BREAKING: CBO on the Supreme Court Ruling
By 2022, 6 million fewer people will be on Medicaid than originally estimated (total of 11 million added; not 17 million). Of these, 3 million will join the newly created health insurance exchanges.
Insurance in the exchange will cost $9,000 for the average person, versus $6,000 if the individual had enrolled in Medicaid.
This is presumably good news for safety net institutions who were fearful of a huge surge in patients paying Medicaid rates.
Full report here.
Surprise! The bill we were sold isn’t the truth
I think more people will get insurance in the exchange. They only have to pay a premium of 2% of their income.
How can we estimate how many fewer people will receive coverage without an in-depth analysis of state legislatures’ internal politics? I know Florida and Texas are rejecting the Medicaid expansion, but how can we guess who else?
The CBO report is misguided. It assumes Medicaid rolls will be only 6 million people fewer than what the PPACA originally stipulated (11 million people added to Medicaid instead of 17 million). Of these 6 million fewer Medicaid enrollees, the CBO assumes only about half will seek coverage in the exchange. The rest will remain uninsured.
Overall, the CBO assumes a net savings of about $84 billion over an 11-year period due to the Supreme Court ruling states do not have to expand Medicaid. In reality, many states will dump their 100% to 138% of poverty population into the federally-subsidized exchange. It’s to states’ advantage to enroll as many uninsured people as possible in the exchange.
To encourage enrollment, states can use carrots and sticks. The carrot could be for the state to pay the (2% of income) premium contribution required of this population. The stick: states could withhold welfare payments or make signing up a stipulation for getting food stamps. The bottom line: The feds will pay far more for states not expanding Medicaid than Medicaid expansion would have cost. The upside (for enrollees; but not taxpayers) is that people will have far better coverage in the exchange.
Those CBO assumptions are not arbitrary, either, so their estimates can be trusted as much as anyone else’s. CERTAINLY as much as the NCPA’s.
Aren’t you missing the whopper: repealing the ACA will add $109 billion to the federal budget deficit over the next 11 years.
No surprise.