<p>^^ Reducing the number of uninsured was one of the main goals as I recall. :-)</p>
<p>How much did it cost to reduce the number of uninsured by 4-percent? Also, I noticed they are counting all Medicaid sign-ups. Medicaid is not a new program. Ugh. Numbers.</p>
<p>LasMa… :).</p>
<p>Flossy, they are counting a fraction of medicaid sign ups. </p>
<p>Sigh… ;).</p>
<p>“Also, I noticed they are counting all Medicaid sign-ups. Medicaid is not a new program.”</p>
<p>So? Medicaid was expanded in many states to cover people who previously were not eligible for it. What difference does it make that it is already an established program? </p>
<p>Emily, it doesn’t make a lick of sense to credit ACA for the people who were already eligible. That would be like counting the people with employer plans. Yeah ACA! lol.</p>
<p>Who is counting people who were already eligible for Medicaid pre ACA? </p>
<p>As of 2010 66,390,642 people were on Medicaid. </p>
<p><a href=“http://kff.org/medicaid/state-indicator/total-medicaid-enrollment/”>http://kff.org/medicaid/state-indicator/total-medicaid-enrollment/</a></p>
<p>We are counting people who were formerly uninsured and who are now insured or are going to be insured because of ACA. We arent counting eligible people. ;)</p>
<p>So, if the program was always available to them but they didn’t use it because they didn’t need it until an ACA activist signed them up, that’s a win? I will never understand this logic. Okay. Carry on. </p>
<p>Flossy, the amount we spent on enrolling the uninsured is a fraction of what we’ve spent on medical care for the uninsured who, for example, used to be forced into the ER for their primary care.</p>
<p>The 4.5 million from the LA Times article is only the people who weren’t eligible for Medicaid pre-ACA, who now are eligible, and who have already enrolled.</p>
<p>If you want to count the people who were previously eligible but didn’t realize it, and who have now signed up ( the “woodworkers” who came out of the woodwork to sign up) that’s an additional 1.8 million people.</p>
<p>“Flossy, the amount we spent on enrolling the uninsured is a fraction of what we’ve spent on medical care for the uninsured who, for example, used to be forced into the ER for their primary care.”</p>
<p>This sounds more like a talking point than a fact unless you have a crystal ball. Even the rosy scenario projections leave some 30-million uninsured. And many people who don’t care about bills enjoy the convenience of the ER. We’ll see. </p>
<p>Here is one analysis of the number of “woodworkers” for those who want to break out those who were previously eligible but signed up after Oct 1. </p>
<p><a href=“ACA Signups: Medicaid: Should "Woodworkers" count as "Due to the ACA" or not?”>http://www.dailykos.com/story/2014/02/24/1279966/-ACA-Signups-Medicaid-Should-Woodworkers-count-as-Due-to-the-ACA-or-not</a></p>
<p>This also breaks out the numbers:</p>
<p><a href=“http://obamacaresignups.net/spreadsheet-med”>http://obamacaresignups.net/spreadsheet-med</a></p>
<p>The convenience of the ER??? Lol!</p>
<p>Agree with you that it would be better if we could get everyone covered. I’m sure you join me in hoping that will happen someday. In the meantime, this is the first meaningful step we’ve ever taken in that direction. It is not perfect, but it is better. </p>
<p>actingmt, it all depends on whether you care if poor people get health care. </p>
<p>If some old guy in Appalachia didn’t realize he was eligible for Medicaid but now with all the publicity he does, and as a result he signs up for Medicaid, so he can get his diabetes treated and he doesn’t lose his eyesight or get his foot amputated, for me that is a huge win. </p>
<p>If you think that guy is so stupid he deserves to go blind, that’s a valid opinion. But it’s not mine.</p>
<p>I’m going to come down on Flossy’s side about the cost of preventative care vs. the cost of acute care. We’d like to think that giving health coverage to all these people will lower the total cost of health care, because we’ll be treating conditions before they get serious.</p>
<p>It doesn’t work that way. Giving people health coverage makes them healthier. But we don’t have data that giving people health coverage saves us money. Also, expect Emergency Department use to go UP with the ACA, because giving people access leads to more access. <a href=“http://www.annemergmed.com/webfiles/images/journals/ymem/YMEM5832_proof.pdf”>http://www.annemergmed.com/webfiles/images/journals/ymem/YMEM5832_proof.pdf</a></p>
<p>Fang, point taken, although I’d note that everyone had access to the ER even before ACA. </p>
<p>I heard something on NPR last night that they do expect total costs to rise by a few percentage points at first, because of pent-up demand. Two or three years down the road it should settle back down. </p>
<p>We’ve addressed the problem of insurance. We will also need to address the cost of health care itself. </p>
<p>Low income people knew that if they went to the ED*, they’d be charged for it. As a result, low-income people would do a kind of cost triage. And people, it turns out, are bad at doing cost triage. They end up not going to the ED when they don’t need to go, but also not going when they do need to go. </p>
<ul>
<li>Apparently they are now called Emergency Departments (ED) instead of Emergency Rooms. </li>
</ul>
<p>You’re right about ED; old habits die hard. ;-)</p>
<p>Well, it’ll be interesting to see what happens with ED utilization. A lot of low-income (and not-so-low-income who didn’t have insurance) were indeed charged for their care but never paid for it. You know the bankruptcy stats; the rest of us ended up paying anyway. </p>
<p>ETA – And the old habits of the uninsured will die hard too. If they’ve never been to a doctors office, that could take some being used to.</p>
<p>I don’t really disagree with any of this but it should be noted that the uninsured is not some unfortunate chunk of people who have never set foot in a doctors office. It’s a fluid group. People gain and lose insurance with job changes. I agree that eliminating ED abuse will be difficult, especially if wait times to see doctors becomes a bigger problem. </p>
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<p>@peacefulmom - We have looked into this several times. If someone is buying ACA insurance, they need to evaluate coverage. Buying insurance in Texas for coverage in Wyoming as an example may not work since the Texas coverage can be mostly limited to Texas doctors and hospitals and one would need to be in Texas to get good coverage.</p>