The number of Americans with health insurance has increased by 9.3 million over the past year, according to a report by the Rand Corporation. Most of this increase came through an uptick in employer-sponsored insurance, with only 3.9 million attributed to the Obamacare exchanges. But, more importantly, less than one third of that number were previously uninsured (1.4 million out of the 3.9). Avik Roy breaks it down further:
If you assume that 80 percent of signer-uppers will eventually pay their premiums, the true number of previously uninsured exchange enrollees is likely closer to 2 million. That’s far from what the Congressional Budget Office has projected; the CBO estimated that 80 to 90 percent of the first-year enrollees would come from the previously uninsured population. Instead, it appears to be more like 24 to 36 percent.
The reality may not be so grim for the Obama Administration. The study used a small sample group with a large margin of error. It doesn’t include data from the last weeks of open enrollment, when many believe the procrastinating uninsured rushed into the system. Roy’s calculations above account for some of these qualifications, but the numbers may still be better than the study suggests. On the other hand, as people fail to pay their premiums and lose coverage, the numbers may end up being even lower.For all these reasons, pinning down the total number of Americans who became newly insured through the exchanges is a tricky business. What is clear, however, is that the top-line figure of “7 million insured” doesn’t prove that the law is a success, as its supporters loudly have been claiming. Democrats have, apparently, won the messaging battle for at least one news cycle, defining down success to mean meeting this one metric. They hope the tactic will tamp down public distrust of the law until after the midterms. But if the Rand study is anywhere near correct, even that lowered-expectations strategy looks shaky.