In a report published on June 13, 2017, the independent chief actuary of CMS estimated that an additional 13 million people will be uninsured in ten years if the American Health Care Act of 2017 (ACHA), the latest ACA repeal act passed by the House on May 4, is enacted.  Although the CMS report may present a less grim outcome of the repeal bill than did earlier reports published by the Congressional Budget Office (CBO), both reports reveal the high levels of uncertainty as it relates to what will actually unfold in a decade given the challenges involved in predicting such a complex framework. 

One explanation for the varying estimates between the CMS and CBO reports may be the different starting points that each government agency worked from.  For example, CBO initiated its analysis by predicting additional States would expand Medicaid under the existing ACA while CMS did not make such assumption.  The CMS report breaks down the 13 million uninsured figures as follows – 8 million fewer Medicaid enrollees, 3 million fewer individuals with employer coverage, and 2 million fewer individuals purchasing insurance through individual markets.  Meanwhile, CBO predicts a total of 23 million fewer insured, divided as follows – 14 million fewer Medicaid enrollees, 3 million fewer individuals with employer coverage, and 6 million fewer people purchasing insurance through individual markets.

Both reports seem to project that healthcare for older and less healthy people will be more costly and that higher premiums could force people with high healthcare costs to find insurance through an employer or to become uninsured.

The CBO report on the AHCA budget can be found here, and the CMS report on the AHCA budget can be found here.