Thread by @charles_gaba

This by @xpostfactoid is excellent. There may only be 10-11 million people enrolled in ACA exchange plans at any given time, but a good 14% of the U.S. population has been enrolled in them at some point in the past 7 years.

https://twitter.com/xpostfactoid/status/1314183465143803904

The irony of Trump pushing #ShortAssPlans so hard instead of ACA-compliment policies is that for millions of Americans, ACA policies THEMSELVES act as “short-term plans”. If you lose a job w/benefits in January and get another in October, guess what’s there for you in between?

One philosophical flaw with the ACA exchange concept was assuming that it would be more like the employer-based market (w/most enrollees sticking around year after year) instead of the Medicaid market (many enrollees moving in & out throughout the year).

My wife and I belonged to the first category for 6 yrs straight; we’re both self-employed, thus the individual market was our only option until she went back to school & we moved to her university plan. When she’s done, we’ll move back to an ACA plan...if the ACA is still around.

The only real report I've ever found tracking ACA exchange enrollment of *specific enrollees* year-round (referenced by @xpostfactoid) is from 2015, but that year, 67% of those enrolled in January were still enrolled in December:
acasignups.net/20/08/20/you-d…

Detractors often attack ACA exchange attrition as a negative thing--"1/3 of them dropped out before the year even ended!", but you have to look at WHY they dropped their coverage mid-year.

Some get a job w/benefits & move to employer coverage.
Some go back to school & move to university plan.
Some turn 65 & move to Medicare.
Some lose income & move to Medicaid.
Some get married & join their spouse's employer plan.

None of these are "bad" (well, an income drop is).

Here's a breakout of how many people ENROLLED in ACA exchange plans mid-year in 2015 (federal exchange only, around 36 states). Notice how 60% of them lost other coverage and another 18% were denied Medicaid coverage for some reason?

Assuming the 2015 pattern still holds, around 2/3 of ACA enrollees are long-term, 1/3 short-term...vs. the employer market, where I assume the vast majority are long-term. Note employers can make you wait up to 90 days before coverage kicks in:
help.ihealthagents.com/hc/en-us/artic….