The Evolution of Affordable Care Act Cost and Coverage Impact Estimates, Summarized on One Table

Posted on December 6, 2013 | No Comments
Filed under Editor's Comment

PDF Version
Details
Library
Expert Commentary
Implementation Briefs
Key Developments

By Sara Rosenbaum and Nikki Hurt

Since the 2010 enactment of the Affordable Care Act (ACA), the Congressional Budget Office (CBO) has issued a series of cost and coverage impact estimates. Evolving cost estimates are, of course, a reflection of changing economic and social conditions such as labor and employment patterns, the cost of goods and services in the economy generally and health care costs in particular, and choices by sponsors of public and private health insurance coverage, such as employers, government programs, about what and whom to cover or how much to pay for care. Impact estimates also reflect changes in law and public policy, such as the 2012 decision by the United States Supreme Court to bar the federal government from enforcing the Act’s Medicaid expansion for low income adults, thereby effectively turning the expansion into a state option.

In addition, the methods used to calculate impact have an important effect. In this vein, it is important to note that with each subsequent estimate, CBO alters its assumption methods as well as the baseline for its projections. For example, between the 2010 and 2011, the CBO cost estimate rose nearly 50%, a seemingly large jump given the relatively small increase in the number of individuals anticipated to gain coverage between the two estimate time frames. But of the 10-year timeframe covered in the 2010 CBO estimate, full implementation of the ACA accounts only for six of those years (2014-2019). The 2011 estimate, by contrast, includes projections from 2012-2021 time period, thereby adding two years of full implementation. The differences in the estimation timeframe, as well as the increased costs of the ACA post-implementation, account for some of the variation seen among the CBO estimates.

The table below summarizes these evolving CBO cost and impact estimates which consider the ACA through a rolling 10-year framework.

aca cost table

Below are links to the CBO estimates:

 

No Comments

Public comments are closed.

The Congressional Budget Office (CBO) recently released a report outlining 103 potential options to reduce federal spending or increase tax revenue. The report, Options for Reducing the Deficit: 2014 to 2023, contains 16 health-related provisions, several of which concern the Affordable Care Act (ACA), that may aid in reducing the deficit. These options include:
In a letter addressed to Rep. Paul Ryan, the Congressional Budget Office (CBO) stated that the administration's decision to delay the employer shared responsibility (employer mandate) provisions of the Affordable Care Act (ACA) would cost the government $12 billion over 10 years. CBO estimated that around $10 billion would be lost from the one-year delay in collecting penalties from employers that did not offer comprehensive, affordable coverage. An additional $3 billion is projected to be lost from the government over-allocating subsidies to individuals qualifying for premium assistance. CBO did, however, project the delay to generate around $1 billion in savings as a result of taxable compensation from people enrolling in Exchanges that would have otherwise received employer-sponsored coverage.
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.
In a letter to Speaker of the House John Boehner, the Congressional Budget Office (CBO) notified Congress that the recently-introduced bill aimed at repealing the Afforadable Care Act (ACA) would add approximately $230 billion to federal deficits during the years 2012 - 2021. CBO also estimates that the bill, H.R. 2: Repealing the Job-Killing Health Care Law Act, would increase the number of uninsured Americans by 32 million over the next decade.
The Congressional Budget Office has released a collection of documents related to health reform, entitled, "Selected CBO Publications Related to Health Care Legislation, 2009–2010."
In May 2013, the Congressional Budget Office (CBO) issued its latest update of estimates of health insurance coverage and costs under the Affordable Care Act. This Implementation Brief summarizes the changes in CBO’s estimates over time, focusing on three key sets of estimates...
In May 2013, the Congressional Budget Office (CBO) issued its latest update of estimates of health insurance coverage and costs under the Affordable Care Act. This Implementation Brief summarizes the changes in CBO’s estimates over time, focusing on three key sets of estimates...
Both the Senate and the House passed H.R.8 (89-8 and 257-167, respectively), the American Taxpayer Relief Act, on January 1, 2013. President Barack Obama signed the Act into law on January 3, 2013. The measure extends Bush-era income and other tax cuts for individuals and families making up to $400,000 and $450,000 respectively. For individuals and families above this income threshold, the bill increases taxes from 35% to 39.6%. H.R. 8 also postpones...
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]
The Affordable Care Act (ACA) established American Health Benefit Exchanges (the Exchange or Exchanges), a marketplace where consumers can choose a private health insurance plan to fit their health needs. The Exchanges will provide Americans with access to the same health insurance choices as members of Congress. Today, the Treasury Department issued final regulations implementing the premium tax credit that will give middle-class Americans unprecedented tax benefits to make the purchase of health insurance affordable. Premium tax credits will, first and foremost, make...
The U.S. Department of Health and Human Services (HHS) and the Internal Revenue Service (IRS) have released Notices of Proposed Rulemaking (NPRM) on Exchange eligibility and insurance premium tax credits, respectively. Additionally, the Centers for Medicare and Medicaid Services (CMS) has released an NPRM related to the Medicaid eligibility expansion authorized by the Affordable Care Act (ACA). All three NPRMs are designed to simplify Exchange eligibility and enrollment by coordinating with state Medicaid agencies and the IRS to determine eligibility for premium tax credits and Medicaid under the new expanded eligibility rules laid out in the ACA. Also addressed in the proposed rules is the eligibility and calculation of tax credits for small businesses. For more information on the Medicaid eligibility expansion, click here. For more information on tax credits, click here. For more information on Exchange eligibility, click here. Finally, for more information on tax credits for small businesses, click here.