Charles Gaba's blog


It's been clear for a couple of weeks now that, while many individual states have already long since surpassed it, nationally we aren't going to quite achieve President Biden's goal of at least 70% of U.S. adults getting their first COVID-19 vaccination shot.

With 4 days to go, we currently stand at 66.5% of all adults w/their first shot...exactly 95% of the way towards the target.

That's around 9 million adults shy of the 7/04 target...with only around 300K - 400K adults getting their first shot each day. We're likely to end up around 7.7 million short, or right around 67% of all adults.

As the Kaiser Family Foundation's Larry Levitt just noted:

This held up. 70% of adults vaccinated by July 4th was not a low bar designed for an easy political win. And, it will still be an important goal even after July 4th passes and President Biden’s target isn’t achieved, as expected.

— Larry Levitt (@larry_levitt) June 30, 2021


August 2020:

We did it!

Missouri just voted #YesOn2 to expand Medicaid, and now, because of YOUR vote, over 230,000 hardworking people will have access to life-saving healthcare!

— YesOn2: Healthcare for Missouri (@YesOn2MO) August 5, 2020

March 2021:

Republican lawmakers blocked Medicaid expansion funding from reaching the Missouri House floor on Wednesday, posing a setback for the voter-approved plan to increase eligibility for the state health care program.

Washington HealthPlan Finder

This just in from the Washington Health Benefit Exchange...

The Washington Health Benefit Exchange (Exchange) reports that tens of thousands of Washingtonians now pay less each month for healthcare coverage. Within two months of the American Rescue Plan Act (ARPA) becoming federal law, the Exchange passed on the expanded savings it made available to new and current customers on the state’s insurance marketplace, Washington Healthplanfinder.

“There has never been a better time to sign up for healthcare coverage in Washington,” said Pam MacEwan, Chief Executive Officer of the Exchange. “We’ve been hearing from people across the state who are saving hundreds or in some cases more than a thousand dollars per month.”

Tracy Roberts from Seattle posted to Facebook, “I just opened my bill for July and it’s $242 less than I presently pay . . . That’s incredible! Absolutely incredible and completely unexpected. Life will be a little easier for now.”

Platinum Blonde

Last week I gave a heads up about the imminent launch of the American Rescue Plan's "Unemployment Insurance Benefit" provision at HealthCare.Gov:

This, again, is a Big Deal for this year. Paired with the beefed-up APTC table, what it means is that if you're on unemployment this year you effectively don't have to pay anything for a benchmark Silver plan. I'm not sure if you have to be unemployed for the full year or not...the wording above sounds like even someone who's only on unemployment for one or two weeks would still be counted as having 133% FPL.

Sure enough, just about anyone who is either currently receiving unemployment benefits or who did earlier this year (or later this year, for that matter) is likely eligible for a FREE ($0* Premium) Silver CSR 94 plan...otherwise known as #SecretPlatinum:

CMS Logo

Last November, regular readers may recall I went on a bit of a personal crusade to rack up as much public comment as possible in opposition to several last-minute time bombs the Trump Administration attempted to plant on their way out the door:

I should also note that not every NBPP rule implemented by the Trump Administration (via CMS Administrator Seema Verma) has been terrible. Some are either perfectly in line with Obama-era NBPPs, inconsequential, and in a few cases have actually been good and helpful.

...Other proposed changes, however, can be either stupid or flat-out devastating. The proposed 2022 rule changes...which were pushed out after hours on Thanksgiving Eve, just 56 days before the Trump Administration ends...includes some OK ideas, but also includes some which would be harmful and one which would be disastrous (I've changed the order they're listed below to put the most troubling ones at the bottom):

The details get wonky, but the bottom line is that there were three proposed rule changes in particular which I was deeply concerned about:


UPDATED 7/01/21

As my regular readers know, a few weeks ago I dove head first into a 2-week project to graph out the COVID-19 vaccination levels per capita across all 3,100+ counties to see where things stood in all 50 states.

Given how insanely politicized the COVID pandemic has been due to the Trump Administration deliberately doing so right from the outset, I ran scatter plot graphs based on what percent of the popular vote was received in each county by Trump last November for every state.

Sure enough, I found a strong inverse correlation between the two in most states, and a weaker (but still significant) correlation in many others. Correlation does not equal causation, of course, and there are plenty of other factors involved in how rapidly a population gets vaccinated, but there's no denying that partisanship is pretty clearly a significant one.

My conclusions have now been further confirmed by David Leonhardt of the New York Times:

Red America’s Covid Problem


I received the following email:

Hi Charles,

Our son's GF moved here (Seattle) last summer from Florida. She was a few months after returning from a teaching gig in Korea (where they met), and unemployed. In FL she wasn't eligible for Medicaid, but a couple weeks after she got here I realized she would in WA.

So she signed up and it's been great, b/c in fact she did need quite a bit of overdue health services.

Now they are moving to Oregon next month and I told her, "so you're going to sign up there, right?". She tells me, "I'm not eligible there".

She shows me the Federal site, and it lists for Oregon the Florida-like limitations: you have to be a parent or pregnant or disabled, etc.

I go, "that's strange..." and look up the California eligibility. Same story.

I look up WA's own eligibility according to - same story!!! Supposedly she's not eligible for the very same coverage she's actually enjoying right now with full approval.

Platinum Blonde

Back in March, I noted that one of the more interesting provisions of the American Rescue Plan is that anyone who receives unemployment benefits at any time during calendar year 2021 is eligible for maximum ACA subsidies:

Sec. 9663 – Application of premium tax credit in case of individuals receiving unemployment compensation during 2021

For 2021, provides advanced premium tax credits as if the taxpayer’s income was no higher than 133 percent of the federal poverty line (FPL) for individuals receiving unemployment compensation as defined in section 85(B) of the Internal Revenue Code.

This, again, is a Big Deal for this year. Paired with the beefed-up APTC table, what it means is that if you're on unemployment this year you effectively don't have to pay anything for a benchmark Silver plan. I'm not sure if you have to be unemployed for the full year or not...the wording above sounds like even someone who's only on unemployment for one or two weeks would still be counted as having 133% FPL.



Back in March, I wrote up an exhaustive history of the House v. Burwell court case, which has seen more twists and turns than a small intestine.

I'm not gonna recap the whole thing yet again today (click the first link above for that), but I concluded the most recent chapter by noting:

Simply appropriating CSR payments and killing off Silver Loading would pay for more than 40% of the cost of massively upgrading the ACA (perhaps $250 billion of the $600 billion or so total 10-yr cost).


This would seem to be an obvious headline, but it's still important to have the official data. Via Rolling Stone:

This week CDC Director Dr. Rochelle Walensky said adult deaths from Covid-19 are “at this point entirely preventable” due to the effectiveness of vaccines. And a new analysis from the AP confirms what Walensky said.

According to the analysis of government data from May, released on Thursday, out of the 18,000 Covid-19 deaths during the month, approximately 150 were fully vaccinated people. That comes out to 0.8 percent, or an average of five deaths per day out of more than 200 average daily deaths. At the height of the pandemic in January of this year, average daily deaths were above 3,400 per day. Additionally, fully vaccinated people accounted for fewer than 1,200 of more than 853,000 hospitalized with the virus (0.1 percent).