Sebelius told reporters "I think what is important, in addition to looking at the expansion of various programs and how much money is coming back to the states ... is that the cost of doing nothing is a huge burden on states. It's not only a burden that they pick up in terms of insured costs, and a sicker workforce and less preventative care, but it is a burden they pay for directly in state employee premiums."
The Department asserts that if nothing is done, by 2019 the number of uninsured people will grow by more than 30% in 29 states and by at least 10% in every state. In addition, the amount of uncompensated care will more than double in 45 states, and businesses in 27 states will see their premiums more than double. Finally, fewer people will have coverage through employers.