The Congressional Budget Office issued a report about the effects of the Supreme Court decision on the Affordable Care Act. Its conclusion is that 3 million people who would have had health insurance before this opinion was passed down will not have it. Clearly, the consequences were unintended, but they leave open how the government and economy will handle the problem of 1% of Americans losing something they expected.
The “Estimates for the Insurance Coverage Provisions of the Affordable Care Act Updated for the Recent Supreme Court Decision” stated:
CBO and JCT (Joint Committee on Taxation) now estimate that the insurance coverage provisions of the ACA will have a net cost of $1,168 billion over the 2012–2022 period — compared with $1,252 billion projected in March 2012 for that 11-year period — for a net reduction of $84 billion.
In 2022, for example, Medicaid and the Children’s Health Insurance Program (CHIP) are expected to cover about 6 million fewer people than previously estimated, about 3 million more people will be enrolled in exchanges, and about 3 million more people will be uninsured.
To some extent, the culprits are the states:
As a result of the Court’s decision, CBO and JCT now anticipate that some states will not expand their programs at all or will not expand coverage to the full extent authorized by the ACA (Affordable Care Act).
The state problem was anticipated. The extent of its effects was not.
Will all 3 million remain uninsured? One of two things could happen to answer that. Congress and the Administration could act to help them, but that is unlikely because of gridlock and the breadth of the decision by the Court. Alternatively, the states that can provide the coverage might be more generous. With so many states faced with budget shortfalls and the prospects of severe austerity, that will not happen.
Because of the Supreme Court decision, 3 million people who should have been able to find affordable health care under the act will not do so.