The Uninsured

The fundamental goal of the ACA was to reduce the number of uninsured in the United States. In 2010 there were approximately 50 million unin- sured people under 65 in the country. Exhibit 2.1 reports the Congressio- nal Budget Office (CBO) estimates of the reduction of uninsured resulting from the enactment of the law. Just prior to the enactment of the law, the CBO estimated 29 million without coverage by 2016. The remaining uninsured were largely those undocumented residents who were not eli- gible for coverage (approximately 10 to 12 million) and those who were exempted or declined coverage. However, the United States did not reach these projections. As we discuss later in the chapter, some 17 states did not expand their Medicaid program and its limited coverage. Each year, the CBO updates its estimates for the next 10 years.shows the most recent CBO estimate, suggesting that the number of uninsured would total 30 to 35 million over the next five years. These estimates incorporate the smaller number of states offering the Medicaid expansion and, of course, reflect the CBO’s assumptions about the growth of the economy.