Charles Gaba's blog

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.

But actually, he thought as he re-adjusted the Ministry of Plenty’s figures, it was not even forgery. It was merely the substitution of one piece of nonsense for another. Most of the material that you were dealing with had no connexion with anything in the real world, not even the kind of connexion that is contained in a direct lie. Statistics were just as much a fantasy in their original version as in their rectified version. A great deal of the time you were expected to make them up out of your head.

For example, the Ministry of Plenty’s forecast had estimated the output of boots for the quarter at 145 million pairs. The actual output was given as sixty-two millions. Winston, however, in rewriting the forecast, marked the figure down to fifty-seven millions, so as to allow for the usual claim that the quota had been overfulfilled. In any case, sixty-two millions was no nearer the truth than fifty-seven millions, or than 145 millions.

Connecticut

via the Connecticut Insurance Dept:

The Connecticut Insurance Department has posted the initial proposed health insurance rate filings for the 2026 individual and small group markets. There are 8 filings made by 7 health insurers for plans that currently cover approximately 224,000 people (158,000 individual and 66,000 small group).

Anthem has filed rates for both individual and small group plans that will be marketed through Access Health CT, the state-sponsored health insurance exchange. ConnectiCare Benefits Inc. (CBI) and ConnectiCare Insurance Company, Inc. have filed rates for the individual market on the exchange.

Before I continue, note that yes, I'm aware the 17.8% average shown below doesn't match the 22.9% average in the headline above. There's a reason for this which should be obvious if you read on:

The 2026 rate proposals for the individual and small group market are on average higher than last year:

Tennessee ACA exchange carriers were instructed to provide two sets of rate filings for 2026: One which assumes CSR reimbursement payments won't be reinstated, one which assumes they are reinstated. In addition, both sets of filings assume that IRA subsidies won't be extended; all but one carrier clarified how much extending the IRA subsidies would impact 2026 premium changes.

Alliant Health Plans: Alliant is requesting a nominal 0.3% increase next year if CSR payments aren't reinstated and a 1.0% drop if they are. In both cases, premiums would be 2.8% lower if IRA subsidies were to be extended by Congress:

A couple of days ago I took a look at the letter sent by the Congressional Budget Office (CBO) to Democratic ranking committee members which broke out the ~16 million Americans expected to lose healthcare coverage via the #MAGAMurderBill passed by House Republicans, assuming they also fail to extend the IRA tax credits beyond the end of 2025.

There was a lot to unpack there, all of it pretty horrible...but I felt one provision in particular was worth its own separate post:

Funding Cost-Sharing Reductions.

Enacting section 44202 would affect the cost-sharing reductions that the ACA requires insurers to offer to eligible people who purchase silver plans through the marketplaces. Those reductions increase the actuarial value—the average share of covered medical expenses paid by the insurer—above the amount in other silver plans, resulting in lower out-of-pocket costs for eligible enrollees. To be eligible for cost-sharing reductions an enrollee’s income must generally fall between 100 percent and 250 percent of the FPL; the subsidy varies with income.

via the Maryland Health Benefit Exchange:

BALTIMORE (June 3, 2025) – The federal budget reconciliation bill passed by the House earlier this month will have significant consequences for the Affordable Care Act in Maryland, if it becomes law as is. For the nearly 250,000 Marylanders who buy health insurance through Maryland Health Connection this bill will increase premium costs, and create unnecessary, inefficient barriers to enrollment.

“For many of those enrolled in Maryland Health Connection, this proposed bill will drive up prices and increase the barriers to quality health insurance,” said Michele Eberle, executive director of Maryland Health Benefit Exchange. “Maryland Health Connection has increased enrollment by 40% in the last four years, because people who know how important health insurance is have found it affordable.”

Increases costs for enrollees

Via the Massachusetts Division of Insurance:

Merged Market Summary for Proposed Rates Effective for 2026

The following tables depict the proposed overall weighted average premium increase and the key assumptions behind premium development for the merged (individual and small employer) market filed by insurance carriers as part of the Massachusetts Division of Insurance rate review process (for rates effective in 2026). This information is subject to change as the rate review process continues.

The Health Care Access Bureau within the Massachusetts Division of Insurance is currently reviewing these assumptions. This review process will culminate in a final decision in August 2025.

There are 711,563 consumers enrolled in merged (individual/small group) market plans (data as of December 2024).

The Congressional Budget Office has published several projections about how many people would lose healthcare coverage and/or become uninsured (these aren't the same thing) under various versions of the #OneBigUglyBill Act passed by House Republicans, which is currently beginning its next phase over on the Senate side of the Capitol.

Their most recent projection put the total at around 11.7 million when you include some technical weirdness which I'm a little vague about...plus another 3.8 million if you include their projection from December 2024 regarding the impact of the upgraded ACA subsidies included in the Inflation Reduction Act being allowed to expire at the end of this year. This placed the grand total at around 15.5 million...except they more recently sent a letter to the House Energy & Commerce Committee which bumped this estimate up a bit more, putting the combined total at 15.9 million.

 

I joined Simon Rosenberg of Hopium Chronicles yesterday to discuss the House GOP budget bill (aka the #MAGAMassacreBill) and the Trump Regime's all-out assault on the U.S. healthcare system.

You can watch/listen to it here, on YouTube, Apple Podcasts or Spotify.

via the Oregon Division of Financial Regulation:

Oregonians continue to have at least five health insurance companies to choose from in every Oregon county as companies file 2026 health insurance rate requests for individual and small group markets

  • In-depth rate review process just beginning, opportunities for public review and input remain through June 20

June 2, 2025

Oregon health insurers have submitted proposed 2026 rates for individual and small group plans, launching a months-long review process that includes public input and meetings.

Five insurers will again offer plans statewide (Moda, Bridgespan, PacificSource, Providence, and Regence), and Kaiser is offering insurance in 11 counties, giving six options to choose from in various areas around the state. 

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