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Making sense of the math on insurance exchange enrollment

On Tuesday, the State Health Department released data showing that 48,162 people have enrolled in the New York health insurance exchange, a total that keeps the state on pace to meet its enrollment goals.

On Thursday, however, the federal government released grim enrollment figures for 36 states relying on the troubled federal insurance exchange and slightly better totals for the 14 states, plus the District of Columbia, running their own exchanges.

The U.S. Department of Health and Human Services put the New York enrollment figure at 16,404, as of Nov. 2. So what explains the difference?

The state included people who signed up on the exchange both in private health plans and with Medicaid, the federal health care program for the poor, while the feds only included people who signed up for private health plans. The state also counted enrollees through Nov. 12, while the federal cutoff was Nov. 2.

The 48,162 enrolled in New York as of Nov. 12 included 24,509 enrolled in private health plans and 23,653 eligible for Medicaid.

Sharp-eyed readers will note that the number of Medicaid-eligible enrollees actually declined from the 23,717 enrolled through the state exchange as of Oct. 23. State officials explained that the earlier, higher figure included people whose eligibility was still pending because they hadn't filed the necessary documentation. Later reporting of enrollment data doesn't include those people, we're told.

-- Stephen T. Watson

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