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ACA Exchange Enrollment Now Forecasted To Be 24 Million By 2016; IRS Lacks Funds To Administer the New Law

February 8, 2013
The Congressional Budget Office (CBO) now estimates the number of Americans obtaining health coverage through the exchanges will rise quickly from seven million in 2014 to 24 million in 2016, a number that does not take into account the millions of people who will apply for Medicaid through the exchanges or churn through them because of changes in their employment status or income.  The CBO attributed the slow start to a combination of factors, including "the readiness of exchanges to provide a broad array of new insurance options, the ability of state Medicaid programs to absorb new beneficiaries, and people’s responses to the availability of the new coverage."  The CBO also revised upwards its forecast of the net number of people who will lose employment-based coverage because of the Affordable Care Act, taking its August 2012 prediction of four million people up to seven million.  Separately, the publication of a report this week from the Treasury Department’s Inspector General highlights the fiscal hurdles faced by the federal government in implementing the ACA.  The report shows that the IRS lacks funding for implementation which may make it harder for the administration to enforce new rules and create new processes needed for the law to take effect.  The IRS requested that HHS  provide it with funding for hundreds of workers to launch the ACA this year, but HHS has not responded.  The IRS faces a significant new workload as it takes on a slew of new taxes and fees as well as building out the system for administering insurance tax credits that Americans can start collecting beginning next year--an effort that will require the agency to build eight new processes that do not exist within current tax administration.
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