(Bloomberg) — About 12 million people will be covered through the Patient Protection and Affordable Care Act (PPACA) exchange system, or insurance marketplaces, this year, the Congressional Budget Office (CBO) said Thursday in a new estimate.
The estimate is a sign of the government’s continuing difficulties in getting people signed up for insurance through the PPACA exchange system.
The estimate, released as part of a wider report, is down from a previous budget office projection of 13 million made in January, and far below the 21 million people that the CBO predicted a year ago would have coverage under PPACA in 2016.
Enrollment in the PPACA exchanges is an indicator of how one of President Barack Obama’s key policy achievements is faring during his final year in office. A principal goal of the law was to cover enough people from a wide enough pool so that monthly insurance premiums from healthy customers will let private insurers pay for the care of those who are sick. So far, many big insurers have racked up losses from PPACA policies.
CBO has repeatedly reduced its estimate of how many people would buy plans on the PPACAs exchanges, in part because more people are sticking with coverage they get through work or buying policies directly from insurers.
Today’s report paints a broader picture of how people get health coverage. It shows that PPACA provisions have helped bring the proportion of people under 65 with health plans to about 90 percent. Those 65 and older are eligible for Medicare, which currently covers about 56 million people. By 2026, CBO projects that 18 million will buy policies through PPACA marketplaces, 71 million will be on Medicaid, and 152 million will still get health plans through their employers.
The report also shows government outlays for health plans. Employer-provided health plans aren’t taxed, at a cost to the U.S. of about $3.6 trillion over the next decade, CBO estimates. PPACA subsidies will cost $802 billion over that period. The Medicaid expansion will account for $969 billion of total outlays of $3.8 trillion on Medicaid and a related children’s health program over that period.
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