Saturday, May 18, 2013

CBO on ObamaCare: Uninsured Remain Above 30 Million Through 2023

    When the most recent Congressional Budget Office (CBO) report on the Affordable Care Act came out last week, most media outlets, particularly conservative ones like the Washington Examiner, focused on the doubling of the costs of the program since it was first scored in 2010.  Philip Klein writes:
When President Obama was selling his health care legislation to Congress, he declared that “the plan I’m proposing will cost around $900 billion over 10 years.” But with the law’s major provisions set to kick in next year, a new analysis by the Congressional Budget Office projects that the law will cost double that, or $1.8 trillion. 
    While the cost increase is certainly noteworthy and was predicted by the opponents of the legislation, the CBO report includes a second aspect of the effects of ObamaCare, or perhaps more appropriately the lack of effect.  Besides the promise that ObamaCare would help control costs, the elimination of barriers to obtaining health insurance to the current uninsured was one of its largest selling points.  It is interesting to note then that under CBO projections, the number of uninsured in the country never drops below 30 million.  Under the heading "Uninsured Under the Affordable Care Act", here are the projections for next decade for "Number of Uninsured Nonelderly People":
2013 - 55,000,000
2014 - 44,000,000
2015 - 37,000,000
2016 - 31,000,000
2017 - 30,000,000
2018 - 30,000,000
2019 - 30,000,000
2020 - 30,000,000
2021 - 31,000,000
2022 - 31,000,000
2023 - 31,000,000
    Also according to CBO projections, this level of uninsured persons persists despite the increase of those on Medicaid and CHIP (Children's Health Insurance Program) from 36,000,000 in 2013 to 47,000,000 in 2023.  Not even the heavily subsidized exchanges will apparently be able to shrink the uninsured population. By 2023, the number of subsidized exchange enrollees is projected at 20,000,000 with an average subsidy of $7,900 for a total of $158 billion.
    It is unclear from the CBO report exactly who these continued uninsured are and how they will obtain healthcare.  But assuming the CBO's projections are accurate, it seems fair to speculate that when the number of uninsured plateaus at 30,000,000 for several years or even begins to increase again, calls will begin afresh for healthcare reform that will provide insurance to those chronically uninsured.  And if ObamaCare's detractors are correct that the law will not lower costs and improve healthcare in the ways promised, the same reasons may be resurrected to push for ObamaCare II: the uninsured clogging emergency rooms, neglecting preventive care, and driving up costs for the rest who are "playing by the rules."
    The reviews coming in so far on ObamaCare are decidedly mixed, and full implementation is still seven months off.  It will be years before the story plays out.  If the Democrats still control the White House after 2016, those uninsured will be on display as 30,000,000 reasons to "finish what we started."  And as everyone knows, the sequel is never as good as the original.

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