Forecasters at the Congressional Budget Office (CBO) and the congressional Joint Committee on Taxation (JCT) are refusing to predict that the Patient Protection and Affordable Care Act of 2010 (PPACA) will lead to a sharp drop in enrollment in employer-sponsored health plans.
The best estimates available suggest that PPACA could cut total U.S. group health plan enrollment by 3 million to 5 million during the period from 2019 to 2022, CBO and JCT analysts write in a PPACA group health report prepared in response to questions about earlier forecasts.
Originally, the analysts were predicting PPACA would cut group health plan enrollment by 3 million.
If PPACA did not exist at all, group plan enrollment could be about 161 million, the analysts say.
Surveys by Gallups and other organizations have found that group enrollment has been falling for years.
If PPACA takes effect as written and works as drafters expect, the law will set federal standards for non-grandfathered group health coverage starting in 2014 and give individuals the ability to buy coverage on their own on a guaranteed-issue, mostly community-rated basis starting.
PPACA will require most employers over a certain size to offer health coverage. The law will permit the employers to get out of offering coverage by paying a penalty for each employee without a minimum level of group health coverage.
Many PPACA critics have argued that employers will escape from the cost and headaches of complying with PPACA by sending large numbers of employees to buy coverage in the individual market.
The CBO and JCT analysts reject the idea that they can make firm predictions about how PPACA will work.