The Centers for Medicare and Medicaid Services (CMS) has issued an actuarial report finding that the recently passed health care reforms will reduce the number of uninsured Americans by 34 million.
The report also found that implementation of the Patient Protection and Affordable Care Act (PPACA) would cost $828 billion over the next ten years, compared to savings of $577 billion, for a net cost of $251 billion. The report acknowledged that revenue from taxes and fees included in the legislation would cover some of that net cost.
Richard Foster, chief actuary for CMS, authored the report. Foster gained public attention in 2003 when he issued a report finding that the Medicare Part D legislation was more costly than estimated by the Congressional Budget Office.
One possible impact of the reform is that some employers would cease offering health insurance, pushing more persons to Medicaid or into health exchanges. This would mainly affect employees and their dependents in lower income brackets.
Foster wrote that, in his opinion, penalties for employers dropping health coverage for their employees were not severe enough to serve as a deterrent.
Another potential effect could be diminished access to health services due to declining reimbursement rates associated with Medicaid. Medicaid enrollees in some markets are finding providers unwilling to treat Medicaid due to inadequate reimbursement.
The report warned that future access to health care and associated costs under the legislation is difficult to assess, saying “. . . the estimates presented here are subject to a substantially greater degree of uncertainty than is usually the case with more routine health care legislation.”