CBO Is Taking the States Threatening to Opt-Out of the Medicaid Expansion Very Seriously
The Congressional Budget Office is out with its analysis of how the Supreme Court decision will impact the Affordable Care Act’s budget. The big ticket takeaway is this: The non-partisan scorekeeper estimates that 3 million people fewer people will gain coverage due to states opting out of the Medicaid expansion, resulting in $84 billion less in federal spending.
Let’s break down those numbers a bit. The Congressional Budget Office does not list out which states could pass up the Medicaid expansion. But it does predict that “some states will probably forgo the expansion entirely.”
The CBO then estimates that for every person who does not enroll in Medicaid because of that, and goes uninsured, the federal government saves $6,000 in spending by 2022. For the average person who does not enroll in Medicaid, but instead gets subsidized coverage from the health insurance exchange, the federal government spends $9,000 - $3,000 more than they would have had those individuals been in Medicaid.
“With about 6 million fewer people being covered by Medicaid but only
about 3 million more people receiving subsidies through the exchanges
and about 3 million more people being uninsured…the projected decrease in total federal spending on Medicaid is larger than the anticipated increase in total exchange subsidies,” the CBO concludes.