The technical problems that plagued healthcare.gov throughout October and November could lead to 1 million fewer Americans signing up for health insurance in 2014, according to a report from the Congressional Budget Office.
The CBO previously estimated that 7 million individuals would enroll in health plans through the Affordable Care Act’s (ACA’s) insurance exchanges this year. But a report released Feb. 4 says it’s more likely that 6 million Americans will sign up during the open enrollment period that ends on March 31.
Currently, more than 3 million people have enrolled in health plans through the state- and federally run exchanges, according to the Centers for Medicare & Medicaid Services. But CBO officials said that they expect many people to sign up toward the end of the open enrollment period, especially if they are purchasing a plan primarily to avoid a tax penalty for being uninsured.
"Thus, it is possible that the number of enrollees will reach the 7 million originally projected for 2014, just as it is possible that the number will fall short of the current estimate of 6 million," the report notes.
The CBO predicts that enrollment through the exchanges will reach 22 million by 2016 as people become more familiar with the new insurance options and federal subsidies.
Healthcare.gov’s technical problems likely also depressed enrollment through Medicaid and the Children’s Health Insurance Program (CHIP) this year. The CBO now estimates that 8 million individuals, not the 9 million initially projected, will enroll in Medicaid and CHIP in 2014.
Employment also could take a hit under the ACA, according to the CBO.
Between 2017 and 2024, there could be about a 1.5% to 2% drop in the total number of hours worked in the United States, mostly among low-wage earners as they choose to cut their hours and income to maintain eligibility for federal health insurance subsidies.
On the employer side, the CBO predicts that businesses could cut back on hiring to stay below the 50-worker threshold that requires them to either offer health insurance or pay a penalty. But the CBO also expects that over time, the penalty will have little effect on the hiring of workers because businesses will pass it on to their employees in the form of reduced wages.
Overall, the CBO estimates that the ACA will reduce aggregate compensation by about 1% over the 2017-2024 period, up from a 2010 estimate of 0.5%.
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