[Excerpt] This document responds to questions that the Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) have received regarding their estimates of the effects of the Affordable Care Act (ACA). In their original analysis of the impact of the legislation, CBO and JCT estimated that, on balance, the number of people obtaining coverage through their employer would be about 3 million lower in 2019 under the legislation than under prior law. As reflected in CBO’s latest baseline projections, the two agencies now anticipate that, because of the ACA, about 3 million to 5 million fewer people, on net, will obtain coverage through their employer each year from 2019 through 2022 than would have been the case under prior law.
The analysis presented here explains two of the key assumptions about employers’ behavior that affect CBO and JCT’s estimates of the effects of the ACA and presents a range of estimates of sources of insurance coverage and federal budgetary outcomes that would result from the ACA under certain alternative assumptions. The analysis also shows how CBO and JCT’s estimates might differ if firms were able to, and ultimately decided to, undertake more widespread restructuring of their workforces than is reflected in the baseline projections—through strategies such as shifting more of their lower-wage workers into separate firms, contracting for the services of more such workers from other companies, or shifting their workforces toward part-time workers instead of fulltime workers.