Charles Gaba's blog

I already mentioned this in my post from a few days ago, but I suspect it was lost in the larger scope of the entry, so I'm calling attention it more explicitly here:

With the 2026 ACA Open Enrollment Period officially starting on November 1st, and with millions of ACA enrollees being bombarded with scary letters from their insurance carriers and headlines warning of massive premium hikes, residents of six states* (as of this writing) can already enter their own household information to find out how much their net health insurance premiums are going to increase starting January 1st, 2026:

*It was five states on Sunday; since then Maryland has also gone live, and other states may have joined them by the time you read this. See here for important info about MD's new state-based financial subsidy program.

The Centers for Medicare & Medicaid Services just published updated enrollment data for Medicare, adding June 2025 to the data archive.

Whether the data posted since January 20, 2025 is accurate or not, I can't say for certain, but at least they're updating it...and so far, at least, I don't see anything in their monthly reports which is setting off any obvious red flags.

In any event, according to the latest report, as of June 2025:

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

June 2025 Key Findings

Medicaid and CHIP Enrollment

  • In June 2025, 77.7 million individuals were enrolled in Medicaid and CHIP.
  • 70.5 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
  • 40.7 million adults were enrolled in Medicaid, and there were 37.0 million Medicaid child and CHIP enrollees.

Medicaid and CHIP Applications Received

Twelve years ago, the Wall St. Journal ran a story about the impact of the American Taxpayer Relief Act of 2012, a sweeping tax bill signed into law by President Obama which locked in the Bush tax cuts for lower & middle-class households while allowing them to expire on schedule for wealthier Americans:

A compromise measure, the Act gives permanence to the lower rate of much of the Bush tax cuts, while retaining the higher tax rate at upper income levels that became effective on January 1 due to the expiration of the Bush tax cuts. It also establishes caps on tax deductions and credits for those at upper income levels. It does not tackle federal spending levels to a great extent, rather leaving that for further negotiations and legislation. The American Taxpayer Relief Act passed by a wide majority in the Senate, with both Democrats and Republicans supporting it, while most of the House Republicans opposed it.

Originally posted 8/12/25

Overall preliminary rate changes via the SERFF database, California Insurance Dept. and/or the federal Rate Review database.

Aetna/CVS

(Aetna/CVS is pulling out of the entire individual market nationally)

Anthem Blue Cross of CA (DMHC)

This is a rate filing for the Individual market ACA‐compliant plans offered by Anthem Blue Cross (Anthem). The proposed rates in this filing will be effective for the 2026 plan year beginning January 1, 2026, and apply to plans both On‐Exchange and Off‐Exchange.

Anthem will continue to participate in its 2025 marketplace footprint consisting of rating areas 1-10 and 12-14 with EPO plans and rating areas 11 and 15‐19 with HMO plans.

Originally published 8/04/25

Via the Utah Insurance Dept:

BridgeSpan Health Co:

The projected average rate change for plans effective January 1, 2026 is 16.0% which is an average rate change of about $87 per member per month (pmpm). Because 16.0% (or about $87) is an average, it is possible to have a different rate change. Factors affecting a member's premium are age, tobacco use, family composition, plan, and geographic area. Expected cost differences by product are updated every year to ensure premium differences are appropriate. BridgeSpan has approximately 200 members enrolled in this line of business as of March 2025.

...The rate change described above is driven by the following factors:

  • Medical Trend : 9.1%
  • Change in Benefits, Age, Area, and Network : -1.5%
  • Change in Market Morbidity : 5.0%
  • Exchange User Fees : 1.0%
  • Other : 2.0%

Other includes: actual results vs. expected, changes to admin expenses, and rx rebates. Actual results vs. expected reflect differences between actual results and past assumptions, including a true-up of market morbidity estimates

In the most recent chapter of the ongoing 2026 Arkansas rate filing saga, I noted that both the total number of residents enrolled in ACA individual market policies as well as the average 2026 rate increases for the six insurance carriers participating in the individual market next year kept changing, often in ways which were contradictory with other numbers claimed within the same press releases:

You'll notice that in addition to the rate changes being updated (increasing from a weighted average hike of 26.2% to 35.7%), most of the current enrollee figures were also modified, although these only changed slightly in most cases. Overall the total number of current individual market enrollees statewide dropped a bit from ~354,000 to ~345,000.

Minor changes like this aren't unusual; sometimes the carriers make slight tweaks as more recent data comes in or clerical errors are corrected; other times they round off the enrollee totals (that doesn't seem to be the case here, however).

originally posted 7/17/25

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.

Originally posted 12/11/24

Iowa has around 136,000 residents enrolled in ACA exchange plans, 88% of whom are currently subsidized. I estimate they also have another ~9,600 unsubsidized off-exchange enrollees.

Combined, that's over 146,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be down to more like 136,000 statewide.

Via NBC News:

A Washington Post poll conducted on Oct. 1, the first day of the shutdown, found that 47% of U.S. adults blame Trump and Republicans in Congress, while 30% blame Democrats and 23% said they're not sure.

The survey found that independents blamed Trump and Republicans over Democrats by a wide margin of 50% to 22%. And one-third of Republicans were either unsure who to blame (25%) or blamed their party (8%).

While I'm glad to see that far more people are rightly blaming Trump & Congressional Republicans, it's the other section of the survey which I find more noteworthy:

Federal subsidies that reduce the cost of Affordable Care Act health insurance plans are scheduled to end at the end of this year. Should these subsidies...

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