Charles Gaba's blog

 

I joined my friend Laura Packard of CareTalk earlier today to discuss the upcoming IRA subsidy expiration iceberg which the ACA Titanic is about to hit just 5 months from today.

(if you tune in while the show is still airing live you'll have to scroll back to the beginning to see my segment)

Me, on April 22nd:

So, all of that was last summer. Skip ahead ten months and voila, the U.S. Supreme Court did indeed hear arguments in the case yesterday...and while the headline from the AP makes it sound positive, there's a potentially very dark lining as well:

 The Supreme Court seemed likely to uphold a key preventive-care provision of the Affordable Care Act in a case heard Monday.

Conservative justices Brett Kavanaugh and Amy Coney Barrett, along with the court’s three liberals, appeared skeptical of arguments that Obamacare’s process for deciding which services must be fully covered by private insurance is unconstitutional.

It's a little awkward to try & pull quotes from Georgia's actuarial memos because they're heavily redacted (see attachments below), but fortunately I also have access to other "just the facts" filing documents which include the hard data I need to compile my weighted averages. These forms--officially called "Rate Filing Transmittal Form LH-T1" and "Unified Rate Review" forms--include, among lots of other numbers, the preliminary avg. rate change being requested for the carrier's individual (or small group) market plans, as well as the number of current effectuated enrollees they have.

In addition, I have alternate rate filings for Georgia individual market carriers which specifically state what their requested rate changes would be if the enhanced premium tax credit subsidies provided by the American Rescue Plan Act & Inflation Reduction Act were to be extended for at least one more year, providing a clear apples to apples comparison.

Neighborhood Health Plan of Rhode Island (if IRA subsidies are extended):

Weighted Average Rate Increase: This represents the average rate increase, including modifications to prior year benefits and other pricing adjustments. The average premium increase to consumers, before reflecting changes in age is expected to be 16.3%.

The range of rate changes, before reflecting changes in age, which consumers will experience, is approximately 15.0% to 17.5%.

Neighborhood Health Plan of Rhode Island (if IRA subsidies AREN'T extended):

Weighted Average Rate Increase: This represents the average rate increase, including modifications to prior year benefits and other pricing adjustments. The average premium increase to consumers, before reflecting changes in age is expected to be 21.2%.

The range of rate changes, before reflecting changes in age, which consumers will experience, is approximately 20.1% to 22.2%.

Blue Cross Blue Shield of RI (if IRA subsidies are extended):

via the Indiana Dept. of Insurance:

Rate Watch is a convenient way for Hoosiers to access key data on Accident and Health rate filings submitted to the IDOI on or after May 1, 2010. Use it to determine which companies have requested rate changes, their originally requested overall % rate change, and the overall final % rate change approved. These are overall rate changes and are not individually specific. The table below is searchable and sortable. You can also download your filtered results by pressing the Save Excel File button at the bottom of the table. If you need the full data set, including a few additional columns, you can download the CSV file.

...INDIANA 2026 ACA FILINGS

The overall requested average rate increase for 2026 Indiana individual Marketplace plans is 20.5%. This year's requested rate increases were substantially impacted by the assumptions that for 2026 Congress will not continue enhanced premium subsidies available to Hoosiers under the American Rescue Plan Act and the Inflation Reduction Act and that Congress will fund Cost Sharing Reductions.

via the District of Columbia Department of Insurance, Securities and Banking:

This page contains proposed health plan rate information for the District of Columbia’s health insurance marketplace, DC Health Link, for plan year 2026.

The District of Columbia Department of Insurance, Securities and Banking (DISB) received 188 proposed health insurance plan rates for review from CareFirst BlueCross BlueShield, Kaiser Permanente and United Healthcare in advance of open enrollment for plan year 2026 on DC Health Link, the District of Columbia’s health insurance marketplace.

The three insurance companies filed proposed rates for individuals, families and small businesses for the 2026 plan year. Overall, 188 plans were filed, compared to 198 last year. The number of small group plans decreased from 171 to 161, and the number of individual plans remained at 27.

From the Arkansas Insurance Dept:

Health Insurance Rate Changes for 2026

Insurance companies offering individual and small group health insurance plans are required to file proposed rates with the Arkansas Insurance Department for review and approval before plans can be sold to consumers.

The Department reviews rates to ensure that the plans are priced appropriately. Under Arkansas Law (Ark. Code Ann. § 23-79-110), the Commissioner shall disapprove a rate filing if he/she finds that the rate is not actuarially sound, is excessive, is inadequate, or is unfairly discriminatory.

The Department relies on outside actuarial analysis by a member of the American Academy of Actuaries to help determine whether a rate filing is sound.

Below, you can review information on the proposed rate filings for Plan Year 2026 individual and small group products that comply with the reforms of the Affordable Care Act.

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.

Well, the Colorado Dept. of Regulatory Agencies isn't mincing words:

Chaos from Congressional Republicans Leads to Average Premium Increases of Over 28% for 2026

  • Average increases as high as 38% have been requested for the Western Slope, and insurance companies estimate nearly 100,000 Coloradans will lose their health insurance coverage

DENVER - The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA) released the preliminary information on private health insurance plans for 2026 for the individual market (for people that don’t get coverage from an employer plan). The filings will be public once the DOI finishes the preliminary completeness review on or about Friday, July 18.

Originally posted 3/18/25

Over the past couple of months I've compiled a master spreadsheet breaking out enrollment in ACA plans (Qualified Health Plans & Basic Health Plans), Medicaid/CHIP coverage (both traditional & via ACA expansion) and Medicare (both Fee-for-Services & Advantage) at the Congressional District levels.

With the pending dire threat to several of these programs (primarily Medicaid & the ACA) from the House Republican Budget Proposal which recently passed, I'm going a step further and am generating pie charts which visualize just how much of every Congressional District's total population is at risk of losing healthcare coverage.

USE THE DROP-DOWN MENU ABOVE TO FIND YOUR STATE & DISTRICT.

Pages

Advertisement