- 31 million nonelderly residents of the United States are likely to remain without health insurance in 2024, roughly one out of every nine such residents. (Page 107).
- This means that we will go from 45 million uninsured to 31 million for a net reduction of 14 million. (Page 108)
- There are 314 million people in America. This equates to a 4.5% reduction.
- About 20% will be eligible for Medicaid but will choose not to enroll. (Page 107)
- 45% will not purchase insurance even though they have access through an employer, an exchange, or directly from an insurer. (Page. 107)
- Starting in 2017, between 24 million and 25 million people are expected to obtain coverage each year through exchanges, and roughly 80% of those enrollees are expected to receive taxpayer subsidies for purchasing that insurance. (Page 107).
- The average taxpayer subsidy to an Exchange enrollee will go from $4,700 in 2014 to $8,370 in 2024. (Page 109)
- Reinsurance payments (often referred to as insurer bailouts) will be made by the federal government to all plans that operate in the individual insurance market whose enrollees incur particularly high costs for medical claims. To cover those costs, the government will collect a per-enrollee assessment ($63 in 2014) from most private insurance plans, including self-insured plans and plans that are offered in the large-group market. (Page 110)
- 6 million and 7 million fewer people will have employment-based insurance coverage each year from 2016 through 2024 than would be the case in the absence of the ACA. (Page 111)
- The Individual Mandate
PenaltyTax will only impact about 6 million people or 1.9% of the population by 2016. Almost nobody will pay this tax that we spent thousands of hours debating and millions of dollar litigating all the way to the Supreme Court. (Page 123)
And on pages 117 to 119, the CBO discusses the loss of employment and the disincentive to work:
The ACA includes a range of provisions that will take full effect over the next several years and that will influence the supply of and demand for labor through various channels. For example, some provisions will raise effective tax rates on earnings from labor and thus will reduce the amount of labor that some workers choose to supply. In particular, the health insurance subsidies that the act provides to some people will be phased out as their income rises—creating an implicit tax on additional earnings— whereas for other people, the act imposes higher taxes on labor income directly. The ACA also will exert conflicting pressures on the quantity of labor that employers demand, primarily during the next few years. ...
CBO estimates that the ACA will reduce the total number of hours worked, on net, by about 1.5 percent to 2.0 percent during the period from 2017 to 2024, almost entirely because workers will choose to supply less labor—given the new taxes and other incentives they will face and the financial benefits some will receive. ...
The reduction in CBO’s projections of hours worked represents a decline in the number of full-time-equivalent workers of about 2.0 million in 2017, rising to about
2.5 million in 2024. ...
CBO’s estimate that the ACA will reduce employment reflects some of the inherent trade-offs involved in designing such legislation. Subsidies that help lower- income people purchase an expensive product like health insurance must be relatively large to encourage a significant proportion of eligible people to enroll. If those subsidies are phased out with rising income in order to limit their total costs, the phaseout effectively raises peo- ple’s marginal tax rates (the tax rates applying to their last dollar of income), thus discouraging work. ...
In CBO’s view, the ACA’s effects on labor supply will stem mainly from the following provisions, roughly in order of importance:
- The subsidies for health insurance purchased through exchanges;
- The expansion of eligibility for Medicaid;
- The penalties on employers that decline to offer insurance; and
- The new taxes imposed on labor income.
The emphasis is mine.
