Charles Gaba's blog

Originally posted 7/17/25

Now that I've finally completed overhauling & updating my House District Healthcare Enrollment Pie Chart project with the latest data, I wanted to address a rather frustrating elephant in the room.

For most of the healthcare programs involved, the enrollment data is now reasonably up to date:

• ACA Qualified Health Plan (QHP) enrollment is as of February 2025 via official Centers for Medicare & Medicaid Services (CMS) public use files.

• ACA Basic Health Plan (BHP) enrollment is as of April 2025 (NY), May 2025 (OR) or July 2025 (MN) via each state's health department monthly reports.

(with apologies to “Weird Al” Yankovic)

Last winter, I initiated an ambitious project in which I generated graphics to illustrate just how much net ACA premiums are likely to increase starting on January 1st, 2026 (slightly over 5 months from today) assuming the enhanced premium subsidies provided by the Inflation Reduction Act over the past several years are allowed to expire.

This project took several months to complete, as I had to generate both tables and bar graphs for all 50 states (+DC), using 4 different households at multiple income brackets for each. All told, that's over 1,600 different examples.

I made sure to include various caveats for these projections. For instance, each of these examples assumes...

The Trump Regime has published an update to the official Medicaid/CHIP enrollment data:

April 2025 Key Findings - Medicaid and CHIP Enrollment

• In April 2025, 78.4 million individuals were enrolled in Medicaid and CHIP.
• 71.1 million individuals were enrolled in Medicaid, and 7.3 million individuals were enrolled in CHIP.
• 41.1 million adults were enrolled in Medicaid, and there were 37.3 million Medicaid child and CHIP enrollees.

Medicaid and CHIP Applications Received

I joined my friend Laura Packard of CareTalk earlier today to discuss the upcoming IRA subsidy expiration iceberg which the ACA Titanic is about to hit just 5 months from today.

(if you tune in while the show is still airing live you'll have to scroll back to the beginning to see my segment)

Me, on April 22nd:

So, all of that was last summer. Skip ahead ten months and voila, the U.S. Supreme Court did indeed hear arguments in the case yesterday...and while the headline from the AP makes it sound positive, there's a potentially very dark lining as well:

 The Supreme Court seemed likely to uphold a key preventive-care provision of the Affordable Care Act in a case heard Monday.

Conservative justices Brett Kavanaugh and Amy Coney Barrett, along with the court’s three liberals, appeared skeptical of arguments that Obamacare’s process for deciding which services must be fully covered by private insurance is unconstitutional.

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 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.

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.

Originally posted 3/18/25

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.

With the pending dire threat to several of these programs (primarily Medicaid & the ACA) from the House Republican Budget Proposal which recently passed, I'm going a step further and am generating pie charts which visualize just how much of every Congressional District's total population is at risk of losing healthcare coverage.

USE THE DROP-DOWN MENU ABOVE TO FIND YOUR STATE & DISTRICT.