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Estimates for the Insurance Coverage Provisions of the Affordable Care Act Updated for the Recent Supreme Court Decision 1 (July 2012)

handle is hein.congrec/cbo10829 and id is 1 raw text is: JULY 2012 Estimates for the Insurance Coverage Provisions of the Affordable Care Act Updated for the Recent Supreme Court Decision The Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) have updated their estimates of the budgetary effects of the health insurance coverage provisions of the Affordable Care Act (ACA) to take into account the Supreme Court decision issued on June 28, 2012.' This report describes those new estimates, how they were derived, and how they differ from the previous ones. The insurance coverage provisions of the ACA establish a requirement for most legal residents of the United States to obtain health insurance or pay a penalty tax; create insurance exchanges through which certain individuals and families may receive federal subsidies to substantially reduce their cost of purchasing health insurance: significantly expand eligibility for Medicaid-now at each state's option; impose an excise tax on certain health insurance plans with relatively high premiums; establish penalties on certain employers who do not provide minimum health benefits to their employees; and make other changes to prior law.2 The Supreme Courtfs decision has the effect of alowing states to choose whether or not to expand eligibility for coverage under their Medicaid program pursuant to the ACA. Under that law as enacted. but prior to the Court's ruling, the Medicaid expansion appeared to be mandatory for states that wanted to continue receiving federal matching funds for any part of their Medicaid program..3 lence, CBO and JCT's previous estimates reflected the expectation that every state would expand 1 See National Federation of Independent Business v. Sebelius, 132 S. Ct. 2566 (2012). The ACA comprises the Patient Protection and Affordable Care Act (Public Law 111-148) and the health care provisions of the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152). As used here, the term ACA includes the effects of subsequent related changes in statute. 2 For more information on the insurance coverage provisions of the ACA, see the statement of Douglas W. Elmendorf, Director, Congressional Budget Office, before the Subcommittee on Health, House Committee on Energy and Commerce, 20'A m!:is ?te o Ie// Ce L(:g~s'atot E~ct di, Mrc 210(March 30, 2011). SCBO and JCT's previous estimate of the effects on insurance coverage of the ACA, before the Court's decision, were reflected in the projections contained in Congressional Budget Office, ' :,ate , dg-e P,'jccio~s Fica L:'aw202 t 222(March 2012) and further described in Congressional Budget Office,Up - itimsj, te/.s¢tacCofc,:: Povsos , th d{2rdai Cre ct(March 2012).

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