Doug Holtz-Eakin, Stephen Parente, and Michael Ramlet: Congressional Budget Office Revision to the Affordable Care Act Baseline

The CBO will release its projection of the ACA budget baseline today in the aftermath of the Supreme Court decisions.  The new baseline is unlikely to be dramatically different from prior budgetary outlooks because CBO doesn’t yet have all the information needed to resolve the uncertainty.

However, based on information already available to CBO and others,  Forum modeling found that the cost of the ACA could rise between $72 to $80 billion between 2014 and 2021 if the six already publicly announced states opt out of the Medicaid expansions.  Alternatively, the maximum potential federal budgetary exposure – in the unlikely scenario all 50 states opted-out – would be an increase of $562 to $627 billion.  Importantly, although the budget impact of the ACA may have changed, we do not expect CBO to change its projections significantly, as it does not yet have the information to resolve the potential swings in cost.

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