H.R. 987 would appropriate $100 million each year beginning in 2020 for the Centers for Medicare & Medicaid Services (CMS) to expand advertising and outreach programs that promote nongroup insurance coverage sold through the marketplaces established by the Affordable Care Act. CBO and JCT estimate that spending for those purposes would increase enrollment in nongroup insurance coverage and Medicaid by about 500,000 each year over the 2020-20209 period. The increase in spending for that coverage would be partially offset by an estimated decline in average nongroup premiums of about 1 percent, which would lower the average subsidy in the marketplaces. That decline is the result of the agencies’ expectation that the people who purchase nongroup coverage as result of CMS’s expanded advertising and outreach activities would likely be healthier, on average, than the average nongroup enrollee who would enroll under current law.
On net, CBO and JCT estimate that enacting H.R. 987 would increase the deficit by $13.5 billion over the 2019-2029 period. That amount includes an $11.8 billion increase in direct spending and a $1.7 billion decrease in revenues.
Details of the estimated budgetary effect of H.R. 987 are shown in Table 1. The costs of the legislation fall within budget function 550.