Over the course of 2014, an average of 6 million Americans will have health insurance through the new Obamacare marketplaces, according to the latest estimate from the nonpartisan Congressional Budget Office (CBO).
All told, the CBO said that 12 million more nonelderly people will have health insurance in 2014 than would have had it in the absence of the Affordable Care Act. That includes the 6 million in private Obamacare plans, 7 million more enrolled in Medicaid or the Children's Health Insurance Program (CHIP), and the subtraction of 1 million losing coverage on the nongroup market.
Critics of the Affordable Care Act have pointed to surveys suggesting that a large portion of Obamacare enrollees were previously covered by some other plan, which they were dropped from. The CBO clarifies that its estimate of 12 million "may differ from the number of people who are expected to be insured this year minus the number who were insured last year, because people move in and out of insurance coverage over time as a result of changes in employment, family circumstances, and other factors. In particular, some people who had insurance coverage in 2013 and would have become uninsured in 2014 for one reason or another in the absence of the ACA will, under the ACA, be covered in 2014 through the exchanges, Medicaid, or CHIP."
Additionally, the CBO estimate for private Obamacare coverage isn't exactly comparable to the enrollment figures the Obama administration has provided.
Last week, Health and Human Services Secretary Kathleen Sebelius announced that 7.5 million Americans had started to enroll in a private plan through the new marketplaces before the open enrollment period closed on March 31.
The CBO clarified that more or less than 6 million may be enrolled in Obamacare at some point over the course of this year.
"Coverage through the exchanges will vary over the course of 2014 not only because of the increase during open enrollment in the first few months of the year but also because people who experience qualifying life events, such as the loss of employment-based insurance or the birth of a child, will be allowed to purchase coverage later in the year, and because some people will drop their exchange-based coverage as they become eligible for employment-based insurance," the report says.
Additionally, the estimate of 6 million people does not include people who enrolled through the new marketplaces but failed to pay their initial premiums. It also takes into account the fact that people may lose coverage if they fail to keep paying premiums.
The CBO report also projected that the coverage provisions of the law will cost $36 billion for 2014 -- $5 billion less than the CBO previously projected. The CBO changed its analysis after considering more updated economic forecasts, more accurate information about the characteristics of Obamacare plans offered, and revisions to estimates of the number of early retirees with employment-based coverage under the ACA.
When it comes to the characteristics of Obamacare plans, the CBO found that Obamacare plans don't resemble plans offered through employer-based coverage as much as anticipated.
"The plans being offered through the exchanges this year appear to have, in general, lower payment rates for providers, narrower networks of providers, and tighter management of their subscribers' use of health care than employment-based plans do," the report says. The differences between Obamacare plans and employer based plans are expected to narrow, it says. "Therefore, projected premiums during the next few years were revised downward more than were premiums for the later years of the coming decade."
White House spokesman Jay Carney said Monday that the report shows the ACA is working as planned.
"It shows that marketplace health care costs have gone down because premium estimates have gone down," he said. "Additionally the effort to constrain health care costs more broadly is showing continued momentum as evidenced by the projected reduction in Medicare spending."