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Two Things the CBO Got Very Wrong About Obamacare

As D.C. buzzes about the Congressional Budget Office (CBO) score for the American Health Care Act (AHCA), a reminder that the CBO is not infallible.


Washington, D.C. is buzzing on Wednesday about the Congressional Budget Office (CBO) score for the American Health Care Act (AHCA), the House GOP’s plan to repeal and replace Obamacare.

Democrats are sure to weaponize the CBO’s projections on cost and coverage, but the CBO, despite its nonpartisanship, has been incorrect about health care projections before.

In fact, CBO made two very incorrect predictions about Obamacare, both concerning enrollment.


As CNN and many other outlets have reported this year, CBO’s 2010 and 2014 projections of Obamacare exchange enrollees was far off the mark:

When the law originally passed in 2010, it estimated 21 million would gain coverage through them in 2016. Three years later, just before the exchanges opened, the agency upped the figure to 22 million.

That didn’t happen. About 10.4 million were actually enrolled last year, according to the Department of Health & Human Services data.

The low enrollment figures have contributed to Obamacare’s problems in 2017. Thanks in part to CBO projections, insurers expected a younger and healthier balance of customers on the Obamacare exchanges. Instead, enrollment is older and sicker on average, contributing to higher costs.


CBO also underestimated the number of people enrolling in Medicaid, as FactCheck.org reported in March:

CBO estimated 10 million would be added to the Medicaid rolls by 2016, even with many states refusing to expand eligibility. But that was too low. As of the first quarter of last year, 14.4 million adults had enrolled in Medicaid as a result of the Affordable Care Act’s expansion of the program, according to an analysis by the nonpartisan Kaiser Commission on Medicaid and the Uninsured.

Medicaid expansion has added to both federal government costs and state governments’ costs.

But most importantly, the AHCA, as it was passed by the House of Representatives, is very unlikely to ever be signed into law. The Senate currently has two working groups – one with all Republicans and one with moderate Republicans and moderate Democrats – taking their time on crafting fixes or replacements to Obamacare.