Reality and Rand

Rand has published an analysis that they had completed which alleges a massive increase in insured under health care. When examining the data one gets a bit concerned. Let me explain.

First they show the following:

There is a massive growth in Employer Insured individuals, specifically some 8 million. Now there has only been 1 million added to the payrolls since then, see our other analyses, yet without an Employer Mandate we see this explosive growth. Why?

They argue: 

Enrollment in ESI increased by 8.2 million. Most of this increase was driven by people who were previously unin- sured. Some of these newly insured individuals may have taken up an employer plan as a result of the incentive created by the individual mandate; others may have newly found a job. The U.S. unemployment rate fell slightly between September 2013 and March 2014, so part of the increase in ESI enrollment could have been due to eco- nomic recovery rather than the ACA. While the 8.2-mil- lion-person increase seems large, more than 100 million 18- to 64-year-olds were covered by ESI in 2013. Since ESI is the dominant source of insurance coverage among this age group, it is not surprising that we could see relatively large effects of the individual mandate and economic recovery in this category. 

Yetthis seems not to make any sense. Look at the following chart:

Some 3 million or more went to Medicaid. Not unreasonable given the circumstances, it is free and no one cares. Some 4 million went to the "Marketplace" the web based sign ups and they are subsidized as well but not 100% Most of them seem likely to have a pre-existing condition. Some 7.2 million were lost, those on private plans most likely.

It will be interesting to see who is paying and who is not, and what the conditions are of the new entrants. The ESI number is truly confusing.