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Jewish World Review Feb 25, 2014 / 25 Adar I, 5774 Obama's claim that 7 million got 'access to health care for the first time' because of his Medicaid expansion By Glenn Kessler
– President Obama, remarks during dinner with the Democratic Governors Association, Feb. 20, 2014 The Fact Checker has written several times about the fuzziness of the Medicaid numbers issued by the Obama administration. But it is like playing whack-a-mole. Every time we rap someone for getting it wrong, the same problem pops up someplace else. But here is the ultimate authority — the president of the United States — making the problematic claim that everyone counted under the administration’s Medicaid math is getting “access to health care for the first time.” Time for a refresher course! The FactsMedicaid is the health-care program for the poor, generally those 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.) The Congressional Budget Office estimates that because of the ACA, the number of Americans on Medicaid will increase by 8 million in 2014. (The estimate was recently revised downward from 9 million because of the stumbling start of the law’s implementation.) Most of those people would be in the new pool of applicants, but it could also include some people who were previously eligible for Medicaid but had never signed up before all the publicity about new health-care options (known as people coming out of the “woodwork”). But the figures released by the Center for Medicare and Medicaid Services, a unit of the Department of Health and Human Services, lumps together all sorts of Medicaid applicants, including people previously enrolled in Medicaid who are deemed eligible for another year (in other words, “normal churn”), as well as people who would have been eligible under the old law. The most recent report gives a top-line figure of 6.3 million people deemed eligible from Oct. 1 to Dec. 31, which is presumably where Obama got his 7 million figure. (An updated report through January is expected soon.)
Avalere, a health consulting firm, in a recent analysis raised serious questions about the 6.3 million Medicaid figure, estimating that only 1.1 million to 1.8 million of the claimed enrollees could be attributed to the Affordable Care Act. That estimate generated headlines, including a full report in The Washington Post that said it suggested “many of the people who have joined the program since the initiative’s rollout in October would have done so absent the law.” Charles Gaba, who keeps careful track of enrollment figures at ACASignups.net, has disputed some of Avalere’s reasoning but has also concluded that not all of the Medicaid data released by the administration can be attributed to the ACA. Here’s how he breaks down the numbers as of Feb. 22: 7,132,277 — deemed eligible for Medicaid 4,815,617 — Medicaid expansion states only, including people coming out of the “woodwork” and “normal churn” 2,600,000 — Medicaid expansion states only, no “woodwork” or normal churn of Medicaid applicants Part of the problem is that few states provide much of a breakdown, making this a bit of a guessing game. But a good example is West Virginia, which on Feb. 21 reported that 130,000 people are eligible under the expansion and that more than 87,000 people had enrolled in Medicaid because of the expansion. This additional data prompted Gaba to reduce the total for Medicaid by 39,600 to remove “woodwork” and “normal churn.” The White House declined to comment. The Pinocchio TestWhat does this mean in terms of evaluating the president’s statement? He seems to be falling into the same trap as other Democrats, and some reporters, by assuming that everyone in the Medicaid list is getting health insurance for the first time because of the Affordable Care Act. But that number is nowhere close to 7 million. It could be as low as 1.1 million (Avalere) or as high as 2.6 million (Gaba.) If one wanted to be generous, one could include people coming out of the woodwork, even though they would have been covered under the old law, but no one is really sure what that figure is. In any case, no matter how you slice it, it does not add up to 7 million. It is dismaying that given all of the attention to this issue, the president apparently does not realize that the administration’s data are woefully inadequate for boastful assertions of this type. Four Pinocchios
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An award-winning journalism career spanning nearly three decades, Glenn Kessler has covered foreign policy, economic policy, the White House, Congress, politics, airline safety and Wall Street. He was The Washington Post's chief State Department reporter for nine years, traveling around the world with three different Secretaries of State. Before that, he covered tax and budget policy for The Washington Post and also served as the newspaper's national business editor. Kessler has long specialized in digging beyond the conventional wisdom, such as when he earned a "laurel" from the Columbia Journalism Review
• 02/11/14: Durbin's claim that 10 million now have health insurance because of Obamacare • 01/29/14: Fact Checking the 2014 State of the Union address • 01/06/14: The White House's claim that 7 million enrolled in Obamacare 'was never our target number' • 01/06/14: Schumer's claims about Democratic and GOP efforts to 'fix' Obamacare • 12/12/13: Harry Reid's explanation for why not all of his staff is going on 'Obamacare' • 09/05/13: History lesson: When the United States looked the other way on chemical weapons • 07/09/13: George W. Bush returns as a uniter • 06/11/13: Obama's claim of 500,000 manufacturing jobs, month after month • 05/15/13: Prez's claim he called Benghazi an 'act of terrorism' • 02/21/13: Obama and early childhood education: a rhetorical leap of faith • 02/14/13: Fact checking the 2013 State of the Union speech • 10/23/11: Fact Checking the Final Debate • 07/10/11: Obama's misleading tweet on Romney's taxes • 02/21/11: The claim that 98 percent of Catholic women use contraception: a media foul • 12/29/11: Ron Paul and Ronald Reagan (Fact Checker biography) • 12/08/11: Romney versus Gingrich: a Super PAC's over-the-top ad • 12/08/11: Obama's Kansas speech: some suspect facts • 11/18/11: The Obama campaign's spin on the Romney tax plan • 09/27/11: Obama' strained symbolism at an Ohio River bridge • 08/25/11: Obama's claim that GOP is holding up trade deals • 08/11/11: Obama's claim that the debt problem can ‘go away’ • 06/22/11: AARP's misleading ad about balancing the budget • 05/24/11: A rare Geppetto for Paul Ryan's assertion on Obama's hidden top marginal tax rate • 05/16/11:Obama administration boasting about border security • 05/11/11: Kathleen Sebelius's outrageous claim that cancer patients would 'die sooner' under the GOP Medicare plan • 05/09/11: A gusher of oil rhetoric • 05/04/11: The Obama administration's odd claims on export growth • 04/28/11: How effective are sanctions in ‘changing behavior’? • 04/14/11: ‘Biggest cuts in U.S. history’? Well, no. • 04/08/11: Nancy Pelosi's absurd math on senior citizens losing their meals • 04/06/11: Hillary Clinton's uncredible statement on Syria • 03/25/11: Libya, Obama and the tragedy in Darfur • 03/22/11: Gifts of bogus statistics for the health-care law's birthday • 03/21/11: Mitch McConnell's not-so-happy birthday greetings for the health care law • 03/10/11: A job-loss statistic produced out of thin air • 03/10/17: A budget analogy that earns a Geppetto checkmark • 03/10/11: Four pinocchios for the American public on the budget • 03/09/11: Obama and the White House's ‘halfway’ fixation with the budget • 03/08/11: Foreign policy braggadocio on Libya and AIDS • 03/07/11: Democrats keep misleading on claimed budget ‘cuts’ • 03/01/11: Mike Huckabee is on to something here, but jumped the gun
• 02/25/11: Harry Reid's illusory $41 billion in budget cuts
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