For years now, but with more urgency since winning the election, Republicans have claimed that the Affordable Care Act marketplaces are collapsing. House Speaker Paul Ryan recently told a cancer patient who credits Obamacare with saving his life that Obamacare is in the midst of a “death spiral. “
Separately, the Trump administration has taken steps to sow uncertainty within these same marketplaces—quite possibly with the intent of turning their fictive death spiral into a self-fulfilling prophecy, and then blaming it on Barack Obama and Democrats.
The professional analysts at the Congressional Budget Office offer a corrective today in their annual budgetary and economic forecast. In projections completed “before the new Administration took office on January 20, 2017,” that, “do not incorporate any effects of executive orders or other actions taken by that Administration,” they concluded
10 million people per month, on average, will have insurance purchased through the marketplaces in 2017; that number is projected to grow to 13 million by 2027. Not all nongroup coverage is purchased through the marketplaces. In total, CBO and JCT estimate that 18 million people will have nongroup coverage in 2017 and that 20 million people would have such coverage in 2027.
In other words, were the Trump GOP to just leave Obamacare as they inherited it, and run it in the same spirit of good faith as the outgoing Democratic administration did, it wouldn’t collapse; indeed its risk pools would remain basically stable for the next decade. If the marketplaces do start to backslide later this year, keep in mind that intentional mismanagement—i.e. “executive orders or other actions taken by [Trump’s] administration”—will be the culprit, no matter how much Republicans try to deny it.