Thread by @charles_gaba

#ACA coverage has likely broken 41 million, and more notes from the @HHS_ASPE report:
acasignups.net/23/03/25/aca-c…

For the most part the ASPE report on #ACA coverage is pretty much in line with my own estimates from January: A bit over 40 million Americans now have healthcare coverage via the ACA via exchange QHPs, basic health plans in MN/NY and Medicaid expansion:
acasignups.net/23/03/23/old-n…

However, the ASPE report has a couple of curious estimates for effectuated QHPs. Overall, they put it at 95.2% of total OEP selections, but this ranges from as low as *78.5%* in New Mexico (?) to *101.3%* in Rhode Island (!)

The first seems way too low; the second is impossible.

The other important thing is that ASPE's Medicaid expansion enrollment data is from last September. I've confirmed that it's grown by at least 385K across 14 states since then.

If this is representative across every expansion state, it's more than ~891K higher nationally.

That would put total #ACA coverage at 41.1 million people nationally:

15.56M exchange QHPs
1.23M Basic Health Plan (MN/NY only)
24.30M Medicaid expansion

That's 12.3% of the total U.S. population, or nearly 1 out of every 8 Americans.

Here's my most recent estimate of the healthcare coverage of the entire U.S. population as of January. The sections w/blue text are #ACA-specific.
acasignups.net/23/02/09/psych…

Over the next year, the Medicaid sections will shrink by up to 15M people as #MedicaidUnwinding kicks in, while the other sections (including, unfortunately, the uninsured slices) will grow accordingly. On the other hand, NC & SD both just expanded Medicaid, which will help some.

North Carolina & South Dakota will find themselves in the odd position of kicking thousands of Medicaid enrollees *off* the program while simultaneously *enrolling* thousands of *other* residents in Medicaid. In some cases they'll be the *same people*.
acasignups.net/23/03/23/north…