Warning: Ignore claims that 3.9 million people signed up for Medicaid because of Obamacarehttp://www.washingtonpost.com/blogs/fact-checker/wp/2014/01/16/warning-ignore-claims-that-3-9-million-people-signed-up-for-medicaid-because-of-obamacare/Look closely at this tweet by the @BarackObama account, maintained by the pro-Obama group Organizing for America. The 6 million figure comes from combining a figure of 2.1 million for people selecting a plan via state and federal exchanges, through December, and 3.9 million for Medicaid, through November. Thus the claim that ?6 million Americans have already signed up for coverage thanks to health reform.?
There is much less to the Medicaid figure than meets the eye. (The exchange figure has been updated recently, to 2.2 million, but not the Medicaid figure.) Indeed, there has been vast confusion about what this figure means, especially in the news media. The Fact Checker cited the 3.9 million figure in a few recent columns, but prodded by a colleague as well as an interesting analysis by Sean Trende at Real Clear Politics, we decided to take a closer look.
Bottom line: This number tells you almost nothing about how the Affordable Care Act is affecting Medicaid enrollment. Reporters need to stop using it.
The Facts
This all started with a dense report issued on December 20 by the Center for Medicare and Medicaid Services, a unit of the Department of Health and Human Services. A CMS official walked us carefully through the numbers, and we also consulted with experts on Medicaid.
Medicaid, of course, is the health care program for the poor, generally at or below the federal poverty level. The Affordable Care Act expanded it to individuals with incomes of up to 138 percent of the federal poverty level (about $15,850), though the Supreme Court gave states the option of whether to participate.
So far, 25 states and the District of Columbia have expanded Medicaid, while four more are considering it. Under the ACA, the government will initially pay 100 percent of the cost of expansion, though it eventually drops to 90 percent. (Under the current formula, the cost is split at least 50-50 between the states and the federal government.)
