In its latest April 2014 report on the Affordable Care Act (ACA), the Congressional Budget Office (CBO) announced that it is no longer possible to project the overall fiscal impact of the health care law.

Buried in an obscure footnote in the report, the CBO wrote that it has become impossible to determine how certain delays and adjustments in various provisions of the Act, including an employer mandate that is expected to bring in new tax revenue, have affected their initial financial projections of the law’s revenue and spending.

Initially the CBO projected that the ACA would reduce the deficit by more than $210 billion over a decade.  However, four years after enactment, it is unclear whether the law is still on track to meet this target.

Nevertheless, the agency maintained in the report that apart from the insurance provisions in the law, “many other provisions, on net, are expected to reduce budget deficits.” 

Specifically, as of February 2014, the CBO estimated that the ACA’s coverage provisions will reduce net costs to the federal government in the following ways: a net cost of $36 billion for 2014, $5 billion less than the previous projection for the year; and $1,383 billion for the 2015–2024 period, $104 billion less than the previous projections.

While the CBO can isolate and reassess the provisions of the ACA that expanded insurance coverage, it cannot perform the same analysis on portions of the law that modified existing federal programs and made changes to the tax code.

As far as what the CBO is still capable of estimating, the report updated the estimates for the health insurance coverage provisions of the law, including insurance subsidies, the Medicaid expansion, penalties paid by employers and individuals for not providing or purchasing insurance, and the excise tax on high-premium insurance plans.

The CBO’s most recent estimate of the law as a whole was in 2012, when the agency said that a GOP proposal to repeal the law would add $109 billion to the deficit over a 10-year period.

According to a public trustee for Social Security and Medicare, Charles Blahous, no one is keeping track of whether the ACA is producing the savings that were originally projected, nor is anyone enforcing the original financing projections.

Thanks to Bill Finerfrock, Matt Reiter, Lara Burt, Cassy Perkins and Carolyn Bounds for contributing this article.