The Congressional Budget Office released an update of their thoughts on the impact the Affordable Care Act might have on the way health insurance is delivered in America. The numbers are a little different than what they thought back in 2010 when the Act was signed into law.
In their report (you can get it off the CHCI web site by clicking here); "Estimates of the Effects of the Affordable Care Act on the Number of People Obtaining Employment-Based Hea
lth Insurance," the CBO attempts to determine the impact all of the new rules of the ACA will have on the different “systems” we have (and will continue to have) to pay for health care in this country. This includes trying to estimate how many individuals will continue to obtain health insurance from their employer; how many will go to the health insurance exchanges, and how many will gravitate to an expanded Medicaid program. In 2010 the CBO thought 8-9 million individuals would lose their health insurance from their employer (primarily small employers) and either purchase health insurance through the health insurance exchange or Medicaid or remain uninsured and pay the penalty. The new number is 11 million.
lth Insurance," the CBO attempts to determine the impact all of the new rules of the ACA will have on the different “systems” we have (and will continue to have) to pay for health care in this country. This includes trying to estimate how many individuals will continue to obtain health insurance from their employer; how many will go to the health insurance exchanges, and how many will gravitate to an expanded Medicaid program. In 2010 the CBO thought 8-9 million individuals would lose their health insurance from their employer (primarily small employers) and either purchase health insurance through the health insurance exchange or Medicaid or remain uninsured and pay the penalty. The new number is 11 million.CBO spent quite a bit of time in this report explaining all the reasons making any projections are so difficult. Behavioral economics plays a large role in what will happen, but, as illustrated by behavioral economist Dan Ariely, we are all “predictably irrational.” We have no idea how all of this is going to change the mix.
Regardless of what the number is, the health insurance market is about to go through a huge shake-up. While today's discussion continues to focus on purchasing “health insurance,” the real discussion should be centered on how we will individually finance the health care services we will inevitably use. An even bigger issue will ultimately be the training and educating of the 11 million (or whatever number it ends up being) individuals who will leave the world of employer-based health insurance to begin making these decisions on their own.
The CBO still has no idea of what will actually happen when/if the ACA moves forward. Suffice it to say the world of health care will continue to change in dramatic ways. The individual and their families are going to need to be engaged whether they want to or not.
