A Tale of Two Pie Charts.


Yesterday morning, Larry Levitt of the Kaiser Family Foundation posted this tweet:

Our polling suggests the public is most likely to blame President Trump and Republicans in Congress for any problems in the insurance market going forward.

— Larry Levitt (@larry_levitt) March 26, 2018

Something about this pie chart seemed awfully familiar to me...

Oh yes, that's right... almost exactly 60% of the average unsubsidized national rate hikes on the individual market this year were caused specifically by deliberate sabotage by Donald Trump and (to a lesser extent) Congressional Republicans, mostly in the form of cutting off CSR reimbursement payments and threatening to repeal the Individual Mandate (which, of course, they actually followed through on in December).

Anyone who followed my painstakingly-detailed state-by-state 2018 Rate Hikes project last summer/fall knows that this breakout is NOT something I'm pulling out of my ass. I've documented not only the specific rate changes for every carrier in every state this year, but in most cases the reason for the rate increases...and many of the major carriers (along with some smaller ones) clearly broke out the justification for thier rate hike requests. It varied widely by state and carrier, but overall around 18 points of the 30% national average increase this year was caused by those two factors.

So what about 2019? Well, we won't know for certain until the final contracts are locked in late September, but several studies have come out which suggest 10% more next year due to the mandate repeal alone (CBO), 18% next year from mandate repeal + Trump's #ShortAssPlan expansion (Urban Institute), or 22% total next year due to all factors (mandate repeal, #ShortAssPlans and normal medical inflation trends (Milliman, via Covered California).

Anyway, the Kaiser survey results are from mid-January. It'll be fascinating to see if the blame game causes the numbers to shift around as the months leading up to the midterms pass.