CBO: Uninsured Under Obamacare Never Falls Below 30 Million

    On Monday, CNBC reported on a new survey that found that two-thirds of Americans currently without health insurance don't know if they will purchase coverage by the deadline, the first day of 2014.  The survey was released by InsuranceQuotes.com, a company that offers comparison shopping for insurance, similar to the "marketplaces" envisioned by the Affordable Care Act (ACA).  The results of the survey surprised Laura Adams, senior insurance analyst at the company:

"I was really shocked that 64 percent [of uninsured adults] said they haven't decided if they will purchase insurance by the Jan. 1 deadline," Adams said. "I was definitely surprised by the high number of people who really have no clue what they're going to do next year." 

"We don't want these consumers to miss this key deadline," she said, adding that new heath-care exchanges under Obamacare will begin accepting applications for insurance in less than four months. "They're going to potentially go without health care for the entire year."

    However, for those who have kept up with Congressional Budget Office (CBO) projections on the implementation and progress of ObamaCare over the next decade, the results will not be all that surprising.  On the contrary, the most recent report issued by the CBO in May appears pessimistic by comparison.  Of the 55 million "Uninsured Nonelderly People" the report lists for 2013, only 11 million, or 20%, are projected to obtain insurance during 2014; the number of uninsured falls only to 44 million next year according to the CBO.  This leaves a full 80% uninsured, significantly more than the 67% found by the survey.
    In fact, the CBO projects that under the ACA over the next decade, the number of uninsured will never fall below 30 million.  Here are the year by year projections from the report:

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

     Despite the ACA's mix of requirements, mandates, subsidies and penalties, the CBO projects that the law will never be able to decrease the number of uninsured below 11% of the population.  During the decade projected by the CBO, the percentage of uninsured nonelderly persons decreases from 20% in 2013 to 11% by 2016, but then remains there for the rest of the ten year period.  Not everything in the CBO report is similarly static, however.  The "Average Exchange Subsidy per Subsidized Enrollee" increases 50% over the same time period, rising from $5,290 in 2014 to $7,900 in 2023.


Note: This article first appeared at The Weekly Standard.

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.