POST-SCOTUS: The Affordable Care Act After the Supreme Court
The Congressional Budget Office today released its updated estimates on the effect of the Affordable Care Act, now that the Supreme Court has affirmed the constitutionality of the individual mandate and established that states can opt out of the law’s Medicaid expansion.
Below are highlights of the report. The Supreme Court’s ruling on the Medicaid expansion:
- Will reduce the cost of the insurance coverage provisions in the ACA by $84 billion by reducing federal spending on Medicaid and CHIP by $289 billion;
- Will reduce the number of U.S. residents expected to be covered by Medicaid or CHIP by six million;
- Will increase enrollment in the state-based exchanges by three million; and
- Will increase the number of uninsured U.S. residents by three million.
[Ed. Note: See the earlier post on the effect of legislation (HR 6079) that would repeal the ACA for CBO's estimates on the effect of the law on insurance coverage.]
The report speculates on the effect of the court ruling that states can opt out of the Medicaid expansion. It estimates that:
- About one-third of newly eligible U.S. residents — those with annual incomes of up to 138% of federal poverty level — will live in states that choose to participate fully in the expansion;
- About half will live in states that partially expand coverage to less than 138% of FPL; and
- About one-sixth will live in states that will not expand Medicaid coverage in the next 10 years.
The court’s ruling on the individual mandate — that it is constitutional under Congress’ power to tax, and not under the Constitution’s commerce clause — will not have any effect on coverage levels, according to the report.
The report notes that “what states will be able to do and what they will decide to do” in regard to the Medicaid expansion “are both highly uncertain.” It also states that “this analysis should not be viewed as representing a single definitive interpretation of how the ACA should or will be implement in light of the court’s decision.”
by Anthony Wilson, Editor
