According to CBO's estimates, in 2014, 156 million Americans under the age of 65 will have an employment-based health insurance plan as their primary source of coverage, 6 million will be covered by private insurance obtained through the health insurance exchanges, and 7 million other people will have private health insurance coverage purchased directly from an insurer outside of the exchanges. National health expenditures in 2012 were $2.8 trillion, of which private insurance financed about one-third. Much of the agency’s recent work in this area has focused on the effects of the Affordable Care Act on private health insurance.
Under the ACA, most legal residents must get health insurance or pay a penalty. CBO and JCT estimate that 30 million will be uninsured in 2016, but most will be exempt from the penalty; 4 million will make payments totaling $4 billion.