Charles Gaba's blog

via Pennie:

PENNSYLVANIA – August 26, 2025 – Pennie, Pennsylvania’s official health insurance marketplace, in coordination with Health Market Connect LLC (HMC), the newly appointed contractor of Pennie’s Assister Network, is taking a major step forward in connecting the uninsured with affordable health coverage. Pennie and HMC are launching a new network of regional organizations dedicated to providing localized support throughout the Commonwealth.

This innovative and community-centered model is designed to ensure that every Pennsylvanian, regardless of where they live, has access to trusted, in-person assistance when exploring their health coverage options. The appointed regional organizations will be responsible for hiring local Pennie-Certified Assisters who will serve as trusted guides throughout the enrollment process and conducting outreach to the uninsured.

via the National Academy for State Health Policy (published by Covered California):

Marketplace enrollees from across the country joined State-based Health Insurance Marketplace leaders and insurance experts at a virtual press conference today to discuss the immediate, real-world impacts of potentially losing their health insurance tax credits.

More than 24 million Americans enrolled in Health Insurance Marketplaces have come to rely on increased insurance affordability, thanks to enhanced premium tax credits (EPTCs) set to expire at the end of 2025. Without Congressional action by September 30, the loss of EPTCs is estimated to cause 4.2 million Americans to lose their health insurance. Marketplace consumers are expected to see an average 75 percent cost increase across states.

From small towns to the nation’s most populous state, enhanced premium tax credits are helping millions of Americans get the financial help they need to get connected to affordable health insurance.

Originally posted 6/11/25

via the Maine Bureau of Insurance:

Each year insurers that sell Individual and Small Group plans in Maine's pooled risk market must submit their proposed forms and rates to the Bureau of Insurance, using the System for Electronic Rate and Form Filing (SERFF). Details of the filings submitted to the state since June 10, 2010 can be viewed in the system.

Anthem Health Plans of Maine:

The proposed rates have been developed from 2024 Individual and Small Group ACA combined experience, and the proposed average annual rate change at the Merged Market level is 18.0%.

The proposed annual rate changes by product for Individual range from 17.9% to 20.6%, with rate changes by plan from 10.1% to 30.0%. These ranges are based on the renewing plans, and are consistent with what is reported in the Unified Rate Review Template. Exhibit A shows the rate change for each plan.

Factors that affect the rate changes for all plans include:

Originally posted 1/09/25

Maine has around 64,000 residents enrolled in ACA exchange plans, 85% of whom are currently subsidized. I estimate they also have another ~4,500 unsubsidized off-exchange enrollees.

Combined, that's around 70,000 people, although it could be somewhat lower due to net enrollment attrition since January.

For months now I've been shouting from the rooftops about the imminent expiration of the improved federal tax credits for ACA enrollees, repeatedly pointing out that those already paying full price are gonna get hit with average premium hikes of over 23% while most of the 92% of exchange enrollees who currently receive at least some federal assistance will see their net premiums skyrocket by up to 100%, 200% or even 300% or more.

Having helped cause this crisis in the first place both by refusing to push Congressional Republicans to extend the enhanced subsidies as well as by changing the Premium Adjustment Percentage Index formula (PAPI) to make the remaining subsidies even less generous, the Trump Regime has come up with what I'm sure they think of as a brilliant "solution" to the problem.

Back in March I wrote about a proposed rule (really a set of rules) put out by the Trump Regime's Centers for Medicare & Medicaid Services (CMS) which, if implemented, would make major changes to how the Affordable Care Act is administered. This rule was finalized in June, with some provisions kicking in immediately, most starting January 1st and others over the next couple of eyars.

This set of regulatory changes is completely separate from the impending expiration of the improved premium tax credits which I've written so much about; these have to do with the specifics of how the ACA is actually implemented going forward.

A very simple example of this is the length of the annual Open Enrollment Period, which has ranged from as long as 6 months during the very first OEP in 2013-2014 to as short as just 75 days during most of the first Trump Administration.

As I noted last month, Colorado's ~321,000 individual health insurance market enrollees are currently staring down the barrel of massive premium hikes less than four months from today:

• Perhaps 96,000 unsubsidized Coloradans are looking at average rate hikes of over 28%.

• Another ~225,000 or so enrollees who are currently receiving federal subsidies will be hit with net increases of as much as 200%, 300% or even more.

Every state government is handling this situation differently. In Arkansas and New Hampshire, the strategy seems to be to either shout at or beg carriers to re-file with lower gross premium increases for 2026. New Mexico, California and New Jersey, in contrast, are all retooling their existing state-based supplemental subsidy programs to help cushion at least some of the impact.

A few weeks ago I posted my analysis of the preliminary 2026 individual & small group market filings for New Hampshire, concluding that the state is looking at average rate hikes of around 22.4% for the indy market and perhaps 13% for small group plans.

For the individual market, this is actually slightly lower than the national average (23.4%), and New Hampshire will still end up with the 2nd-lowest avg. premiums in the country (Idaho should be slightly lower next year), but 22.4% is still pretty steep, and the state insurance dept. isn't happy about it:

 

New Hampshire Insurance Department Urges Health Carriers to Submit Revised 2026 Premium Rates Reflecting Current Economic Conditions

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

April 2025 Key Findings - Medicaid and CHIP Enrollment

• In May 2025, 78.1 million individuals were enrolled in Medicaid and CHIP.
• 70.8 million individuals were enrolled in Medicaid, and 7.3 million individuals were enrolled in CHIP.
• 40.9 million adults were enrolled in Medicaid, and there were 37.2 million Medicaid child and CHIP enrollees.

Medicaid and CHIP Applications Received

IMPORTANT: See here for methodology & state-by-state analysis

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.

As of September 2nd, I've managed to fill in preliminary weighted average 2026 rate filings for all 50 states +DC as well as the final/approved rate filings for 15 states.

While it will move up or down slightly as more states finalize their 2026 filings, as of this writing, the weighted average rate increase for unsubsidized enrollees is 23.4% nationally.

This is the 2nd highest year-over-year gross rate hike since the ACA overhauled the individual market starting in 2014.

And yes, a significant chunk of this is due specifically to three factors: