Skip to main content
Sister Publication Links
  • ESG: THE NEW IMPERATIVE
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Digital Health
  • Insights
    • ACA 10 Years After
    • Best Practices
    • Special Reports
    • Innovations
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Supply Chain
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • MORE +
    • Contact Us
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Government
February 14, 2018 12:00 AM

Repealing individual mandate penalty will cause spike in uninsured: CMS

Virgil Dickson
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print

    The Trump administration is projecting that nearly 8 million people will voluntarily lose insurance in the next eight years as a result of the repeal of the Affordable Care Act's financial penalty for not having health insurance. In all, 37.7 million people will be uninsured by 2026, up from the estimated 30 million in 2018, according to an analysis CMS actuaries released Wednesday.

    "These estimates assume that some younger and healthier people will choose to be uninsured, particularly those with comparatively higher incomes who would not qualify for premium subsidies in the marketplaces," Gigi Cuckler, senior economist in the office of the actuary at the CMS said at a news briefing.

    The findings appear in the agency's annual National Health Expenditure report.

    Less healthy people in the marketplace will mean higher premiums for those that remain, though many will be protected by the ACA's tax credits, according to Yevgeniy Feyman, a Republican analyst. A silver lining is that the estimate is notably lower than what Congressional Budget Office had previously projected, Feyman said.

    The CBO had estimated 13 million additional people would be uninsured by 2026. It's unclear why the CMS and CBO disagree. Cuckler said she could only speak to the estimates of her agency, and not others.

    Others disagreed that elimination of the penalty would lead to a rise in those without coverage. "The mandate was pretty weak and had enormous exemptions, so I expect its repeal will have little effect on the number insured," said Christopher Pope, senior fellow at the conservative Manhattan Institute. The loss of healthy, young people on the exchanges—those that were considered integral to a more balanced risk pool—are likely to have a significant impact on the stability of those exchanges, however.

    Agency officials also revealed that the CMS expects to be repaid billions of dollars it paid to managed Medicaid plans that covered adults newly eligible under Medicaid expansion. States and the federal government offered risk-mitigation payments to protect plans from large losses.

    In 2017, insurance companies returned some of these payments because the expansion population ended up being healthier than predicted. Medicaid expenditures are projected to have grown more slowly in 2017, at 2.9%, after increasing 3.9% in 2016.

    "The experience has demonstrated that the losses have been much smaller," said John Poisal, a deputy director in CMS's office of the actuary.

    Overall, payments for coverage in 2014 and 2015 for the newly eligible population are estimated to be $82 billion.

    The exact amount of money returned by plans is still being calculated, according to agency officials. The agency previously estimated that $8.7 billion in payments related to risk mitigation would be returned.

    Meanwhile, Medicare spending growth is projected to have to hit 5% in 2017, up from 3.6% in 2016. That's mostly the result of higher cost per beneficiary spending as overall healthcare costs grow. The next few years will also bring higher costs as MACRA begins to offer bonuses to physicians that improve care and keep costs down.

    Medicare spending is on track to hit $873 billion by 2020, up from $705 billion in 2017.

    Finally, spending growth for private health insurance grew 5.6% in 2017, compared to 5.1% in 2016. That's the result of an increase in spending on non-medical expenses such as administrative costs, taxes, net gains or losses to reserves, and profits, according to the analysis.

    Overall, national health spending is projected to grow 5.5% in 2017 up from 5.3% in 2016.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Hospital systems finance 3
    Mississippi lawmakers consider easing restrictions on public hospitals
    Biden COVID_i.jpg
    Biden to end COVID emergency declarations on May 11
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Modern Healthcare Alert: Sign up for this breaking news email to be kept in the loop as urgent healthcare business news unfolds.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Digital Health
    • Insights
      • ACA 10 Years After
      • Best Practices
      • Special Reports
      • Innovations
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Supply Chain
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • MORE +
      • Contact Us
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing