Obamacare Enrollment is Mostly Medicaid Expansion

The Urban Institute produces a quarterly survey of Obamacare enrollment. The latest corroborates that Obamacare enrollment is largely an increase in Medicaid dependency. Let me start off by repeating the same criticism I have made of the Gallup-Healthways survey. Namely, that this survey does not differentiate between people who were uninsured for one month before signing up for Obamacare and those who were uninsured for twelve months. This leads to a too high baseline measurement of the uninsured.

Nevertheless, there is a reduction in the proportion of uninsured, and it is much larger in states that expanded Medicaid than in states that did not [Figure 1]:


Further evidence that enrollment is dominated by Medicaid dependency is that people living in households earning below 138 percent of the Federal Poverty Level dominate enrollment, especially in Medicaid-expansion states. This is the income cut-off for Obamacare Medicaid eligibility [Figure 2]:


The real story about what is happening in the private market iis being uncovered by scholars at the Heritage Foundation, who ave reviewed actual enrollment data in health-insurance policies, as filed with state regulators. Their results: Although the individual market has grown by 2.2. million in the wake of Obamacare, the employer-based market has declined by 1.7 million, resulting in a net increase in enrollment of just half a million [Chart 1]:


Comments (13)

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  1. Bart I. says:

    And how much of the net increase in the last graph is result of economic expansion?

  2. Steve says:

    John Graham makes a good point about the difference between those uninsured in the previous month versus those who had been chronically uninsured. And I also agree with him that the big difference between Medicaid expansion states and non-expansion states is evidence of Medicaid driving the Obamacare “enrollment” numbers.

  3. Flyover Country American says:

    Even though noninsurance rates decreased for both expansion and non-expansion states, I wonder why they initially increased for both in Q2 of 2013. Regardless, non-insurance rates fell more aggressively in states that expanded Medicaid, clearly supporting the idea that most of the new enrollees are using Medicaid.

  4. SPM says:

    Yes, it definitely does seem that most of the increase is in fact due to increased Medicaid enrollment. The first two graphs demonstrate that pretty effectively. So why does this have to be researched by public policy groups? Why doesn’t the government simply publish the data? We get plenty of excuses from them but I think they just don’t want to release that information because it discredits their notion that the public is jumping at the chance to enroll in the ACA.

    • martin says:

      actually, those numbers are given, and they are reflected in chart 3 at the bottom of the post. From this, its clear that the administration’s propaganda concerning the popularity of the ACA and its exchanges is mostly myth. People had their employed-based coverage canceled, and were basically force into the exchanges.

  5. Freedom Lover says:

    Lower income earners and minorities comprise the biggest groups getting coverage, and that is the intent of Obamacare. But the shame is that it’s taking illegal taxpayer subsidies to do it.

  6. Matthew says:

    “Nevertheless, there is a reduction in the proportion of uninsured, and it is much larger in states that expanded Medicaid than in states that did not”

    There should be somewhat of a reduction in states that did not expand Medicaid as well. States that did not expand Medicaid are seeing more enrollees into their Medicaid programs as well, such as Texas and Florida.

  7. Thomas says:

    Is anyone surprised that most of ObamaCare enrollment is Medicaid? Who is keeping their ObamaCare coverage? And enrollments will certainly decrease in the marketplace since subsidies are excluded from the federal exchanges.

    • Erik says:

      the courts have not ruled on that subject yet. I hope they disallow the subsidies.

      That will leave a few GOP Politian’s facing their constituents in an election year explaining why they are paying the taxes but not receiving the subsidy based on their decision not to go forward with a state exchange.

      That will be interesting…

  8. James M. says:

    It is interesting how the net increase isn’t as significant since many people lost employer coverage. ObamaCare can tout the number in the individual market, but they keep quiet about what happened in the employer market.

  9. Erik says:

    The simple fact is Medicaid expansion enrollments are increasing at a higher rate due to the stagnation of income. People could not afford private insurance before so they went without.

    • John R. Graham says:

      I agree with that: Obamacare is a vicious circle. It depresses economic growth, making more peole dependent on Obamacare.