Michigan: So much for being tapped out...ACA Medicaid expansion up to 533K

Here in Michigan, the official estimates of how many residents are eligible for ACA Medicaid expansion ranged from around 477K to 500K, and over the past month or so, the weekly reports from the official MI Dept. of Community Health "Healthy Michigan" website has pegged the current enrollment total at between 490K - 510K. This led me to assume, naturally, that the program has been essentially tapped out, with close to 100% of those eligible already having signed up within the first 10 months.

Yesterday, however, they posted the weekly update again, and guess what?

Healthy Michigan Plan Enrollment Statistics

Beneficiaries with Healthy Michigan Plan Coverage: 533,110
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)

*Statistics as of January 26, 2015 
*Updated every Monday at 3 p.m.

Wow. 533,000 people. So, what's going on here? Well, possibilities include:

• The earlier estimates may have simply been underestimating by 10% or so.
• The earlier estimates may have been accurate at the time, but it's possible that another 40K or so Michiganders who didn't qualify last spring have fallen on hard times since then and do qualify now.
• There may be a small amount of genuine fraud going on here; hey, it does happen.

There's one other possibility: 36,307 of the 533K total are people who were previously covered through Medicaid's adult benefits waiver program. I've been assuming all along that the 477K - 500K eligible estimate included those 36K as well, but it's possible that it didn't. If that's the case, then the actual number eligible should be closer to 540K, which would dovetail nicely with today's update.

Anyway, that's a lot of people.