Tax Reform

CBO to Estimate That Repealing Obamacare's Individual Mandate Will Have a Smaller Effect on Health Insurance Coverage

New report suggests the Republican tax bill will have a smaller coverage effect, but cause an even bigger increase in the deficit.


The individual mandate is less important to maintaining health insurance coverage levels than previously estimated, according to a new report from the Congressional Budget Office (CBO). The new report suggests that the GOP tax bill will have a smaller effect on insurance coverage, but a bigger effect on the deficit, than official figures have indicated so far



The mandate, which imposes a penalty for failing to maintain health coverage, was repealed as part of the tax reform legislation that passed in December. But it proved a sticking point for congressional Republicans earlier in the year as they attempted to pass legislation overhauling Obamacare, the health law that included the insurance requirement.

CBO estimates showed that repealing the mandate as part of the overhaul would reduce health coverage by about 15 million people, a figure that was later reduced to 13 million as a result of a change in the CBO's baseline. CBO also estimated that this would result in about $340 billion budgetary savings, as a result of reduced government spending on health insurance.

Critics argued that the coverage loss estimate was far too high, in part because it assumed a significant reduction in Medicaid coverage as a result of eliminating the mandate. In most cases, Medicaid does not charge premiums.

After the health care effort stalled, reports surfaced indicating that CBO was at work on a revised estimate of the mandate's impact, one that would show a much smaller coverage effect. CBO confirmed in November that it was at work on revising its methodology.

A presentation published by CBO today indicates that the new estimate will show that repealing the mandate will result in fewer people losing coverage than previously estimated.

The report, which looks at how cost estimates are produced for legislative proposals affecting health insurance, says that CBO and its sister organization, the Joint Committee on Taxation, have "undertaken considerable work to revise and update their methods" estimating the cost and coverage effects of the mandate. "The preliminary results of analysis using revised methods indicates that the estimated effects on health insurance coverage will be smaller" than previously estimated.

We don't yet know what the new tally will be. It's unlikely to be zero. It is possible and even likely that CBO will still estimate that repealing the mandate will result in millions fewer people with coverage. But it does strongly hint that the impact on health coverage will be smaller than official numbers have shown so far.

It also implies that the GOP tax bill, which was estimated to increase the deficit by a little more than $1.4 trillion over a decade, will be shown to increase the deficit even more than previously estimated, because when the coverage loss figure shrinks, so do the budgetary savings.

In short: The tax law is shaping up to have a larger than estimated impact on the deficit, and a smaller impact on health care.

NEXT: D.C. Deregulates Birth Control...and Dooms It With Obamacare Add-Ons

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  1. “A presentation published by CBO today indicates that the new estimate will show that repealing the mandate will result in fewer people losing coverage than previously estimated.”

    A better word than “losing” should be used here. “Choosing” less coverage, for instance . . .

    1. That is the question that immediately comes to my mind. How is allowing someone to decide whether or not they buy something the same as taking it away from them?

      I wonder also how they know how many people will choose to stop buying Obamacare. I mean, heck, why would they, it being so popular (or so the progs tell me).

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    3. Maybe we should start describe people being released from prison as being “evicted.”

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  2. Newt: “CBO is corrupt.”
    CBO: “No it isn’t!”
    Newt: “I don’t trust a single word they have published, and I don’t believe them.”
    CBO: “”People maybe misjudge what [the CBO is] supposed to do. Their job is to figure out whether or not this is something that can get through on reconciliation, right? Not to make a judgment about [the legislation as a whole].”
    Newt: “No. Let me be very clear. I helped balance the budget four straight times […] We fought the Congressional Budget Office every time.”
    CBO: “Yeah well this is different. We won’t pooch it this time. We’re revised.”

  3. What is CBO estimate of the impact of the mandate repeal on individual liberty?

    1. There is not this idea at the CBO.

    2. The argument is definitely shifting in a dangerous way if all we do is squabble over cost. That’s a real impact, of course. But the true indignity is that you force someone at gunpoint to buy something for their own supposed good.

      1. It’s even worse than that. Did you know you’re required to buy food for entirely other people? And school supplies? Freaking notebooks?

        Practically a shotgun to every parent’s face. We might as well be North Korea.

        1. I love that you were going for parody there, but proved the point instead.

          1. I’m such a brave hero superman…. also, waaahh adult responsibilities everyone in every civilized place on earth has to deal with. Waaaahhhhhh.

            1. What does that have to do with sticking a gun in my face if I don’t want to pay for your welfare.

              1. You’re not paying for my welfare, you’re paying for a system of welfare that you, for all you know, may depend on one day in order to feed yourself or your offspring. Never heard of a libertarian denying government services on principle.

            2. So, it’s an adult responsibility to take care of other people, but not yourself?

              1. It includes both, but I shouldn’t have to explain that since presumably we’re all adults here.

                1. Then why are you bitching about Obama being responsible for Obamacare and the follow on consequences of it?

                  Grow the fuck up.

                  1. Obamacare increased the amount of human well-being in the world. That’s the basic criterion I have for any policy.

                    1. Cool, if you think that, not what I asked you.

                      Is it reading? Is that hard for you, hence your difficulty answering questions?

                    2. Besides, if you really think that, why are you bitching about him getting credit? What’s the problem?

                    3. “”Obamacare increased the amount of human well-being in the world.””

                      If you totally ignore Syria, Libya, and all the bombs he dropped on people, you might be on to something.

            3. Without theft and threats of murder, how could there be civilization? We’d all be children!!!!

        2. Today we learn that Tony’s parents made sure he knew from a very early age that they didn’t love him.

        3. The individual mandate in this case is being forced to buy something you may not want for yourself. So it doesn’t even fit into your warped sense of buying things for other. It’s just a way to force business for insurance companies.

          1. That’s what cracks me up. The ACA was written largely by an insurance company lobbyist and its primary effect is requiring people to give money to insurance companies, and somehow its defenders continue to portray it as a blow against those evil insurance companies.

            1. The individual mandate balances the requirement to cover preexisting conditions and other things they weren’t required to cover before. It’s a private-sector approach to universal healthcare coverage, the most private-sector approach you’re going to get.

              So if you think the best possible society is one in which healthcare is unnecessarily expensive for everyone because you can choose to increase premiums when you go to the ER for treatment with no coverage, or perhaps one in which the poor and sick simply die in the streets, just say so.

              1. I sure hope your strawman there has good coverage, ’cause he’s gonna be in the burn ward for a while.

                1. There is a logical conclusion to the bullshit you believe.

                  Who pays to clean up the bodies from the streets, by the way? The omnipresent and infinitely wealthy local charity, I presume?

                  1. Doubling down on your strawman auto-da-fe is one response, i guess.

                    1. Libertopia: There is no universal healthcare, and no requirement to treat patients who can’t pay. Thus, bodies in the streets. That’s not a strawman, but it might be a metaphor. Bodies in recliners. Whatever. Obviously corpse cleanup would be a private enterprise too.

                      Do you just sprinkle magic freedom dust on this scenario and make the consequences go away or what? I want to know who cleans up the bodies of the dead poor.

                    2. It’s interesting that you assume all people to be as selfish and misanthropic as you seem to be. I mean, not really interesting, but it is certainly an observable phenomenon.

                      Look out, Strawman Tokyo! Here comes Tony Doolittle!

                    3. “Hear him squeal meekly! Run away, run away!”

                    4. Sorry but you don’t get to defend your program by just assuming that charity would take care of everybody’s basic needs. I don’t think this ridiculous amount of extra credit you’re giving yourself is even subtle enough to count as a logical fallacy. It’s just obviously horseshit.

                    5. His strawmen burnt to ashes, Tony frantically begins relocating goalposts.

                    6. In Libertopia, if enough people can’t pay, the process will go down. In Libertopia, potential doctors aren’t prohibited from practicing on people who are willing to pay their prices. And in Libertopia, Catholic and other philanthropic hospitals come back into the picture, like in the good old days before the government backed insurance companies forced them out.

                    7. There was a world before government healthcare. Would you want to live there?

                    8. What? A world where the FDA didn’t screw up most everything and force it to cost a thousand times more than it normally would. A world where hospitals don’t need to pass a needs based test to open. A world where the terminally ill are allowed to try experimental medications before those meds are tested for a million years on rats. A world where every fucking little thing medically related doesn’t have a standardized code system that is so complicated it requires expensive specialists just to navigate the morass of codified bullshit. A world where I go to see a doctor and can actually what something will cost up front because it doesn’t need to be translated into a million different codes first and can pay with cash or credit on my way out. A world where markets are open and if I want to go to a different doctor I don’t have to check to find out who is in my network or be limited by state as to where I can buy a health plan or be able to legally buy medications online from other countries where they are cheaper.

                      I don’t know, it might be worth a shot.

                    9. There was a world before government healthcare. Would you want to live there?

                      I grew up there. Healthcare was more widely available and affordable back then. You must be under 40.

                    10. Sorry but you don’t get to defend your program by just assuming that charity would take care of everybody’s basic needs.

                      Some of us actually give to (good) charities. How about you, Tony?

                    11. Charity probably could if your precious all powerful state weren’t constantly draining everyone’s resources. And it will be conservatives carrying the load. As studies show that people like you Tony are not very philanthropic.


                      I can reference lots of other articles n the subject, but chose the MYTimes article so you couldn’t whine about the information coming from a conservative run source.

                    12. Look back to American history. Charity hospitals did not prevent a high mortality rate. They never will. There just aren’t enough do-gooders and the do-gooders are not in the right places. See:


                      (I’m lazy so take out the carriage return).

                      Getting rid of all medicaid will not improve effectiveness of charity care. Here’s a quote from an Atlantic article above:

                      “As for hospital-based charity, it can vary widely. Most studies find for-profit hospitals provide less charity care than nonprofit medical centers. But getting aid from a non-profit hospital isn’t exactly a gimme. A paper published by the Brookings Institution in 2015 pointed out that the non-profit hospitals with the most funds that could be devoted to charity care?that is, covering or forgiving medical bills of those who cannot pay full?are not located in the geographic areas where the need is greatest. The higher the wealth in a particular region, the more money a hospital is likely to have for indigent or needy patients. But those patients who need financial assistance are likely to live in lower-income areas where there is less in the way of resources.”

                  2. I’m curious Tony, since you are so pro government I’m sure you have a tattoo of Obama in the bottom of your back.

                    The government allows you to send them extra money beyond taxes. How much do you give? I mean you think government is the only body capable of doing something so you must give them all your money to run your life.

                    Funny, you think people won’t help each other…but government is made up of people so..

                    1. Social insurance programs are not the same thing as charity and never were. I don’t even know why you’re talking about charity except to introduce the laughable claim that they’re sufficient to address everyone’s basic needs.

                    2. Tony, charity should NEVER have to “address everyone’s basic needs”. It should only be necessary to cover some people’s needs some of the time. At least as long as people like you aren’t running anything.

          2. The larger goal being to increase healthcare coverage for Americans. Not my ideal policy route either, but if you want a public option you should just say so.

            1. The public deserves the option to buy health insurance or not.

              1. And then people with no ability to pay for healthcare they need should [fill in the blank].

                1. Ask their brother to stop fucking around on the Internet and get a second job to hell them out?

                  1. And if they have no friends or relatives willing to shell out charity, they should [fill in the blank].

                    1. Find some.

                    2. By the way, did you notice how Tony just tacitly admitted he’s a deadbeat who won’t help his sister?


                    3. I don’t do too badly but I can’t shell out $40,000 if she has a major medical issue. Because healthcare costs are unpredictable and often large, that’s the entire fucking reason we pay for it using the insurance model.

                    4. And apparently can’t stop fucking around on the internet to help with legwork.

                    5. And apparently, he hasn’t realized that he’s also admitted to being too much of a deadbeat to help her out by paying an insurance premium, either.

                    6. Funny, my car insurance doesn’t cover oil changes, tire rotations, new tires, new brake pads, etc. Then again, congress hasn’t made auto maintenance so complicated that it costs a substantial fraction of a car’s purchase price just to change the air filter. I’m also allowed to do a lot of it myself, I can test the tire tread depth and air pressure but I can’t go get a CBC or check my cholesterol levels without the added cost of getting the written blessing of a doctor. Hell, it’s a miracle that pregnancy tests are available easily and I’ll never understand why my uncle needs a prescription to get lances and test strips for his blood sugar monitor.

                      Now that I think of it health care is more an assurance model than an insurance model, like the extended car warranty scams they constantly offer via robo-call at dinner time.

                    7. Why would you have to shell out $40k? Just help her cover her premiums. Of course, a selfish prog like you would never shell out a dime.

                2. And then people with no ability to pay for healthcare they need should [fill in the blank].

                  There are places they can go and people who will help them. There would be a hell of a lot more of that sort of thing if most of it wasn’t illegal. I’m talking about mutual aid societies and independent group self-insurance. Right now, I think you have to claim some sort of religious exemption to do it. I’m also talking about going to someone other than an MD for routine care and some other things. There’s no need to pay an MD and everything associated with the a full doctor’s office to get a prescription for antibiotics or whatnot.

                  Besides, if you want to expand Medicaid or some other program for the poor, just do that and tax people for it honestly. Don’t force them to pay double or triple in premiums for the same insurance and tell them that it’s for their own good.

                  1. I want to expand Medicaid or something like it to everyone, which all evidence suggests would be the cheapest of available options.

                    But we can’t have that because too many people bought the stupid “government is evul” crap from the 80s and never looked back.

                    1. Jonathan Gruber was right

                    2. It’s not “evul” it’s spelled “incompetent”.

                    3. And the politicians you support spend every day proving you right.

                    4. “I want to expand Medicaid or something like it to everyone, which all evidence suggests would be the cheapest of available options.”

                      Tony, no real evidence suggests that. in fact, the opposite is true. However, a progressive drone like you only thinks what you’re told to think.

          3. The mandate and the badly misnamed “essential services” clause. Nothing like forcing people to buy more insurance than they need, very profitable business.

      2. Hello BUCS, you asked where I have been last night –

        28 days in Florida, tending to family issues and play time. Aside from having my wife check some matters on her laptop and phone, I was blissfully without any computer / internet access.

        1. Well hopefully the family issues weren’t anything dire. Hope you had a good time and happy New year.

          1. Thank you and happy new year to you.

            Family issue was primarily the transition of my mother from house to assisted living.

    3. They can put a price on some things but liberty is priceless!

  4. Oh uh Team left, ObamaCare repeal is coming soon.

    Team Red has been embolden by getting tax reform passed.

    1. Maybe they’ll even reduce federal health care spending. I’m not holding my breath on that one, though.

  5. My sister just lost her health insurance. Trumpcare is a failure.

    1. Go with that and see how it works for you.

      1. Lots of people here thought their sob stories proved the same about Obamacare, and I’m not even lying.

        1. But you’re admitting that you’re lying now.

          1. Just applying the same standard. My relative lost her healthcare just two days ago. Ipso facto, Trumpcare is a failure.

            Also Trump is a fucking senile idiot and Republicans are nihilistic assholes with no intention of helping any Americans except the superrich, so it shouldn’t come as much of a surprise.

            1. “Just applying the same standard. ”

              Nah. You’re saying the guy who handed you some TP under the stall is to blame for that giant shit you just took.

            2. My relative lost her healthcare just two days ago. Ipso facto, Trumpcare is a failure.

              What part of Trumpcare caused it? When I lost my policy it was because Obamacare made it illegal. And don’t give me bullshit about scam insurance. It was basically the same coverage you’d get in a Silver Obamacare exchange plan.

        2. But? it’s still Obamacare. Trump hasn’t actually done anything yet.

          How fucking stupid are you?

          1. He signed the bill with his big dumb pen. I saw it.

            1. Sorry, that’s your millstone. Wear it with pride.

            2. He signed the bill with his big dumb pen.

              That law hasn’t actually gone into force, yet, you poor, poor moron.

        3. I only related my “sob story” only to counter claims that Obamacare didn’t cause anyone to lose their insurance coverage, which it did to me.

          1. And Tony’s sister.

            1. She was not covered until Obamacare, which offered her an affordable option. Her employer then started adding health insurance to her benefits, but just took them away. Obviously because Trump.

              Why is it so easy to get you people to defend Trump anyway?

              1. I’m sure all the fucking around on the Internet instead of finding her help is appreciated.

                1. So you believe in an obligation to help your community, just not in a modern, civilized, or efficient way.

                  1. I believe that if I had a sister that needed help, I wouldn’t be fucking around on the internet insisting government is more efficient that face to face interaction.

                    I wouldn’t be fucking around on the Internet at all.

                    1. She doesn’t need help. I’m just saying Trump took away her healthcare.

                    2. Wait, if she doesn’t need help, what the fuck are you bitching about?

                      And, do you honestly expect the posts you made discussing how she needs 40k and you can’t help her to disappear?

                      Jesus Christ man, get the fuck off the internet.

                  2. Only a dipshit like Tony could possibly believe that the modern, civilized and/or efficient way to help people is by government fiat.

              2. “Obviously because Trump.”

                Obviously. Explain it to me anyway because I’m stupid.

                1. And I’m mocking the stupidity. The GOP and its zombie-like followers (including most of you) blamed everything that ever went wrong in the insurance market on Obama for the last 8 years, so I don’t see why you’re not applying the same logic.

                  1. So you were lying.

                    Got it.

                  2. Hmmm, I still don’t understand. Slower. Please.

                  3. “blamed everything that ever went wrong in the insurance market on Obama for the last 8 years”

                    Every workplace I’ve ever been in has the same rule. You touch it it’s yours.

                    That’s life in the adult world. Stop whining.

                    1. Trump touched it.

                    2. Do you see me crying about the as yet to be seen follow on consequences, like you are?


                    3. Are you crying about the trillions of dollars in deficit spending? Would you be if Hillary were president?

                    4. It’s a yes or no question.

                      And the answer was no.

                      Meanwhile, you are trying to adhere to the rule of “he touched it so it is his” for Trump, while whining about the rule being applied to Obama.

                      Pick one.

                      And, the answer was still no.

                  4. blamed everything that ever went wrong in the insurance market on Obama for the last 8 years

                    Oh no. Many more people besides Obama are to blame.

              3. She was not covered until Obamacare, which offered her an affordable option.

                Every plan on the exchanges was way overpriced and were not very affordable without a subsidy.

                The plan I had was $83/mo with a $2500 deductible, which was quite affordable. It covered a couple of routine visits a year (checkups) for free and had a $30 copay for other visits. I think the ER copay was $100. If I had bought a similar plan from the exchange it would have been $225/mo.

                1. A comparable plan to the mediocre coverage I had from Assurant in 2013 currently costs over $800/mo. My 2013 premium cost was about $250.

            2. It’s like arguing with a ham sandwich, isn’t it?

              1. No, because ham sandwiches don’t rely almost exclusively on silly-ass strawman arguments.

                Also, ham is delicious, whereas if Tony was a sandwich he’d taste like cigarettes and spite.

              2. Sadly, the brave pig that gave his life for the ham sandwich (And bacon!) was an order of magnitude smarter than Tony.

                Tony was trying to be funny…it didn’t work.

    2. What ‘Trumpcare’ asshole? The ACA was never repealed. Obama is the one who failed her. Of course, your kind never have any accountability.

  6. So if my city stops fining me for not mowing my lawn, is it really accurate to say that I am “losing my lawn care” based upon the new policy? (Asking for a friend.)

    1. Those fines pay for the lawn care of the truly less fortunate, like the people without lawns.

  7. Let me get this straight. CBO had an estimate of $X. Now they’re saying, “Our previous estimate wasn’t right. Here’s a new estimate that says $Y.” Why, exactly, are we supposed to give more credence to the $Y estimate?

    Here’s how I translate what CBO is saying. “Hey, we made up some numbers, but we’re not sure that we like the numbers we made up, so we’re going to make up a different set of numbers.”

    1. Simple, when it might result in the repeal of barrycare they used ridiculously high numbers with known incorrect starting points. Now that the same analysis was used to help pass tax cuts, the narrative must change to match the desired conclusion.

      1. It’s amazing how such ludicrous conspiracy theories just fall from your fingers with the ease of a discarded tissue.

        1. This from the guy who sees russians under his bed.

          It’s amazing that you manage your regular autonomic functions.

          Do you seriously deny that the cbo used flawed numbers during the barrycare repeal effort? The documentation is literally in the cbo report itself. The honestly claimed that more ppl were on barrycare than actual hard data contradicted. Instead they relied on earlier estimates which had already been proven wrong.

  8. Gee, suddenly pete realizes that the cbo estimates of obamacare repeal were wrong. Well, it fits the narrative now. Oh, and let’s make sure we go with the static scoring estimate at all times, too.

    Hasn’t EA put out something to distract this guy for a while again?

  9. “You have to purchase private fire / life / health insurance because you’re already paying for things like welfare and cleaning of bodies on the streets” – Tony.


    Why won’t the government just take half of everything Tony makes to fund my future kid’s college tuition? He’d be paying for their healthcare anyways.

    1. Civilized countries do subsidize college education with taxes.

      1. They also restricr who can attend and limit abortions to 20wks or less. Ready to go whole hog, tony?

        1. This is America, we’re supposed to be able to do things better than everyone else. Why not let’s try the welfare state again?

          1. Jonathan Gruber was right

          2. We’re doing less of it, so by definition we’re already doing it better.

      2. “”Civilized countries do subsidize college education with taxes.””

        They also have very tight immigration controls.

        But I have a saying when it comes to education and investing into one’s self.
        If you don’t think you are worth investing your own money in your education. You’re probably right.

  10. Want to piss off a liberal that has no health insurance? Ask them why they are not complying with Obamacare. Tell them they are required by law to have insurance and they are bad for avoiding to comply and that failure hurts the system for everyone else.

    I have had people with no insurance claim to love Obamacare, yet do not want to abide by it.

    1. Which is a liberty Obamacare afforded them. It’s not illegal not to have health insurance, you just have a different tax situation. It’s quite possibly the most market-friendly and individualist “universal” scheme you can think of. But Obama is a Kenyan Marxist and all.

      1. Which is why Obamacare is based on coercion and fraud.
        So advanced.

      2. “”It’s not illegal not to have health insurance””

        I didn’t say illegal, it’s not criminal, but it’s a mandate. You are in fact REQUIRED to have insurance else pay a penalty/tax, whatever. By not abiding by the mandate the law demands, you are not in compliance with the law.

        Do you have a different definition of mandate?

        1. Or so it was.

  11. The far more important issue than the CBO score is the fact that repealing the mandate was a move towards more freedom. It is so very rare to gain back freedom once government grabs hold of it. Freedom is a good more valuable than money and this was a step in the right direction.

  12. Damn, if only those chicken-bones were more consistent.

  13. The CBO has been wrong on practically every estimate produced. The biggest one were the estimated affects of Obamacare.

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