Estimated impact of ACA and related proposals (2009 & 2010)

The Office of the Actuary has estimated the financial, coverage, and NHE effects through fiscal year 2019 of the non-tax provisions in the "Patient Protection and Affordable Care Act" (P.L. 111-148) (PPACA) as enacted on March 23, 2010 and amended by the "Health Care and Education Reconciliation Act of 2010" (P.L. 111-152) as enacted on March 30, 2010. In addition, we provide corresponding estimates prepared during the legislative process for the proposed "America's Affordable Health Choices Act of 2009" (H.R. 3200 as reported by the Ways and Means Committee and H.R. 3962 as passed by the House on November 7) and the "Patient Protection and Affordable Care Act of 2009," (H.R. 3590 as proposed by the Senate Majority Leader on November 18, 2009 and as passed by the Senate on December 24, 2009).

The estimates include the net Federal expenditures in support of expanded health insurance coverage, the associated numbers of people by insured status, the changes in Medicare and Medicaid expenditures and revenues, the proposed CLASS program of federal long-term care insurance, and the overall impact on total national health expenditures. Unless noted in the memoranda, we have not estimated the impact of the various income and excise tax proposals or the impact on income and payroll taxes due to economic effects of the legislation. Similarly, the impact on Federal administrative expenses is excluded.

The Office of the Actuary has prepared these memoranda in our longstanding capacity as an independent technical advisor to both the Administration and the Congress. The costs, savings, and coverage impacts shown here represent our best estimates for the PPACA, H.R. 3200, H.R. 3962, and H.R. 3590. We offer these analyses in the hope that they will be of interest and value to policy makers as they implement and monitor these far-reaching national health care reforms. The statements, estimates, and other information provided in these memoranda are those of the Office of the Actuary and do not represent an official position of the Department of Health and Human Services or the Administration.