And it was put together by Charles Gaba at ACASignups.net:
I am amazed at how much work Charles has put into becoming one of the two or three most informed people on the matter of health insurance enrollment. I could not even start figuring out where to ask the right questions to put together the pie graph that rules them all.
Bravo Zulu!
And now let’s use this as an early morning open thread.
Baud
What do ## 23 and 24 mean?
Currants
@Baud: I’d guess ‘uninsured who would get a break if they bought insurance on the exchange’ and ‘biting off nose to spite face’ (or possibly that group would identify as ‘self-insured’–which means something different to them than to the rest of us, I suspect).
Matt McIrvin
While 2.8 million people is nothing to sneeze at, I expected the Medicaid gap to be larger than that.
BGinCHI
Almost as good as this pie chart:
https://flowingdata.com/2008/09/19/pie-i-have-eaten-and-pie-i-have-not-eaten/
Punchy
Section 18 looks gray on the chart, but the key shows lime green. Is this a Punchy Needs A Rods And Cones Adjustment or did Chucky G biff on his color scheme?
Dork
You should see the pie charts Steven Serotonin and Andy Acetylcholine have constructed.
Face
@Punchy: Are you saying that Section Eight (een) houses the wrong color?
currants
@Punchy: Not sure it’s either–the original at Chucky G’s link has both in grey, not green.
Matt McIrvin
“Woodworkers” here seems to be his term for people who were actually eligible for government coverage before the ACA, but only signed up thanks to the ACA’s outreach efforts. I wonder where that term comes from… Googling for it mostly just brings up literal health insurance for woodworkers.
Richard Mayhew
@Matt McIrvin: That term was floating out there in the summer of 2013 as people were “coming out of the woodwork…”
amygdala
I wonder if the number of Medicaid (and CHIP) eligible people has changed at all post-ACA. Also wonder what the uncovered rate is in other advanced economies that utilize private insurance to cover health care.
Smedley Darlington Prunebanks (formerly Mumphrey, et al.)
The governor of North Carolina is peeved that news outlets are writing and speaking about the shitty law they passed there. Wouldn’t it be so much better for everybody if the press just minded its own business and did its job, which is mainly telling us which actresses are getting fat, so Republicans can be left alone to do their work in private, the way the framers meant things to work?
WereBear
It was stupid in the first place (Nixon!) to tie health insurance with employment. You get sick and lose your job, what then?
At the point you need it most, it gets yanked away. How… flippin’… Republican.
Gin & Tonic
@WereBear: I thought it had more to do with WWII-era wage and price controls.
Pogonip
@Gin & Tonic: It did.
My dad will be in rehab for at least 2-3 weeks, keeping a small army of contract employees in business: social workers, therapists, nurses, housekeepers, cooks. As far as I can tell the only one who isn’t contracted out is the therapy dog. Likewise when he was in the hospital. It used to be, when you were in the hospital, nurses Tom, Dick, and Harry were on the same shift every day; nurse Tom got to know his patients and they him. Now you have, just for the day shift, nurses Tom, Dick, Harry, Harold, and Kumar. Every day a different one is your nurse. There’s no continuity of care. Your doctor doesn’t make hospital rounds, at least not around here. There’s the hospitalists and the doctors in their offices, and never the twain shall meet.
It’s a bad state of affairs.
WereBear
@Gin & Tonic: I thought it was some kind of compromise to keep public health care at bay. This was in the early 1970’s, and a lot had happened since WWII.
Some kind of tax deal for employers.
But it leads to the horrible story I read in Dr. Otis Brawley’s How We Do Harm. A woman shows up in the emergency room with terminal breast cancer. She had felt the lump years before, but had seen how women who took time off to get treatment had been fired, losing both their job and their health insurance.
She’d waited, with agonizing pain, until her last child had finished high school.
She didn’t make it.
Matt McIrvin
@amygdala:
That’s wedge 11 on the chart. Also probably a portion of wedges 19 and 20.
The blue part is people who have health insurance directly because of the ACA, one way or another. It doesn’t look like a large fraction of the US population, but it’s over 23 million people. And it’s only going to grow into the red area. It looks to me like 8 million uninsured people could get Medicaid under current policy if someone could sign them up, and another nearly 3 million could get Medicaid if their state governments would stop being asses. The undocumented immigrants aren’t going to get insured without major and unlikely changes in policy. Not sure about the people in categories 23 and 24.
Brachiator
@WereBear:
It was a WW II era development. And it wasn’t stupid because there was no expectation that the federal government provide or subsidize health insurance.
amygdala
@Pogonip: Tom, Dick, et al are probably not all RNs. Now that nurses are paid something a little closer to their actual value, hospitals have responded by staffing as few of them per shift as they can without breaking the rules.
At my former hospital, the nurses spent almost their entire 12 hour shifts doing what only they were allowed to do–pass meds. And because there’s data suggesting that not distracting them prevents med errors, they wore a badge that basically said everyone else couldn’t talk to them.
So the med assistants and other staff who relied on the RNs for supervision had no one to talk to, and therapists and docs couldn’t either. Plus the nurses rarely had time to get to know their patients. Nursing burnout is multifactorial, but systems that preclude them from making connections with patients and colleagues don’t help.
Don’t get me started on the whole hospitalist thing, which is driven by hospital profits and life style considerations.
Matt McIrvin
…Also, as Gaba says on that page, the ACA also affects health insurance, mostly positively, for all the insurance-holders in the other sections. The vaunted “losers” would mostly be some subset of people in wedge 16 who are paying substantially more than they used to because they had garbage insurance that was essentially unregulated.
amygdala
@Matt McIrvin: I may be misunderstanding you (or the chart), but I was curious how the absolute number or percentage of slices 19 and 20 compare to, say, a decade ago. Those, I believe, are folks eligible for Medicaid but not on it.
Hospitals will get these individuals enrolled, if they get hospitalized, in order to get paid. I often asked patients why they hadn’t enrolled and invariably the answer was that they hadn’t known they were eligible. Anecdata, obviously, but always made me wonder about policies to fix that. I’d think, post-ACA, that with all the publicity the rates or numbers would be lower. But if they’re not, then maybe there are language, cultural or other barriers that need to be addressed. Or maybe these are folks who have some sort of objection to insurance, government-provided or otherwise.
Kropadope
I’m in the 18 slice, damn, didn’t know there were so few of us.
Jacel
That’s a phenomenal chart. Are there ones done for past years (including pre-ACA) for comparison? I suspecf that would make a lot of improvements visible, and a lot of the-sky-didn’t-fall stuff visible as well.
Matt McIrvin
@amygdala: I see. Yeah, it doesn’t really say.
Matt McIrvin
@amygdala: …Anyway, those “woodworkers” in section 12 were apparently people who really were eligible before but got on after the ACA passed, probably as a result of ACA-related outreach efforts. So the new law seems to have done some good there but it hasn’t gotten to everyone.
amygdala
@Matt McIrvin: Agreed. I worked in the system for long enough to know that even slow change will inevitably cause all kinds of disruptions.