CBO Estimates 10 Million More Uninsured by 2034 Due to New Legislation

The Congressional Budget Office (CBO) has projected that the recent budget reconciliation package signed into law on July 4 will result in an increase of 10 million uninsured individuals by 2034. This estimate includes significant losses from Medicaid, Medicare, and health insurance exchanges.

According to the CBO, approximately 7.5 million people are expected to lose Medicaid coverage, while around 100,000 will be affected in Medicare due to changes in eligibility for certain immigrant populations. Additionally, 2.1 million individuals are projected to lose coverage through the health exchanges, with another 300,000 expected to be impacted by various policy interactions.

The estimates reflect a mix of cautious and speculative interpretations of the new law’s provisions. The CBO anticipates that work requirements will account for a substantial portion of the uninsured, estimating that 5.3 million individuals will lose coverage due to these provisions by 2034. Other eligibility verification measures in Medicaid and the exchanges are expected to increase the uninsured by 700,000 each.

Chris Jacobs, founder and CEO of Juniper Research Group, remarked, “The estimates suggest that many recipients may not comply with the new requirements or could face bureaucratic hurdles that lead to loss of coverage.”

Supporters of the work requirements argue that they are a reasonable approach to ensure that Medicaid recipients engage in community activities and are not solely reliant on government assistance. Critics, however, contend that the new verification processes may disproportionately affect vulnerable populations who may struggle to provide necessary documentation.

The immigration-related changes in the legislation also contribute to the projected increase in uninsured individuals. The bill restricts Medicaid, Medicare, and exchange insurance subsidies to specific categories of non-citizens, including lawful permanent residents and certain entrants from Cuba and Haiti. CBO estimates that these changes will lead to approximately 1.4 million more uninsured, with 900,000 expected to lose coverage through the exchanges alone.

Jacobs noted, “Many individuals across the political spectrum may view these provisions as a reasonable attempt to limit taxpayer-funded coverage to citizens and select groups.”

Another aspect of the CBO’s analysis involves Section 71114 of the new law, which sunsets a provision from the 2021 Covid spending package that temporarily increased federal Medicaid matching rates for non-expansion states. This change is projected to contribute an additional 100,000 to the uninsured count, although critics argue that it does not represent an actual loss of coverage.

The CBO’s categorization of this provision as an increase in the uninsured has drawn skepticism. Critics assert that it reflects a speculative scenario rather than a concrete loss of coverage. As Jacobs pointed out, “Most ordinary Americans wouldn’t call this an ‘increase in the uninsured’ by any stretch.”

As the CBO’s estimates circulate, the implications of the new law will likely shape public opinion and policy discussions in the coming years. With the media poised to report the headline figure of 10 million uninsured, the nuances behind the estimates may not receive the attention they warrant.

In conclusion, the CBO’s projections highlight the complex interplay of policy changes and their potential impacts on health coverage in the United States. As states prepare to implement the new requirements, the effectiveness and fairness of these measures will be closely scrutinized.