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RAND study on Obamacare draws wildly different coverage

A new RAND corporation study on Obamacere has been interpreted in very different ways by media organizations.
A new RAND corporation study on Obamacere has been interpreted in very different ways by media organizations.
Screenshot by Ryan Witt

Yesterday the non-profit RAND corporation released a new report that showed that 9.3 million people gained insurance under the Affordable Care Act, otherwise known as Obamacare. That is good news or bad news depending on which headline you read covering the study.

The slightly left-leaning Talking Points Memo ran with the following headline covering the RAND study:

Obamacare Might Be Covering Way More People Than Previously Thought"

Meanwhile the more conservative Weekly Standard ran with the following headline:

RAND Study: Only 36% of Obamacare Enrollees Were Previously Uninsured"

The left-leaning Huffington Post ran with this headline:

Millions More People Are Getting Health Insurance Because of Obamacare, Study Finds"

Finally, there is the the far-right covered the study with this headline:

RAND Study: Vast majority of Obamacare 'Enrollees' Already Had Insurance"

How can one study be covered in such a wildly different manner?

Part of it can be attributed to politics behind Obamacare which automatically cause organizations with different agendas to interpret data however they wish. Some would interpret any reduction of the uninsured under Obamacare as a good thing, but others who oppose the law see small reductions as too little given the costs of the program. These organizations are ultimately about increasing readership and page views, so they will create headlines which appeal to their readers who either want to see Obamacare succeed or fail.

Another reason for the different views is that it is very hard to determine with any precision just how many new people were covered under Obamacare. Many of the people who enrolled did undoubtedly have insurance before. But it is hard, if not impossible, to determine:

  1. How many of them would have lost their insurance without Obamacare;
  2. How many saved money by gaining access to lower premiums under Obamacare;
  3. How many were enrolled in "junk" policies that really did not constitute full insurance before Obamacare;
  4. How many people who lost coverage did so because of Obamacare; and
  5. How many obtained new insurance solely because of Obamacare as opposed to an improving economy, for example.

The best breakdown of the study may come from Adrianna McIntyre of The Incidental Economist. As McIntyre points out, the RAND study has a margin-of-error of +/-3.5 million people, nearly enough to wipe out one-third of the decrease in the uninsured reported under Obamcare or, conversely, to increase the gains under Obamacare by more than 20 percent.

McIntyre explains that much of the decrease in uninsured can actually be attributed to an increase in employer based coverage. The increase in employer coverage may be attributable to many factors including, but not limited to, an improvement in the quality of employer-based policies under the Obamacare mandate or a fear of the financial penalty employees might face by turning down employer-based coverage.

McIntyre also points out the the RAND study might actually be underestimating Obamacare's gains because it did not include any people who gained coverage after March 28. Many people enrolled in Obamacare exchanges from March 29-31, and many more are still enrolling ahead of the April 15 "extension."

So what we know is that there are now more people with health insurance under Obamacare than there before. The specific numbers, and the reasons for that increase in coverage are still not well known. The two goals the Obamacare were increasing health insurance coverage while reducing the increasing costs of health care. The RAND study undoubtedly shows that the first goal appears to have been partially met.

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