I know… shocking.
Yesterday, in its budget and economic outlook for the next decade, the Congressional Budget Office (CBO) substantially changed its short-term Affordable Care Act (ACA) estimates in ways that show the law is performing far worse than expected. CBO’s new projection of 13 million exchange enrollees in 2016 is nearly 40% below previous expectations. CBO’s also projects that the average subsidy per enrollee in 2016 will increase by about 18% relative to its March 2015 ACA estimate—an indication that enrollees are both less healthy and poorer than the agency originally projected.
Additionally, the ACA’s Medicaid expansion is costing far more than projected because of higher enrollment and higher spending per enrollee. The costs of Medicaid expansion almost certainly exceed corresponding benefits given the findings of a recent study by MIT, Harvard, and Dartmouth economists that Medicaid expansion enrollees only receive about 20 to 40 cents of benefit for each dollar of program spending. Overall, CBO’s revision demonstrates that the ACA’s coverage expansion is primarily benefiting people earning less than 200% of the federal poverty level (FPL)—an income equal to $23,540 for a single person—while its costs, largely in the form of higher premiums and taxes and fewer health insurance choices, are widespread.