Health Reform Public Policy

CBO 2014 Budget Projections

California Healthline reports that At least one million fewer people than previously expected are projected to obtain health insurance coverage through the Affordable Care Act’s exchanges this year, primarily because of the troubled rollout of the federal health insurance exchange website last fall, according to the Congressional Budget Office’s new annual budget outlook report.

WonkBlog has a nice summary of the good, bad and ugly.

  • Good: Risk Corridors.  Insurers aren’t having a problem making a profit.  The risk corridors set up by the ACA have not run a deficit.  CBO projects s projecting that the federal government will take in $16 billion from health plans that are essentially making a profit on the exchange — and will redistribute $8 billion to other insurers running a loss. That means $8 billion in net savings for the federal government.
  • Bad: Coverage expansion below expectations. CBO projects 2 million fewer people than expected will gain health insurance coverage.  “Half of the reduction comes from private insurance sign-ups, where the 2014 projection is reduced from 7 million to 6 million. The other half comes from Medicaid, where the Congressional Budget Office cut its projection of 9 million sign-ups in 2014 down to 8 million.”
  • Ugly: ACA will cut full-time employment by 2 million. “CBO thinks that Americans will work less, and the health-care law will reduce full-time employment, in 2024, by 2 million people. The health-care law creates certain disincentives to work higher hours. Workers would see their subsidies reduced or eliminated altogether, for example, as their salary increases.”  This doesn’t even take into account the employer side that they can get off not paying for health insurance for their part-time workers.

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