🚨🚨🚨
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:
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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More from @charles_gaba

Aug 27, 2018
⚠️ GRAPHICS-HEAVY THREAD: Next week, the #TexasFoldEm lawsuit brought by 20 Republican Attorneys General against the #ACA goes to court. The Trump Administration is refusing to defend against it even though it EVERY legal expert says it’s a pile of steaming garbage. 1/
2/ If the #TexasFoldEm plaintiffs succeed, federal protections for those w/#PreExistingConditions would be gone. Not just on the individual market…people w/EMPLOYER coverage would be at risk as well, especially since most people are out of a job at least once in their lives.
3/ Here’s a reminder of the idiotic “argument” the #TexasFoldEm plaintiffs are using:
1. SCOTUS ruled the #ACA mandate is only Constitutional because it’s a tax.
2. The GOP repealed the mandate tax.
3. Therefore, they get to repeal the rest of the #ACA as well.
Really. That’s it.
Read 67 tweets
Aug 21, 2018
THREAD: For those who still don’t understand how important the #ACA #TexasFoldEm case is (along #StopKavanaugh), here’s a simple timeline of the ACA’s 3-Legged Stool:
1/ Here’s how the #ACA’s 3-Legged Stool was *supposed* to work when the law was passed. The blue leg includes the patient protections. The red leg is the part everyone hated but which served an important purpose. The green leg is the financial help for people to pay for it.
2/ This is what it ACTUALLY ended up looking like: There were two main problems. The financial assistance was cut off at 400% FPL income (& wasn’t generous enough), and the mandate penalty wasn’t strong enough to be fully effective. Both were EASILY fixable.
Read 13 tweets
Aug 13, 2018
THREAD FOR EVERYONE OVER 40 YEARS OLD:

Do you remember “Harry & Louise”?

Here’s a reminder. Watch both commercials, but especially the second one. There’s a LOT going on here:

2/ First of all, notice how in 1993, “community rating” (i.e., not being allowed to charge people more based on their health status) was considered a HORRIBLE thing.
3/ Cut to 2018: 8 yrs after the Affordable Care Act was signed into law, 89% of the public thinks it’s important NOT to charge people more for their health insurance based on their health status. EIGHTY-NINE PERCENT. This is the real legacy of the #ACA.

kff.org/health-costs/p…
Read 19 tweets
Aug 10, 2018
ATTENTION MICHIGAN RESIDENTS: I’m trying to track down the Twitter handles for the following 2018 Democratic nominees; please help if you can, thanks!

HD001: Tenisha Yancey
HD003: Wendell Byrd
HD004: Isaac Robinson
HD005: Cynthia A. Johnson
HD006: Tyrone Carter
HD012: Alex Garza
HD013: Frank Liberati
HD014: Cara Clemente
HD016: Kevin Coleman
HD022: John Chirkun
HD024: Laura Winn
HD025: Nate Shannon
HD028: Lori M. Stone
HD030: John P. Spica
HD031: William J. Sowerby
HD032: Paul Manley
HD036: Robert Murphy
HD045: Kyle Cooper
HD048: Sheryl Y. Kennedy
HD049: John D. Cherry
(yes, THAT John Cherry…he doesn’t seem to be on Twitter?)
HD050: Tim Sneller
HD051: David E. Lossing
HD054: Ronnie D. Peterson
HD056: Ernie Whiteside
HD057: Amber Pedersen
HD058: Tamara C. Barnes
HD059: Dennis B. Smith
HD063: Jennifer Aniano
Read 5 tweets
Aug 10, 2018
THREAD: Yeah, I have insomnia, so here’s some wonky info re. single payer, M4A and the Michigan Gubernatorial primary. 1/
2/ Now that the #MIGov primary is over, since the most contentious debate between El-Sayed and Whitmer (besides 'dark money') was about single-payer healthcare, let's get a few things straight:
3/ 1. "Single Payer" refers to any healthcare system where the gov’t is the payment source for healthcare providers (doctors/hospitals/drug cos/etc).
Read 44 tweets
Aug 5, 2018
Annnnd they’re finally being completely honest: They’re not Americans anymore.
For anyone wondering, here’s where this came from: facebook.com/photo.php?fbid…
Read 7 tweets

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