The CBO projected that about 10 million to 11 million individuals would be enrolled in the public option by 2019. “For several reasons, we anticipate that our estimate of the number of enrollees in the public plan would be substantially smaller than the Lewin Group's,” the report stated.
One consideration is that large employers are expected to have lower administrative costs for health insurance than public and private plans offered through the legislation's health insurance exchange.
“As a result, employees of large firms would be less likely than those of small firms to find the option of purchasing coverage through the exchange attractive,” as opposed to getting insurance through their employer, the report stated.
The report also estimated that employer-based coverage would increase only slightly, by about 3 million people by 2016. In most cases, employers facing the bill's penalties for firms that don't offer qualified coverage would have a strong financial incentive to continue offering coverage to their workers, the report stated.
The analysis confirms that the bill's provisions “would result in dramatically increased coverage without crowding out private insurance,” according to a statement from the Democratic staffs of the House Ways and Means, Energy and Commerce and Education and Labor panels. Energy and Commerce has yet to complete negotiations on the bill.
The CBO reiterated its earlier estimate that the legislation would add nearly $240 billion to the federal deficit over the next decade. Beyond that point, “the proposal would probably generate substantial increases in federal budget deficits,” the report stated.