Charles Gaba's blog

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:

Neighborhood Health Plan of Rhode Island (if IRA subsidies are extended):

Weighted Average Rate Increase: This represents the average rate increase, including modifications to prior year benefits and other pricing adjustments. The average premium increase to consumers, before reflecting changes in age is expected to be 16.3%.

The range of rate changes, before reflecting changes in age, which consumers will experience, is approximately 15.0% to 17.5%.

Neighborhood Health Plan of Rhode Island (if IRA subsidies AREN'T extended):

Weighted Average Rate Increase: This represents the average rate increase, including modifications to prior year benefits and other pricing adjustments. The average premium increase to consumers, before reflecting changes in age is expected to be 21.2%.

The range of rate changes, before reflecting changes in age, which consumers will experience, is approximately 20.1% to 22.2%.

Blue Cross Blue Shield of RI (if IRA subsidies are extended):

via the Indiana Dept. of Insurance:

Rate Watch is a convenient way for Hoosiers to access key data on Accident and Health rate filings submitted to the IDOI on or after May 1, 2010. Use it to determine which companies have requested rate changes, their originally requested overall % rate change, and the overall final % rate change approved. These are overall rate changes and are not individually specific. The table below is searchable and sortable. You can also download your filtered results by pressing the Save Excel File button at the bottom of the table. If you need the full data set, including a few additional columns, you can download the CSV file.

...INDIANA 2026 ACA FILINGS

The overall requested average rate increase for 2026 Indiana individual Marketplace plans is 20.5%. This year's requested rate increases were substantially impacted by the assumptions that for 2026 Congress will not continue enhanced premium subsidies available to Hoosiers under the American Rescue Plan Act and the Inflation Reduction Act and that Congress will fund Cost Sharing Reductions.

via the District of Columbia Department of Insurance, Securities and Banking:

This page contains proposed health plan rate information for the District of Columbia’s health insurance marketplace, DC Health Link, for plan year 2026.

The District of Columbia Department of Insurance, Securities and Banking (DISB) received 188 proposed health insurance plan rates for review from CareFirst BlueCross BlueShield, Kaiser Permanente and United Healthcare in advance of open enrollment for plan year 2026 on DC Health Link, the District of Columbia’s health insurance marketplace.

The three insurance companies filed proposed rates for individuals, families and small businesses for the 2026 plan year. Overall, 188 plans were filed, compared to 198 last year. The number of small group plans decreased from 171 to 161, and the number of individual plans remained at 27.

From the Arkansas Insurance Dept:

Health Insurance Rate Changes for 2026

Insurance companies offering individual and small group health insurance plans are required to file proposed rates with the Arkansas Insurance Department for review and approval before plans can be sold to consumers.

The Department reviews rates to ensure that the plans are priced appropriately. Under Arkansas Law (Ark. Code Ann. § 23-79-110), the Commissioner shall disapprove a rate filing if he/she finds that the rate is not actuarially sound, is excessive, is inadequate, or is unfairly discriminatory.

The Department relies on outside actuarial analysis by a member of the American Academy of Actuaries to help determine whether a rate filing is sound.

Below, you can review information on the proposed rate filings for Plan Year 2026 individual and small group products that comply with the reforms of the Affordable Care Act.

via the Iowa Insurance Division:

Iowa Code §505.19 requires the Commissioner to hold a public hearing on a proposed individual health insurance rate increase which exceeds the average annual health spending growth rate as published by the Centers for Medicare and Medicaid Services of the United State Department of Health and Human Services.  For 2026 the growth rate is 5.6%.

The Iowa Insurance Commissioner will hold a public hearing regarding the relevant rate increases on August 19, 2025.

The purpose will be to hear public comments on the proposed increase in the base premium rate. Consumers wishing to make a public comment at the hearing are encouraged to attend the hearing via the live webcast. 

All comments received will be considered public records and will be posted here. The Consumer Advocate will present the public comments received at the hearing.

Well, the Colorado Dept. of Regulatory Agencies isn't mincing words:

Chaos from Congressional Republicans Leads to Average Premium Increases of Over 28% for 2026

  • Average increases as high as 38% have been requested for the Western Slope, and insurance companies estimate nearly 100,000 Coloradans will lose their health insurance coverage

DENVER - The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA) released the preliminary information on private health insurance plans for 2026 for the individual market (for people that don’t get coverage from an employer plan). The filings will be public once the DOI finishes the preliminary completeness review on or about Friday, July 18.

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