The troubled start of the public exchange program will likely mean 6 million people will enroll in commercial plans – 1 million fewer than originally projected — and that it may save the federal government a bit of money over the next 10 years, Congressional Budget Office analysts say.
The analysts now estimate that the net cost of the Patient Protection and Affordable Care Act coverage provisions to the federal government will be $1.335 trillion from 2014 through 2023.
That figure is 0.7 percent lower than the estimate CBO analysts published in May 2013, the analysts wrote in a new commentary on CBO PPACA budget impact projections.
The CBO analysts also cut projected 2014 public exchange “qualified health plan” enrollment to 6 million, from 7 million, and projected Medicaid and Children’s Health Insurance Program plan enrollment growth, to 8 million, from 9 million.
The analysts also are assuming that the number of uninsured people will fall just 13 million, rather than 14 million.
But, because exchange enrollment will be lower than expected in 2014 and QHP premiums seem to be cheaper than originally anticipated, the government could end up spending just $1.058 trillion on QHP subsidies from 2014 through 2023, the analysts say.
That’s 1.5 percent less than the QHP subsidy spending figure in the May 2013 report.
But the analysts warn that making predictions about the effects of PPACA is difficult because they are not sure what health insurance premiums and enrollment will look like after 2014.
The analysts also are assuming that insurers in the commercial individual and small-group health insurance markets will spend $8 billion more on PPACA “risk corridor” program assessments than QHP issuers get out of the program.
The risk corridors program is supposed to use cash from individual and small-group health insurers with good underwriting results to help exchange plan issuers with poor underwriting results from 2014 through 2016.