurance while Obamacare was still in effect, even though that clearly has some risk attached.

All in all, whether the number of people who lost their insurance as a result of Obamacare was 2.6 million or 5.9 million, or somewhere in between, the REAL number of people being covered by Obamacare has never actually reached the 20 million additional people the ACA proponents claim. No matter what, you can tell how easily manipulated as well as only partially reliable numbers can be.

Yet even today, I have come across “figures” being touted that 30 to 32 million people will “lose insurance” if the Unaffordable¬† Care Act is repealed without a replacement. All I’ve heard from Congress and Trump is replacement, replacement, replacement … so where are those people getting their information? From the fake news?