THREAD: For anyone who doesn’t believe the latest batch of #ACASabotage by Trump isn’t gonna jack rates up next year, I’ve already got receipts out of Virginia.
1/ As I noted earlier today, Virginia insurance carriers have already submitted their *preliminary* 2019 premium rate filings. While these may be revised/change over the summer/fall, the initial statewide average is around 15.1%.…
2/ The averages range from a 5% *drop* (Optima Health) to as high as a 64% *increase* (GHMSI). That much is pretty clear. What’s less clear is *how much* of these increases is due specifically to #ACASabotage, as opposed to normal inflation/etc. HOWEVER…
3/ …we have some guidance on that. The CBO projects around a 10% hike on avg. nationally due to the mandate being repealed.…
4/ Meanwhile, a separate @urbaninstitute study projects a national avg. hike of 16.4% including BOTH mandate repeal *and* #ShortAssPlans, and also breaks it out by state:…
5/ Unfortunately, only one of the 8 carriers participating in the Virginia individual market next year has *specifically* called out a hard number: CareFirst BlueChoice…
6/ HOWEVER, most of the other carriers *did* make it clear that mandate repeal + #ShortAssPlans = a *significant* contributing factor. For instance, here’s Anthem HealthKeepers. Note that “potential movement into other markets” basically means #ShortAssPlans.
7/ Here’s Optima Health Plan:
8/ Here’s Cigna, which lists mandate repeal/#ShortAssPlans as the last 2 bullets…but the three listed above them are basically CAUSED by those last two bullets.
9/ Finally, Kaiser Foundation Health Plan*, simply says “the PRIMARY CAUSE for the increase in morbidity is related to non-enforcement of the Individual Mandate”. “Morbidity” = “How much the risk pool sucks”.

*(this is completely separate from the @KaiserFamFound, by the way)
10/ Now, it’s REALLY important to keep in mind that the @UrbanInstitute projections MAY not be accurate. They may be overestimating the impact. Even the carriers can’t be 100% certain ahead of time. Risk/uncertainty is a HUGE part of how health insurance pricing works.
11/ All of this is exactly why, as I’ve noted many times before, to some degree Trump constantly THREATENING to “blow up” the exchanges most of last year did as much damage as when he actually attempted to do so by cutting off CSR payments.
12/ Some of the carriers bailed from the individual market altogether, effectively pulling an Eric Cartman by saying “screw you guys, I’m going home!”
13/ Most of the carriers which DIDN’T drop out padded their rate hikes considerably based partly on Trump’s threat to cut off CSRs (which he did), partly on concern re. the mandate not being enforced (which it mostly won’t be), and partly on other sabotage (slashed outreach etc).
14/ As a result, of the ~29% avg. rate hikes in 2018, around 60% of it (~17 points) was due specifically to #ACASabotage on average; the other 11 points were due to “normal” factors:…
15/ So what about next year? Again, it’s gonna vary widely by state, carrier and individual plan, but it’s not gonna be pretty. /END
UPDATE: Here's a slightly corrected/revised version of the table I posted at the top of the thread. I had "Optima Health" and "Optima Health Insurance Co." switched (easy mistake!), and I cleaned up the labels/color coding a bit to make it clearer.
CORRECTION TO THE CORRECTION: Here’s an updated version w/explanation for the change:…

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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

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.…
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 8, 2018
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.
Read 67 tweets

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