Included for the first time is the CMS projection for how much HHS and states will spend to administer some of the law's requirements. Federal health officials will spend roughly $2.4 billion through 2019 on oversight, the projections show. States will spend $37.7 billion during the same period to operate newly created heath insurance exchanges, where low- and moderate-income households can buy subsidized health plans starting in 2014.
The CMS says 30.6 million people will buy benefits through an exchange by the end of the decade, including some that formerly received health insurance from an employer. The projections, published online by the journal Health Affairs, say 100,000 fewer U.S. workers will have health insurance through an employer by 2019. Fewer workers during the decade will gain workplace health benefits than will be shifted by employers into Medicaid or an exchange.
States will spend $4.4 billion between 2011 and 2013 to create exchanges and an estimated 15.8 million people are expected to enroll in an exchange plan during the first year of operations, the CMS says. Projections are based on the cost of operating Massachusetts' Commonwealth Health Insurance Connector.