re: CBO: Repealing the ACA will leave 32M Uninsured and Double Premiums by 2026

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It's fun how you guys take neutral analysis from a non-partisan agency and claim it's biased just because you don't like the results

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CBO’s 2009 premium projection did not accurately predict that low health care inflation would continue. CBO also projected that the economy would grow much faster than it actually has; the nation’s 2016 gross domestic product (GDP) is roughly 7% lower than CBO projected it would at the time. This is important since growth in health care spending and growth in the overall economy are positively correlated. Thus, given the much slower rate of growth in overall health care spending than expected due to factors largely unrelated to the ACA, we should expect premiums to be below projections. However, in an indication of how much the ACA increased premiums, the nominal 2017 premium for the ACA benchmark plan—the plan to which the law’s subsidies are pegged—is actually 1% above what CBO expected when the law passed.

Moreover, ACA plans—extremely high deductible policies with very narrow provider networks—are generally lower quality than CBO expected when the law passed. Therefore, it not an apples-to-apples comparison to contrast 2017 premiums with what was projected in 2009. Since lower quality coverage carries lower premiums, the larger than expected premiums for the ACA benchmark plans are in effect even worse.

HHS’ report also stated that “[t]hrough 2016, Marketplace rates remained below initial projections from the independent [CBO], and below the cost of comparable coverage in the employer market.” This is misleading for the previously mentioned reasons, plus it fails to account for insurers receiving larger than expected back-end subsidies, which allowed insurers to offer lower premiums, nor does it account for the huge losses incurred by insurers. After correctly adjusting for these factors, ACA plan premiums prior to 2016 were above CBO’s initial projections and also above the cost of comparable employer coverage.

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