Perhaps the most egregious error I have seen in recent reporting on Medicaid enrollment and this ACA is from a recent report in CBS News.
A CBS News analysis shows that in many of the 15 state-based health insurance exchanges more people are enrolling in Medicaid rather than buying private health insurance. And if that trend continues, there’s concern there won’t be enough healthy people buying health insurance for the system to work.
The story goes on to cite “lopsided” enrollment numbers from Washington state where many more folks are signing up for Medicaid than the exchange and culminates by saying that the insurance industry is worried about this robust Medicaid enrollment undermining the whole system.
Memo to CBS news analysts: Successful enrollment in Medicaid will NOT undermine enrollment in the exchanges – the opposite may be true in fact for reasons I will explain – but those enrolling in Medicaid ARE NOT ELIGIBLE FOR TAX CREDITS IN THE EXCHANGE. It is either one or the other – you can’t be eligible for both. So no one who understands the law has been counting on these Medicaid enrollees to make the exchanges work.
In many ways, the insurance industry has always liked the fact that Medicaid tends to serve those with higher health care needs, thus taking expensive and sicker customers out of their risk pools so it is easier to make a profit. From that perspective, Medicaid has always supported the private insurance system by serving those who can’t afford private insurance or have higher health needs that a private insurance typically doesn’t cover.
Now I have to throw in my second point. The implication that Medicaid and private insurance are two entirely separate things as seen in this story is just wrong. (And sadly, this inaccuracy was reinforced by the Washington Post in the headline of last Friday’s story “Medicaid tops private plans in tallies of new sign-ups” that I blogged about last Friday.) The vast majority of the newly eligible Medicaid beneficiaries who are signing up for coverage will be enrolled in privately operated for-profit managed care plans. In fact, at some point we will have good data on this, but many of the plans may even be run by the same “private plans” who are also operating in the new marketplaces.
So I am going to keep a sharp eye on these inaccuracies and try to call them out when I can. Follow me on twitter (@JoanAlker1) to stay tuned.