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Mandate delay would save $36 billion

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A federal health law mandate delay bill could save about $36 billion over a five-year period, with about half of the savings coming from reductions in Medicaid and the Children’s Health Insurance Program enrollment.

The Patient Protection and Affordable Care Act mandate delay bill could increase the total number of uninsured people to about 55 million in 2014, compared with 44 million if the PPACA mandates take effect on time, according to analysts at the Congressional Budget Office and the Joint Committee on Taxation.

The PPACA mandate delay could cut Medicaid and CHIP enrollment by 5 million; commercial individual policy ownership by 2 million; and employer plan enrollment by 4 million.

The analysts also predict that the mandate delay bill would increase commercial individual health premium, because insurers would still have to sell coverage on a guaranteed-issue basis, without basing premiums on applicants’ health status.

“Those features would be most attractive to applicants with relatively high expected costs for health care,” the analysts say.

The CBO and JCT analysts have published their figures in a review of H.R. 2668, the Fairness for American Families Act bill.

The bill would delay the effective date of both the Patient Protection Affordable Care Act individual coverage mandate provision and the employer mandate provision by one year.

PPACA now calls for many individuals who fail to own a minimum amount of health coverage to start paying penalties for the 2014 tax year. The penalties would start at $95 per affected individual in 2014 and rise to $695 in 2016.

The employer mandate would require large employers that fail to offer a minimum amount of coverage to some or all employees to pay a penalty of $2,000 per worker in some situations or $3,000 per worker in others.

The employer mandate would not have any effect on federal or spending or revenue because the Obama administration already has agreed to postpone implementation of the employer mandate, CBO and JCT analysts say. 

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