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115,000 people have signed up through the exchanges. At least 82,000 got Medicaid.

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Dan Diamond, Managing Editor

Two conclusions from spending three-plus weeks compiling and analyzing early enrollment data from the Obamacare exchanges.

1) Lots of people are getting coverage through the 15 state-based exchanges. 2) Most of them (so far) are signing up for Medicaid.

Here's a quick state-by-state look at that enrollment data, as it stood on Thursday afternoon.

With a few exceptions—mostly in the states that have had tech glitches with their exchanges—officials have been consistently updating enrollment figures and growing increasingly transparent when releasing that data.

That's allowed us to get an early read on how many people have used the state exchanges to pick a plan. And as of Oct. 24, we'd counted at least 115,060:


But a closer look reveals that in states that have reported a specific breakdown, the balance is heavily tilting toward Medicaid. Again, as of Oct. 24, at least 82,047 of those 115,060 enrollees had signed up for Medicaid or other public programs.


That's not surprising in the early going; Medicaid is an auto-enroll public program, whereas new shoppers likely need time to decide before choosing private coverage and spending their own dollars. Advocates and state officials also have been gearing up to get low-income residents into their states' Medicaid programs for months, too. (More analysis on those high Medicaid numbers here.)

Don't judge the exchanges' fate too soon: Join us for a conversation on November 15 as our experts perform a pulse check on Obamacare.

And many potential customers for private plans are queued in the pipeline. A Kentucky spokesperson pointed out that while more than 80% of enrollees through the state's exchange have ended up in Medicaid so far, another 10,000-plus accounts have been found eligible for subsidies to purchase private plans.

The balance of overall account eligiblity is about 66% Medicaid, 34% private plan, she added. 

Finally, don't forget: getting coverage through "Obamacare" encompasses much, much more than these exchanges. The law also allowed for early Medicaid expansion in states like California, which on Jan. 1, will move 600,000 residents into its version of the public program.

And thinking about the Affordable Care Act's effects means contemplating so much more than these top-line numbers. At some point soon, we'll start seeing data that allow us to get into the real nitty-gritty for the health care industry: Who these customers are, what sorts of plans they're picking, and what happens next for hospitals, doctors, and insurers.

How do health insurance exchanges work?

Government officials often compare the exchanges to online travel sites like Expedia or Orbitz. But given that many exchange websites aren't fully functional yet, I find it helpful to picture a big box store.


For more: Read our primer, or our white paper, for answers to eight key questions and implications for providers.


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