Ever since the MAGA Murder Bill (officially H.R. 1, the so-called "One Big Beautiful Bill Act") was passed by Republicans in the U.S. Senate & House and signed into law by Donald Trump a few days ago, I've seen a growing conventional wisdom taking hold on social media: People keep claiming that either all, "nearly all"or at least "most of" the budget cuts & other gutting of various programs and departments won't actually kick in until after the November 2026 midterms.

Now, don't get me wrong--most of those making these claims are well-intentioned; they're saying this cynically, to underscore how disingenuous Congressional Republicans are by back-loading the pain until the midterms are safely in their rearview mirrors. And, to be fair, much of the damage won't being until well after next November.

Over at The New Republic, Greg Sargent has taken this thinking one step further, noting that by delaying so much of the ugliness of the new law until 2027 or beyond...

Originally posted 2/26/25

Political battles are usually won based on appealing to emotion, not to facts, policy or logic.

However, you should still have those facts at your disposal for two reasons: First, they still help you craft appeals to emotion. Second, they also help you craft the actual policy. Besides, I'm a data guy; my primary job is to help put facts & policy into easily-understandable context.

Over the past couple of months I've compiled a master spreadsheet breaking out enrollment in ACA plans (Qualified Health Plans & Basic Health Plans), Medicaid/CHIP coverage (both traditional & via ACA expansion) and Medicare (both Fee-for-Services & Advantage) at the Congressional District levels.

Every year, I spend months painstakingly tracking every insurance carrier rate filing (nearly 400 for 2025!) for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease.

Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need.

I really only need three pieces of information for each carrier:

USE THE DROPDOWN MENU ABOVE TO PICK A STATE.

It was in early 2021 that Congressional Democrats passed & President Biden signed the American Rescue Plan Act (ARPA), which among other things dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the level it should have been in the first place over a decade earlier.

In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA also eliminated the much-maligned "Subsidy Cliff" at 400% FPL, wherein a household earning even $1 more than that had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.

Here's what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:

Originally posted 2/2/25

Wyoming has ~46,000 residents enrolled in ACA exchange plans, 95% of whom are currently subsidized. They also have an unknown number of off-exchange enrollees (likely only a few thousand at most). Combined, that's around 8% of their total population.

(Note, however, that the official actuarial rate filings for the 3 carriers offering coverage in the Wyoming individual market only report a combined total of around 39,000 enrollees as of spring 2025, or 6.6% of the total population).

Originally posted 2/05/25

Alaska has around ~28,000 residents enrolled in ACA exchange plans, 88% of whom are currently subsidized. They also have an unknown number of off-exchange enrollees in ACA-compliant individual market policies, or roughly 4% of the total state population.

Overall preliminary rate changes via the SERFF database, Wyoming Insurance Dept. and/or the federal Rate Review database.

Blue Cross Blue Shield of WY

Blue Cross Blue Shield of Wyoming (BCBSWY) has offered comprehensive and fully insured coverage to members in the Individual ACA market since 2014. BCBSWY is filing a rate increase for 2026 products. All plans will be offered statewide; plans with be offered either on or off the Federally Facilitated Marketplace in Wyoming.

Overall preliminary rate changes via the SERFF database, Wisconsin Insurance Dept. and/or the federal Rate Review database.

Aspirus Arise Health Plan of WI

The average proposed rate increase of 12.6%, effective January 1, 2026 is expected to impact 13,677 members, based on membership as of March 31, 2025. The rate increase varies by plan, ranging between 4.4% and 20.5%. Rate changes vary by plan due to the impact of changes in benefits and rating adjustments to account for the non-funding of Cost Sharing Reduction (CSR) payments.

Overall preliminary rate changes via the SERFF database, Alaska Insurance Dept. and/or the federal Rate Review database.

Moda Assurance Co:

(Moda has heavily redacted their actuarial memo and isn't providing the number of current enrollees)

The average rate change is X.XX% as shown on Worksheet 2 of the URRT. The proposed rate Proposed Rate Increase change varies by product and plan, and the proposed rates vary by plan, age, geographic area, and tobacco use. The average rate change was calculated by comparing the weighted average premium for members on current plans and rates to the weighted average premium for members on renewal plans and rates.

A summary of the major components and their contribution to the rate change is provided in the table below.

Components of the rate change / % Impact

Overall preliminary rate changes via the SERFF database, Virginia Bureau of Insurance and/or the federal Rate Review database.

Aetna Health:

(Aetna/CVS is dropping out of the entire individual market nationally in response to Congressional Republicans allowing the upgraded ACA subsidies to expire):

...This letter is formal notice that Aetna Health Inc. (“AHI”) intends to exit from the Individual health insurance market in Virginia effective January 1, 2026. Subject to the Department’s review, we will mail the 180-day notices of discontinuance to covered individuals.

As of May 2025, our records show that AHI has 9,810 subscribers and 13,721 total members in Virginia.

Anthem Health Plans of VA:

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