The Congressional Budget Office delivered another round of sobering news to federal health reformers Tuesday, estimating that providing insurance to the 20 million lowest-income Americans would cost another $500 billion or so in the next decade.
The CBO estimated on July 2 that providing subsidized insurance coverage to Americans with incomes between 150% and 400% of the federal poverty line would cost about $611 billion, based on the latest versions of the Affordable Health Choice Act under discussion in the Senate Committee on Health, Education, Labor and Pensions.
However CBO noted that expanding coverage only to people within that income range would leave about 33 million Americans without insurance. In response to a follow-up request from U.S. Sen. Judd Gregg (R-N.H.), the CBO said in a July 7 letter that expanding coverage to include the Americans with incomes below 150% of the poverty line would add another $500 billion in Medicaid liabilities between 2009 and 2019. That additional spending would still leave at least 15 million non-elderly people without coverage.
The latest estimate did not include a $100 billion margin for error in tax collections, employer penalties and other factors. “It bears emphasizing that this analysis is preliminary and the figures cited are approximate because they do not reflect specific legislative language nor do they incorporate, in detail, a variety of interactions and other effects that changes in Medicaid would cause,” CBO Director Douglas Elmendorf said in the July 7 letter.