Apr. 14—Falling incomes will increase Medicaid enrollments by nearly 1 million beneficiaries annually over the coming decade, while employer-provided coverage will decline by about the same amount, according to updated projections by the Congressional Budget Office (CBO).

The changes in projections for the coverage and cost of the Affordable Care Act (ACA) were issued this week as part of regular updates Congress’ chief scorekeeper provides for the law. Overall, recent CBO recalculations projected to increase the number of uninsured the law covers by about 1 million to a total of 26 million by 2024.

The increased number of Medicaid enrollees was expected to result from declines in wages over the coming decade and an increase in the number of states adopting the ACA’s eligibility expansion. The reductions in employer-provided coverage were expected to stem primarily from fewer companies covering retired workers and their families.

The number of people receiving coverage through the ACA’s government-run marketplaces was not expected to increase by less than 500,000, to a total of 25 million by 2024.

Costs Reduced

Good news for the Obama administration included in the new projections was the finding that marketplace premiums have dropped 15 percent below what CBO originally projected for 2016, which led to a 14 percent drop in the cost of taxpayer-provided subsidies for income eligible enrollees. The projected cost of the ACA’s coverage provisions dropped by a total of $104 billion over the coming decade to $1.38 trillion.

The Obama administration’s tweaks to the marketplace plan risk corridor program left the program budget neutral, instead of providing $8 billion in net savings to the federal government, as previously projected.

The CBO found the federal government will garner about $6 billion less in tax penalties during the coming 10 years from people who do not meet the law’s requirement for most Americans to obtain qualifying insurance coverage. Among the factors driving reduced penalties was lower projected future wages, which will leave fewer uninsured population subject to the penalty (lower-income Americans are exempt from the penalty).

Publication Date: Monday, April 14, 2014