Republicans Will Revive Unemployment Benefits Only If They Get to Keep More People From Getting Medicaid

Reporting on Politics and Policy.
Jan. 7 2014 10:40 AM

Republicans Will Revive Unemployment Benefits Only If They Get to Keep More People From Getting Medicaid

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Explain the math, Mitch.

Photo by Kris Connor/Getty Images

Not long from now, the U.S. Senate will vote on whether to revive the unemployment benefits that expired at the end of 2013. Democrats think they've got 59 votes—the Republican holdouts are doing so either because they fundamentally disagree with extending the benefits or because they want to attach an amendment that would "pay for" the $6 billion in benefits.

What's the amendment? Ah, you guessed: a one-year delay of the Affordable Care Act's individual mandate.

When Mitch McConnell made this announcement, in his morning floor speech, I noticed a few reporters wondering about the math. The mandate is a tax; how does eliminating a tax save money? Well, the answer is in a CBO study that the GOP asked for last year, when it was trying to cram a mandate delay into one of the mandatory spending bills. The delay, according to the CBO, could save $35 billion over 10 years, because fewer uninsured people would seek Medicaid coverage.

CBO and JCT estimate that delaying the mandate to have health insurance coverage would increase the number of people without health insurance coverage—relative to the current-law projections—by about 11 million people in 2014, resulting in an estimated 55 million uninsured in that year. That increase in the uninsured population would consist of about 5 million fewer individuals with coverage under Medicaid or CHIP, about 4 million fewer individuals with employment-based coverage, and about 2 million fewer people with coverage obtained in the individual market (including individual policies purchased in the exchanges or directly from insurers in the nongroup market).
Because the mandate would become effective in 2015 under the legislation, CBO and JCT project smaller incremental increases in the uninsured population in years after 2014. Specifically, CBO and JCT estimate that there would be increases of 2 million uninsured in 2015 and 1 million uninsured in 2016.
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Fewer people on Medicaid, less taxpayer money being spend to insure people. Democrats disagree with static scoring like this, and point to evidence that the ACA's payment reforms are saving money. But Republicans can wave around that CBO report, with its promise of savings, and present it as a "payfor" whenever the need arises. Like today.

David Weigel is a Slate political reporter.