On June 28, 2012 the Supreme Court announced its decision on the health care law, which upheld the constitutionality of the individual mandate and allowed states to opt-out of Medicaid expansion. The Congressional Budget Office (CBO) recently released an updated budget estimate to reflect changes in the insurance coverage provision of the ACA resulting from the Supreme Court’s decision.

While SCOTUS upheld the constitutionality of the ACA’s individual mandate that requires people to purchase insurance or pay a penalty tax, this is not the reason why the CBO revised its budget estimate. The update was necessary to reflect projections stemming from the SCOTUS decision that fewer people will be covered by Medicaid and CHIP (6 million), and more people will be enrolled in and exchanges (2 million) and uninsured (4 million) than their previous estimate. As a result of these changes, CBO estimates net costs will be $84 billion less than originally projected.


CBO Budget Estimates for(2012 – 2022) Net Costs (billions)
March  2012 $1,252
July 2012 – Post SCOTUS update $1,168
Savings $84


Changes In Insurance Coverage (millions)

March 2012 July 2012 Difference
Medicaid & CHIP












Numbers may not add up to totals because of rounding.

Read the entire CBO report.

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