www.UncoverObamaCare.com How Many People Will Sign Up for ObamaCare’s Exchanges? Projections of how many Americans will enroll in the Patient Protection and Affordable Care Act (ObamaCare) insurance exchanges are a moving target. The Supreme Court’s ObamaCare ruling in 2012 and the implementation decisions of individual states have kept federal projections in flux. Initial estimates of 14 million enrollees in 2014 have been quietly downplayed by the Centers for Medicare and Medicaid Services—an agency within the Department of Health and Human Services. The non-partisan Congressional Budget Office now predicts just 7 million people will enroll in the exchanges in 2014. The administration hopes that enrollment will rise to 24 million individuals by 2017. The Foundation for Government Accountability (FGA) keeps tabs on these federal projections and calculates enrollment projections on a state-by-state basis. Over the next six months, FGA will track actual enrollment as well to see how successful the federal government has been in convincing Americans to enroll in the ObamaCare exchanges. STATE-BY-STATE ESTIMATES FOR EXCHANGE ENROLLMENT State Projected 2014 Enrollment State Projected 2014 Enrollment Alabama Alaska Arizona Arkansas* California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky 102,300 19,311 140,497 58,345 691,016 114,864 59,117 13,898 9,520 501,749 240,216 18,603 54,857 236,810 152,044 62,139 79,108 88,205 Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio 104,233 35,711 91,528 82,853 181,985 129,999 75,297 159,733 37,626 52,691 62,378 32,430 167,395 47,020 411,304 268,086 18,203 196,605 State Projected 2014 Enrollment Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Total 94,062 108,703 266,858 21,826 123,923 25,520 167,940 780,959 83,368 15,116 184,519 149,043 30,686 132,724 17,076 7,000,000 * Estimate does not include Medicaid “private option” enrollment Source: Author’s calculation . FOUNDATION FOR GOVERNMENT ACCOUNTABILITY | OVER www.UncoverObamaCare.com STATE-BY-STATE ESTIMATES FOR EXCHANGE ENROLLMENT State Projected 2017 Enrollment State Projected 2017 Enrollment Alabama Alaska Arizona Arkansas* California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky 350,743 66,209 481,704 200,041 2,369,197 393,819 202,685 47,651 32,640 1,720,281 823,597 63,782 188,082 811,921 521,293 213,047 271,229 302,417 Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio 357,370 122,438 313,810 284,068 623,949 445,710 258,160 547,657 129,002 180,654 213,868 111,188 573,927 161,213 1,410,184 919,150 62,411 674,076 State Projected 2017 Enrollment Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Total 322,498 372,697 914,942 74,833 424,878 87,496 575,796 2,677,575 285,833 51,825 632,638 511,005 105,210 455,055 58,546 24,000,000 METHODOLOGY Enrollment projections produced for the Society of Actuaries with the Lewin Group’s Health Benefits Simulation Model (HBSM) were used to calculate the distribution of exchange enrollees by state. The HBSM projections were modeled for each state with and without the optional Medicaid expansion. States’ current decisions on whether to expand Medicaid were utilized to determine ultimate enrollment in each state. These decisions were reported by the Centers for Medicare and Medicaid Services. Because the HBSM projections assume ultimate enrollment in the exchanges is immediate, the projections were revised downward to reflect the fact that enrollment will likely phase in over the next few years. National projections of exchange enrollment produced by the Congressional Budget Office were used to revise downward the total enrollment figures. Given that Medicaid expansion discussions are ongoing, these estimates could change from time to time. The Foundation for Government Accountability is actively monitoring this process and will update these projections to reflect future changes. Authored by: Jonathan Ingram, Director of Research Josh Archambault, Senior Fellow References: Randy Haught and John Ahrens, “Cost of the future newly insured under the Affordable Care Act (ACA),” Society of Actuaries (2013), http://cdn-files.soa.org/web/research-cost-aca-report.pdf. Congressional Budget Office, “CBO’s May 2013 estimate of the effects of the Affordable Care Act on health insurance coverage,” Congressional Budget Office (2013) http://www.cbo.gov/sites/default/files/cbofiles/ attachments/44190_EffectsAffordableCareActHealthInsuranceCoverage_2.pdf www.The FGA . o rg Centers for Medicare and Medicaid Services, “State Medicaid and CHIP income eligibility standards effective January 1, 2014,” U.S. Department of Health and Human Services (2013), http://www.medicaid.gov/ AffordableCareAct/Medicaid-Moving-Forward-2014/Downloads/Medicaid-and-CHIP-Eligibility-Levels-Table.pdf FOUNDATION FOR GOVERNMENT ACCOUNTABILITY