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.