Sunday, February 9, 2014

Oh, right wing. How many times am I going to fall for your shenanigans? Obamacare/CBO edition.

Part 247 of my 596-part series, "Crap, Snookered Again."

From John Podhoretz (referring to the recent CBO report (PDF)):

Even more damaging is this projection: “About 31 million nonelderly residents of the United States are likely to be without health insurance in 2024, roughly one out of every nine such residents.”
Why? Because, in selling the bill to the American people in a nationally televised September 2009 address, President Obama said the need for ObamaCare was urgent precisely because “there are now more than 30 million American citizens who cannot get coverage.”

I should have caught the sleight of hand on the first pass.  Podhoretz clearly wants the reader to take away the idea that Obamacare won't make a dent in the problem of the uninsured, which seems absurd on its face.  I didn't figure it out for myself, and went scouring the Internet for answers.  I found them at No More Mr. Nice Blog.  Thanks!

The CBO is referring to "uninsured residents of the United States," while the second refers to "uninsured American citizens."  In the report, the CBO actually estimates that there will be 25M fewer uninsured Americans thanks to Obamacare.  By pretending we were starting with about half as many uninsured as we actually have, Podhoretz tries to make these 25M Americans disappear.  Given that I was three pages into the search results for that quote before I found the answer, it seems he was successful.

So, who are these 31M uninsured?

  • 30% : Illegal immigrants (who are specifically excluded from benefitting from Obamacare)
  • 5% : People who can't get on Medicaid because their states haven't expanded it.
  • 20% : People eligible for Medicaid, who don't enroll
  • 45% : People who have access to coverage, but don't take it.

Honestly, that 45% is higher than I expected.  They'll be the ones paying the fines under Obamacare, a way higher number than I would have guessed.

Still, it's surprising to suddenly discover that Republicans are now angry that Obamacare doesn't cover illegal immigrants.

Now, the CBO in context:

CBO and JCT estimate that the insurance coverage provisions of the ACA will markedly increase the number of nonelderly people who have health insurance--by about 13 million in 2014, 20 million in 2015, and 25 million in each of the subsequent years through 2024 (see Table B-2). Still, according to the estimates by CBO and JCT, about 31 million nonelderly residents of the United States are likely to be without health insurance in 2024, roughly one out of every nine such residents.  Of that group, about 30 percent are expected to be unauthorized immigrants and thus ineligible for most Medicaid benefits and for the exchange subsidies; about 20 percent will be eligible for Medicaid but will choose not to enroll; about 5 percent will be ineligible for Medicaid where they live in a state that has chosen not to expand coverage; and about 45 percent will not purchase insurance even though they have access through an employer, an exchange, or directly from an insurer. [page 107]