Expanded health insurance coverage under the Affordable Care Act,
President Barack Obama's signature legislative legacy, will cost the
government more, according to an official study released Thursday.
Still, on balance, the measure more than pays for itself.
The nonpartisan Congressional Budget Office said the health care
law will cost $1.34 trillion over the coming decade, $136 billion
more than the CBO predicted a year ago. That 11 percent hike is
mostly caused by higher-than-expected enrollment in the expanded
Medicaid program established under the law.
All told, 22 million more people will have health care coverage
this year than if the law had never been enacted, CBO said. The
measure's coverage provisions are expected to cost $110 billion this
year.
The number of uninsured people this year is anticipated at 27
million.
About 90 percent of the U.S. population will have coverage, a
percentage that is expected to remain stable into the future.
The study also projected a slight decline in employment-based
coverage, although it will remain by far the most common kind among
working-age people and their families.
Employers now cover some 155 million people, about 57 percent of
those under 65. That's expected to decline to 152 million people in
2019. Ten years from now, employers will be covering about 54
percent of those under 65.
CBO said part of the shrinkage is attributable to the health care
law: some workers may qualify for Medicaid, which is virtually free
to them, and certain employers may decide not to offer coverage
because a government-subsidized alternative is available. (Larger
employers would face fines if they take that route.)
But the agency also noted that employer coverage had been
declining due to rising medical costs well before the health
care law was passed, and that trend continues.
The analysis underscores the view that the health care law is
driving the nation's gains in insurance coverage, which raises
political risks for Republicans who would repeal it.
Taking seniors covered by Medicare out of the equation, the
government devotes $660 billion to subsidizing health care for
people under 65, including the Medicaid program for the poor and
disabled and tax benefits for employer-provided health
insurance.
The budget office did not provide a new estimate of
Obamacare's overall impact on the federal deficit, other than to
say that it is, on net, expected to reduce the deficit. The law
included a roster of tax increases and cuts in Medicare payments
to hospitals and other providers to pay for coverage expansion.
The Obama administration said the report shows that the law
is working to cover the uninsured and that the cost projections,
when viewed in context, remain positive.
"It's important to appreciate that the (health care law) is
not just about some race to meet a given number of enrollees,"
spokesman Aaron Albright said in a statement. "It is about
health care in America for all of us as we go through life ...
affordable insurance is not out of reach because of costs or a
pre-existing condition."
CBO is a congressional agency that does budget forecasts and
cost estimates of legislation.
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