In the Updated Estimates of the Effects of the Insurance Coverage Provisions of the Affordable Care Act, January 2015, the CBO and JCT estimated that coverage through the exchanges to be at an average of 6 million for 2014 (taking into account plan loss and special enrollment). That number is projected to increase to an average of 12 million people in 2015, 21 million in 2016, and 24 – 25 million in each year between 2017 and 2024. Roughly three-quarters of those enrollees are expected to receive exchange subsidies. These totals represent the whole of the calendar year, not enrollments at any given date. This shouldn’t be confused with total enrollments in any type of coverage. Those numbers are similar, thereby resulting in 26 million more insured under the ACA by 2017 than without it. (NOTE: Estimates are different in past CBO reports, such as the April 2014 ACA coverage provision projections)
Enrollment is expected to increase as people respond to subsidies and to penalties for failure to obtain coverage. The same report shows a decline in baseline projections on the ACA’s cost and lower premium prices than originally projected in 2010 or 2013.
The report also shows that, despite the increase in insurance coverage through the marketplace, about 31 million non-elderly are expected to be uninsured by 2024. For that year, only 31 million are projected to be uninsured as opposed to 57 million without the ACA. The uninsured number for that year includes 30% unauthorized immigrants and 5% ineligible for Medicaid due to states refusing expansion. Surprisingly perhaps, the remaining 65% will have coverage options and choose not to take advantage of them. This includes 20% who are eligible for Medicaid but are projected to not sign up and 45% who will have access to marketplace, work-based, or non-marketplace coverage but will choose not to obtain health insurance regardless.