Today it’s a few hundred thousand people. By next year, it will be at least a few million. Their health insurance status is changing dramatically: What they have in 2014 and beyond will look nothing like what they had in 2013 and before. For many of these people, the difference will be hundreds or even thousands of dollars a year. In a few cases, it may be the difference between life and death.

You probably think I’m talking about the people getting cancellation notices about their private insurance policies. I’m not. I’m talking about the people getting Medicaid. Both stories are consequences of the Affordable Care Act. But one is getting way, way more attention than the other.

It’s no mystery why. Stories of people losing something are more compelling than stories of people gaining something. The policy cancellation story is also newsier, because fewer people expected it to happen. Obamacare’s expansion of Medicaid was something the advocates of reform advertised. Reform’s effect on people with skimpy or medically underwritten insurance policies they liked was something that few advocates, including the president, even acknowledged. Had Obama pointed out, all along, that some people might lose existing plans or pay more for coverage in 2014, it would seem a lot less shocking.

But there is also a class element to the way this debate has evolved. By and large, the people receiving those cancellation notices and facing large premium increases are at least reasonably affluent. They’re not necessarily rich, particularly if they live in higher cost areas of the country. Many of them sweat monthly bills just like most of the country does. But, by definition, they don’t qualify for huge subsidies that would offset premium increases mostly or completely. By contrast, the people getting Medicaid are poor. They have to be, because it’s the only way to sign up for the program. And as political scientists have shown, the poor don't command the same kind of attention from politicians that the middle class—and particularly the upper middle class—does.

And this fact, I suspect, is also magnifying the impact of those cancellation letters. The best estimates suggest that 12 to 15 million people currently buy coverage on their own—i.e, in what's known as the non-group market. It appears that only a fraction of them will get to keep their current policies. The rest will end up having to get new coverage, or updated versions of their old coverage, that offers greater benefits and/or is available to everybody, regardless of pre-existing condition. That will drive up the price of insurance.