My must read of the day is "Obamacare Is Helping People Via Medicaid—Except In States Where Officials Are Fighting It," by Jonathan Cohn, in the New Republic:
Some new Obamacare information: As of the end of February, the number of Americans on Medicaid and the Children’s Health Insurance Program (CHIP) was 3 million higher than it was at the beginning of the Affordable Care Act’s open enrollment period. It’s one more sign that the health care law is reducing the number of Americans without insurance significantly—although it doesn’t tell us by how much or whether, at year’s end, the reduction will live up to original projections. […]
In states expanding Medicaid, enrollment in the two programs rose by more than 8 percent. In states that haven’t expanded Medicaid, enrollment rose by just 1.8 percent.
Cohn is arguing that increases in Medicaid enrollment must be because of Obamacare.
Cohn explains what the expansion was: "anybody with income below 133 percent of the poverty level … could get the program." He briefly mentions that many of the recent enrollees were "presumably … already eligible for Medicaid but either didn’t know it or hadn’t decided to do it before they heard about Obamacare." However, he makes no mention of the categories of enrollees.
That’s important information to include in any article where Medicaid enrollment is discussed.
Because of the expansion there are now two groups of Medicaid enrollments—"newly eligible" and "traditionally eligible." Newly eligible enrollees could not qualify for Medicaid before the Affordable Care Act.
The most important difference in those categories is that the federal government pays 100 percent of the cost for "newly eligible" (for the first three years) enrollees, while the "traditionally eligible" are still paid for jointly by the state and federal government.
In most states, we don’t have concrete data on who is in which group. The HHS report Cohn references is information from February, not March—states file for reimbursement from the federal government at the end of the first quarter (March 31). Until we have that data, we don’t know how many people in each state are being completely paid for by the federal government.
I would contend that we lack the information to know whether Obamacare is providing more individuals insurance through the Medicaid program, because we do not know if people are on Medicaid because of the new Medicaid criteria or if they were eligible before and for whatever reason had not enrolled before this time. If they aren’t "newly eligible," they do not have Medicaid as a direct result of the healthcare law.
Could we reasonably debate—and disagree—on whether that is a distinction without a difference? Yes, but this article makes no mention of the two categories. It’s an important detail to understand the direct impact of the law on Medicaid enrollment. Neglecting to mention that is misleading, and if a conservative news outlet left out these kinds of details everyone would have a fit.