ACA/Obamacare: A Closer Inspection of the Much Anticipated RAND Study

“Last week, I wrote about an article in the Los Angeles Times, on a then-as-yet unpublished report from the RAND Corporation. The report indicated that only one-third of Obamacare’s purported 7.1 million exchange sign-ups were from the previously uninsured. But Noam Levey, the author of the Times article, didn’t disclose RAND’s actual findings as to the actual number of previously uninsured exchange enrollees. Well, now we know why. RAND published the full report yesterday; it indicates that Obamacare’s exchanges only enrolled 1.4 million previously uninsured individuals.

That 1.4 million is out of a total of 3.9 million exchange enrollees overall. That is to say, a little over a third of enrollees—36 percent—were previously uninsured. RAND’s figures don’t take into account the last few weeks of the Obamacare open enrollment period, and they contain a substantial margin of error, due to the study’s small sample size. (RAND surveyed 2,425 individuals aged 18 to 64; the 1.4 million figure has a margin of error of 700,000, meaning that there is a 95 percent probability that the actual number is between 700,000 and 2.1 million previously uninsured enrollees.)

If you assume that 80 percent of signer-uppers will eventually pay their premiums, the true number of previously uninsured exchange enrollees is likely closer to 2 million. That’s far from what the Congressional Budget Office has projected; the CBO estimated that 80 to 90 percent of the first-year enrollees would come from the previously uninsured population. Instead, it appears to be more like 24 to 36 percent.

Because the RAND survey is quite small—a comparable survey by the U.S. Census Bureau surveys around 250,000 individuals—its results aren’t as reliable. But the RAND authors, Katherine Grace Carman and Christine Eibner, perform a useful service, because they break out how people of varying insurance statuses in 2013 fared in 2014. For example, of the 40.7 million people they consider to have been uninsured in 2013, RAND can break out the fraction of those who gained insurance via the exchanges, via Medicaid, via employer-sponsored insurance, et al.

RAND finds that, overall, 9.3 million more U.S. residents have health insurance in 2014 relative to 2013. That figure has a margin of error of 3.5 million. But that’s not the interesting part. The interesting part is that 8.2 million of that comes from growth in employer-sponsored insurance. Labor force participation has been steadily declining, especially among younger individuals, which would seemingly make this result unlikely. Other surveys from ADP and Aon Hewitt have found that employer-sponsored coverage among the young has been flat to down.” - RAND Comes Clean: Obamacare's Exchanges Enrolled Only 1.4 Million Previously Uninsured Individuals, Forbes, 04/09/2014

　

Link to the entire article appears below:

http://www.forbes.com/sites/theapothecary/2014/04/09/rand-comes-clean-obamacares-exchanges-enrolled-only-1-4-million-previously-uninsured-individuals/?partner=yahootix