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CBO Lowers Cost Estimates for ACA to Reflect Supreme Court Decision

July 27, 2012—A joint analysis released July 24 by the Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation says the Affordable Care Act [ACA, P.L. 111-148 and P.L. 111-152] will cost $84 billion less over 11 years than CBO’s previous estimate as a result of the June 28 Supreme Court decision. Because the decision essentially made the expansion of the Medicaid program a state option, CBO projects that 6 million fewer people will sign up for Medicaid by 2022, but 3 million more will sign up for the federal subsidized insurance exchanges, resulting in 3 million fewer people with insurance and a net reduction of $84 billion over the 2012-2022 period.

As a result of the Court’s decision, CBO and JCT now anticipate that some states will not expand their programs at all or will not expand coverage to the full extent authorized by the ACA. CBO and JCT also expect that some states will eventually undertake expansions but will not do so by 2014, as specified in the ACA.

CBO also released a letter to Speaker of the House John Boehner (R-Ohio) providing an estimate for the Repeal of Obamacare Act (H.R. 6079), as passed by the House of Representatives on July 11.  H.R. 6079 would repeal the ACA, with the exception of one subsection that has no budgetary effect. Assuming that H.R. 6079 is enacted near the beginning of FY 2013, CBO and JCT estimate that, on balance, the direct spending and revenue effects of enacting that legislation would cause a net increase in federal budget deficits of $109 billion over the 2013–2022 period.

CBO notes that neither of these reports represents a comprehensive new estimate of the budgetary effects of the ACA. The updated estimates for the coverage provisions, taking into account the Supreme Court decision, do not include the budgetary impact of other provisions of the ACA.


Dave Moore
Senior Director, Government Relations
Telephone: 202-828-0559


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