How Many People Will Sign Up for ObamaCare’s Exchanges? www.UncoverObamaCare.com

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
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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