The Congressional Budget Office (CBO) has forecast that 14 million more people will be uninsured in 2018 under the House of Representatives’ American Health Care Act (AHCA) than under the Affordable Care Act (ACA) with the number rising to 19 million in 2020 and 23 million in 2026. The CBO acknowledges its estimates are “uncertain” because it is “difficult to predict” how states, federal agencies, physicians, hospitals, individuals, and employers will respond to the legislation. But their estimates are beyond “uncertain” – they are demonstrably wrong.
To estimate the impact of the AHCA, the CBO had to compare it to predictions of coverage under the current law, the ACA. If the prediction for the current law is incorrect the prediction of lost coverage will be too.
Yet the CBO has consistently overestimated future ACA coverage gains. In 2012 it predicted an additional 28 million would gain health insurance by 2017. The actual figure is 20 million. It forecast 25 million would gain coverage on the ACA exchanges and 10 million would gain Medicaid coverage. Less than half as many actually enrolled on the exchanges and not all of them gained coverage – many were replacing non-exchange policies they lost after ACA passage. Conversely, about 14 million – 40 percent higher than predicted – newly enrolled in Medicaid. The CBO prediction that 5 million would lose employer coverage was also wrong – employer provided coverage was stable.
The CBO’s ACA coverage forecasts in its AHCA report are also likely inaccurate. They are based on CBO’s March 2016 baseline which predicts that under current law marketplace enrollment will magically jump to 18 million in 2018 and stay steady until 2026. But we already know the March 2016 baseline estimate that 15 million would be enrolled on the exchanges in 2017 is wrong – only about 11 million are. Getting anywhere close to 18 million by 2018 is unlikely. Current exchange enrollees are unlikely to drop out by 2018 since almost all of them are receiving subsidies and will continue to do so until 2020. Hence, nearly all of 8 million in coverage losses in the nongroup market the CBO predicts for 2018 under the AHCA are accounted for by “lost” ACA coverage gains predicted by the March 2016 baseline that are unlikely to materialize.
Read the full article at Inside Sources.