Thread by @charles_gaba

🚨🚨🚨
GRAPHICS-HEAVY THREAD WARNING!
How Much More Will #ACASabotage Cost Unsubsidized Enrollees in YOUR Congressional District???

1/ Last year, I posted state-by-state infographics which broke out the estimated number of Americans who would lose healthcare coverage if each of the various #ACA repeal bills form the GOP were to become law.

2/ At first I used my own estimates, but then @EmilyG_DC and her colleagues from the Center for American Progress (@amprog) stepped up and started compiling their own projections. Their methodology was different but our estimates were generally in the same range.

3/ At the same time, every year I also spend countless hours analyzing the actual #ACA premium rate filings from the insurance carriers to estimate how much rates are expected to go up the following year for #ACA individual market plans in each state.

4/ For 2018 and again for 2019, I’m also breaking out the PORTION of the rate change which can be squarely placed specifically on #ACASabotage by Donald Trump and Congressional Republicans, as opposed to normal reasons like inflation, tax/fee changes, etc.

5/ Last year I estimated that of the ~29% national average premium increase for #ACA plans, around ~17% of it was due specifically to CSR payments being cut off, the shortened open enrollment period, the HC.gov marketing budget cuts, navigator cuts and so on.

6/ This translated into an ADDITIONAL average premium cost of roughly $960 more per enrollee for all of 2018 due *specifically* to #ACASabotage: acasignups.net/18/04/11/updat…

7/ THIS year, the sabotage impact comes mostly from OTHER factors: #MandateRepeal and expansion of #ShortAssPlans, for the most part.

8/ This year @EmilyG_DC and Aditya Krishnaswamy (I think his handle is @diddykrish but could be wrong) of @amprog have run their own analysis of how much #ACASabotage will cost unsubsidized enrollees NEXT year…by CONGRESSIONAL DISTRICT!
americanprogress.org/issues/healthc…

@EmilyG_DC @diddykrish @amprog 9/ Again, they use different methodology so their estimates are different. They use household-specific examples: A single 40-year old adult; a family of four; a 55-year old couple, and break it out by CD; I look at the statewide average per enrollee, regardless of age/etc.

10/ WITH THAT IN MIND, I hereby present the estimated impact of #ACASabotage on unsubsidized #ACA enrollees in ALL 50 STATES / ALL 435 CONGRESSIONAL DISTRICTS. Buckle up, it’s gonna be a bumpy ride! acasignups.net/18/08/06/how-m…

11/ Oh, one more REALLY IMPORTANT THING: In many states, 2019 premiums are only increasing slightly vs. 2018, or are actually *DROPPING*…but they WOULD be dropping (or dropping MORE) if not for #ACASabotage.

12/ OK, here goes:
ALABAMA: I estimate around an extra $1,100+ MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

13/ ALASKA: I estimate around an extra $600+ MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

14/ ARIZONA: I estimate around an extra $1,000+ MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

15/ ARIZONA: I estimate around an extra $750+ MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

16/ CALIFORNIA: I estimate around an extra $230 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay…it’s lower than average thanks to strong management/regulation of their market.

17/ COLORADO: I estimate around an extra $800+ MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

18/ CONNECTICUT: I estimate around an extra $400+ MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

19/ DELAWARE: I estimate around an extra $900+ MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

20/ DISTRICT OF COLUMBIA: I estimate around an extra $450+ MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay. NOTE: This could drop substantially if/when DC’s *restoration* of the #ACA mandate penalty is approved!

21/ (taking a break to do some housework…will pick up this thread a little later…)

22/ OK, picking this back up again…remember, if you find my work of value and are able to afford to do so, please consider supporting it here:

https://twitter.com/charles_gaba/status/954188046676742150

23/ FLORIDA: I estimate around an extra ~$800 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

24/ GEORGIA: I estimate around an extra ~$880 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

25/ HAWAII: I estimate around an extra ~$750 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

26/ IDAHO: I estimate around an extra ~$680 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

27/ ILLINOIS: I estimate around an extra ~$1,000 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

28/ INDIANA: I estimate around an extra ~$750 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

29/ IOWA: I estimate around an extra ~$950 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

30/ KANSAS: I estimate around an extra ~$720 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

31/ KENTUCKY: I estimate around an extra ~$820 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

32/ LOUISIANA: I estimate around an extra ~$724 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

33/ MAINE: I estimate around an extra ~$852 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

34/ MARYLAND: I estimate around an extra ~$931 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay. NOTE: The actual hike will likely be reduced if MD’s reinsurance program is approved…but that’s SEPARATE from sabotage efforts.

35/ MASSACHUSETTS: NO 2018 #ACASabotage EFFECT thanks to MA still having their own individual mandate penalty & having strict restrictions on #ShortAssPlans!

36/ MICHIGAN: I estimate around an extra ~$303 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

37/ MINNESOTA: I estimate around an extra ~$474 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay. MN’S reinsurance program helps, but that’s SEPARATE from sabotage effects.

38/ MISSISSIPPI: I estimate around an extra ~$805 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

39/ MISSOURI: I estimate around an extra ~$943 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

40/ MONTANA: I estimate around an extra ~$757 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

41/ NEBRASKA: I estimate around an extra ~$1,394 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

42/ NEVADA: I estimate around an extra ~$608 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

43/ NEW HAMPSHIRE: I estimate around an extra ~$993 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

44/ NEW JERSEY: NO ADDITIONAL 2018 #ACASabotage IMPACT thanks to swift action on the part of the NJ Dem-controlled state gov’t, which reinstated the #ACA individual mandate & strictly regulated #ShortAssPlans!

45/ NEW MEXICO: I estimate around an extra ~$379 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay. NOTE: NM is making major progress towards a possible Medicaid Buy-In public option proposal; check w/@colinb1123 for details!

46/ NEW YORK: SPECIAL CASE. *OFFICIALLY*, there’s no #ACASabotage impact because Gov. Cuomo “isn’t allowing” carriers to raise rates to account for #MandateRepeal, & NY bans #ShortAssPlans. Realistically, there’s probably more than meets the eye here: acasignups.net/18/08/04/new-y…

47/ NORTH CAROLINA: I estimate around an extra ~$367 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

48/ NORTH DAKOTA: I estimate around an extra ~$1,237 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay. NOTE: ND didn’t allow *this* year’s rates to include an increase to make up for CSR cut-off, so it was added for NEXT year.

49/ OHIO: I estimate around an extra ~$679 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

50/ OKLAHOMA: I estimate around an extra ~$1,033 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

51/ OREGON: I estimate around an extra ~$384 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

52/ PENNSYLVANIA: I estimate around an extra ~$518 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay. NOTE: I believe the districts shown are the OLD PA districts, not the NEW ones.

53/ RHODE ISLAND: I estimate around an extra ~$50 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay. Interesting case—the carriers in RI were oddly dismissive of the impact of #MandateRepeal there, projecting only nominal impact.

54/ SOUTH CAROLINA: I estimate around an extra ~$903 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

55/ SOUTH DAKOTA: I estimate around an extra ~$1,078 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

56/ TENNESSEE: I estimate around an extra ~$1,508 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay. NOTE: This may drop significantly if BCBSTN refiles their 2019 rate requests thanks to the #RiskAdjustmentFreeze being resolved.

57/ TEXAS: I estimate around an extra ~$783 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

57/ UTAH: I estimate around an extra ~$829 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

57/ VERMONT: I estimate around an extra ~$130 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay. Fairly nominal impact but that’s still a family meal out at a very nice restaurant.

58/ VIRGINIA: I estimate around an extra ~$975 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay. NOTE: Rates will likely be refiled at a lower increase thanks to Medicaid expansion, but that’s SEPARATE from the sabotage impact.

59/ WASHINGTON STATE: I estimate around an extra ~$858 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

60/ WEST VIRGINIA: I estimate around an extra ~$1,345 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

61/ WISCONSIN: I estimate around an extra ~$1,161 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay. NOTE: WI’s just-approved reinsurance program will help cancel out much of the sabotage…but it’s a SEPARATE issue.

62/ WYOMING: I estimate around an extra ~$1,448 MORE per unsubsidized enrollee *specifically* due to #ACASabotage than they’d otherwise have to pay.

63/ NATIONALLY: I estimate unsubsidized #ACA enrollees will have to pay around an extra ~$607 MORE apiece *specifically* due to #ACASabotage than they’d otherwise have to pay.

ADD THIS to the ~$960 apiece THIS year from LAST year’s sabotage efforts and that’s over $1,500 on avg.

64/ Methodology for each state’s estimates here: acasignups.net/rate-hikes/2019

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