CBO’s economic outlook predicts slower than expected insurance enrollment

Posted on February 5, 2013 | No Comments
Filed under Congressional Budget Office, Congressional Documents, Health Insurance, Library, Medicaid and CHIP

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Key Developments

The Congressional Budget Office (CBO) today released an economic outlook, which predicts that consumers will not enroll in the Affordable Care Act’s (ACA’s) health insurance marketplaces and expanded Medicaid programs as quickly as previously estimated.

Lower Projected Costs for Medicaid and the Children’s Health Insurance Program: According to the report, the ACA will increase the number of people enrolled in Medicaid by 12 million in 2022, as opposed to the 11 million estimated in August 2012. Despite this difference, the projected costs for Medicaid and the Children’s Health Insurance Program are $93 billion (or 14 percent) below the earlier projection for the 2013–2022 period,

Higher Enrollment in and Subsidies for Coverage Through Exchanges: The report estimates that the costs of subsidies for insurance obtained through the exchanges and for related spending over the 2013–2022 period is now $32 billion (or about 3 percent) higher than it was in August, mostly due to higher projected enrollment in the exchanges. All told, the report projects that 26 million people will be enrolled in the insurance exchanges in 2022, about 500,000 more than estimated in the August 2012 report.

Fewer People with Employment-Based Coverage: In 2022, according to the report, 7 million fewer people will have employment-based health insurance as a result of the ACA; in August, that figure was estimated to be about 4 million people.

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Congressional Budget Office and Joint Tax Committee Estimates of Cost and Coverage under the ACA after the Supreme Court Ruling in NFIB v. Sebelius and the Effects of H.R. 6079, the Repeal Obamacare Act

August 1, 2012

The Congressional Budget Office (CBO), the legislative branch agency responsible for estimating the cost of legislation, issued two reports on July 24th related to the Affordable Care Act (ACA). The first report, revised cost and health insurance coverage estimates for the ACA in the wake of the Supreme Court ruling in NFIB v. Sebelius^[1]. In that ruling, the Court concluded the individual requirement to purchase health insurance coverage, while not a reasonable exercise of congressional Commerce Clause authority, is constitutional as a tax under congressional Spending Clause authority. The Court also held that the ACA’s Medicaid expansion, requiring states to cover all non-elderly individuals with incomes below 133^[2] percent of the federal poverty level was unconstitutional. However, rather than striking the requirement, the Court precluded the Secretary of the Department of Health and Human Services (HHS) from enforcing the mandate by withholding all Medicaid funds. As a result of the ruling, states now have the option of expanding coverage to 133 percent of the federal poverty level (FPL), and will receive enhanced federal matching funds as provided under the law, but are not required to expand coverage.^[3]

Medicaid and CHIP – Outreach and Enrollment

June 21, 2010

This brief provides an in-depth look at the outreach and enrollment provisions in the Patient Protection and Affordable Care Act affecting Medicaid and CHIP.

CBO re-scores ACA in light of SCOTUS decision

July 24, 2012

The Congressional Budget Office (CBO) and the Joint Committee on Tax (JCT) have revised their estimates of the total cost of the Affordable Care Act (ACA) as a result of the Supreme Court's ruling that essentially makes State expansion of Medicaid eligibility optional. CBO and JCT now estimate that the coverage provision in the ACA will cost $84 billion less over 10 years, coming in at $1,168 billion over the 2012–2022 period. This is down from their original score of $1,252 billion, issued in March of 2012. In a separate analysis, CBO and JCT have also scored H.R. 6079, a bill to fully repeal the ACA. If enacted as currently written, CBO and JCT estimate that H.R. 6079 will reduce spending by $890 billion and reduce revenues by $1 trillion over the 9 year period of 2013-2022, for a total of $109 billion added to the federal deficit during that time. Stay tuned to HealthReformGPS.org for additional in-depth analyses of the CBO estimate.

CBO updates cost estimates of ACA

March 13, 2012

The Congressional Budget Office (CBO) released today an update on the budgetary impact of the Affordable Care Act (ACA). Although overall projections are similar to those released in prior years, there are several important changes in this year's updated estimates. For example, in March 2010 when the ACA was enacted, CBO estimated that the number of uninsured individuals would fall by 32 million by 2019. Now CBO estimates that the number will only fall by 31 million by 2019, but by 33 million by 2022. The projections regarding health insurance coverage has also changed...

IRS and Treasury release FAQs about ACA automatic enrollment, employer shared responsibility, and waiting periods

February 10, 2012

The Internal Revenue Service answered frequently asked questions related to automatic enrollment, employer shared responsibility payments, and waiting periods under the Affordable Care Act (ACA). The notice addressed employers' questions and invited comments on proposals that the Treasury, Labor, and Health and Human Services departments expect to include in future guidance or rulemaking under the ACA. The notice included the following information...

CMS issues notice of proposed rulemaking on federal funding for Medicaid eligibility and enrollment activities

November 10, 2010

The Centers for Medicare and Medicaid Services has issued a notice of proposed rulemaking (NPRM), which, the summary explains, proposes to "amend the definition of Mechanized Claims Processing and Information Retrieval Systems to include systems used for eligibility determination, enrollment, and eligibility reporting activities," modifies "our regulations so that the enhanced Federal financial participation (FFP) is available for design, development and installation or enhancement of eligibility determination systems...," and proposes "that all Medicaid Management Information Systems (MMISs) meet certain defined standards and conditions in terms of timeliness, accuracy, efficiency, and integrity and that they achieve high positive levels of consumer experience, acceptance and satisfaction in order to receive enhanced FFP."