Charles Gaba's blog

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.

As noted in the methodology for each, there's a small amount of fuzziness in some of the numbers for a couple of reasons, the main one being that the "as of" date varies depending on the type of coverage--Medicaid/CHIP total numbers are as of last October, while ACA Expansion Medicaid is as of last June; Medicare data is as of September 2024; and ACA exchange QHPs/BHPs are as of January 2025.

But actually, he thought as he re-adjusted the Ministry of Plenty’s figures, it was not even forgery. It was merely the substitution of one piece of nonsense for another. Most of the material that you were dealing with had no connexion with anything in the real world, not even the kind of connexion that is contained in a direct lie. Statistics were just as much a fantasy in their original version as in their rectified version. A great deal of the time you were expected to make them up out of your head.

For example, the Ministry of Plenty’s forecast had estimated the output of boots for the quarter at 145 million pairs. The actual output was given as sixty-two millions. Winston, however, in rewriting the forecast, marked the figure down to fifty-seven millions, so as to allow for the usual claim that the quota had been overfulfilled. In any case, sixty-two millions was no nearer the truth than fifty-seven millions, or than 145 millions.

Last winter, Rhode Island residents were hit by an extremely nasty security breach of their RIBridges social services computer system:

On Monday, Gov. Dan McKee said his team has identified 650,000 people whose personal information was stolen in the recent cyberattack on the state’s IT system for social services.

...Earlier this month, the cyberattack shut down the state’s IT system known as RIBridges, which serves as an eligibility database for a host of social services, such as SNAP and Medicaid, along with subsidized health insurance through HealthSourceRI.

...According to McKee, the state aims to turn the system back on in January. In the meantime, R.I. Human Services Director Kim Merolla-Brito said people will still receive benefits through SNAP, Medicaid and other cash-assistance programs. She said EBT cards should be refilled for January under normal distribution methods.

She added that nobody will be terminated from Medicaid while the system is down.

Every year around this time I start my annual individual & small group market rate filing analysis project. This involves spending months painstakingly tracking every insurance carrier rate filing for the upcoming year to determine just how much average insurance policy premiums on the individual market are projected to change.

Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need.

The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier:  How many effectuated enrollees they have in ACA-compliant policies this year; the average projected rate change for those policies; and, ideally, a breakout of the rationale behind the changes.

Usually the reasons given are fairly vague things like "increased morbidity" (ie, a sicker risk pool) or the like. Sometimes, however, there's a very specific reason given for some or all of the premium changes. Major examples of this include:

Via North Carolina Governor Josh Stein (D) this morning:

As of today, 650,000 North Carolinians have access to affordable health care thanks to Medicaid expansion! When leaders come together across political differences, we can make people’s lives better.

Now we must come together to defend this bipartisan victory from proposed federal cuts. People’s health and our health care system depend on it.

The official press release:

Governor Josh Stein announced that as of today, 650,000 newly eligible North Carolinians have gained access to affordable health care through Medicaid expansion, including veterans and workers in child care, construction, hospitality, home health care and other industries essential to the state.

I thought I had finally wrapped up my ambitious Congressional district-by-district healthcare program enrollment pie chart project (for all 435 districts...actually 436 w/DC included). I knew I'd still have to update the numbers every few months, but at least the dust had finally settled on the layout and what info I'd include on each graphic.

Originally posted 10/18/20.

RE-UPPED 1/31/22: It was announced this morning that John James, who lost not one but two statewide U.S. Senate races back to back in 2018 & 2020, is taking a third swing at elected office in 2022. This time he's setting his sights lower, going for Michigan's new open 10th Congressional district, which is still competitive but which definitely has more of a GOP-tilt to it. In light of that, I decided to dust off this post again.

RE-UPPED 4/9/25: It was announced yesterday that John James, who finally made it into elected office as a U.S. Representative in Michigan's 10th Congressional District (only to essentially abandon his district the moment he got re-elected in 2024) is now running for statewide office again, this time for Governor. In light of that, I decided to dust off this post again (again).

A month ago, incumbent Democratic Senator Gary Peters of Michigan and his Republican challenger John James were both interviewed as part of a Detroit Regional Chamber series on several issues, including healthcare policy and the ACA.

via Access Health CT:

Connecticut Residents Can Now Request Information About Health Insurance Options While Filing Taxes

HARTFORD, Conn. (April 7, 2025) — Access Health CT (AHCT) and the Connecticut Department of Revenue Services (DRS) today announced that Connecticut residents can now check a box on their state income tax return to get information about health coverage options. In 2023, the state passed Public Act 23-204 which provided the authority for this partnership.

AHCT is the official health insurance marketplace for Connecticut and the only place to get financial help to help offset the cost of health coverage. Eligible customers can enroll in Qualified Health Plans (QHPs) or other low- or no-cost health coverage including the Covered CT Program which provides health and dental coverage at no cost to the customer, or HUSKY Health, Connecticut’s Medicaid Program and Children’s Health Insurance Program (CHIP).  

I realize the Musk/Trump Administration is attempting to turn the United States into a fascist regime while simultaneously burning the federal government to the ground and pushing the economy into a global recession, but hey, you gotta take positive news where you can find it.

With that in mind, via Connect for Health Colorado:

‘Biggest Enrollment Period Ever’: Connect for Health Colorado Releases its Annual Report on Open Enrollment 

Denver, Colo.– Connect for Health Colorado, the state’s official health insurance marketplace, released its annual open enrollment report today. This year’s By The Numbers report includes new data and information about the record-breaking open enrollment period for plan year 2025, which enrolled 296,449 people in health insurance through Connect for Health Colorado and Colorado Connect, Connect for Health Colorado’s public benefit corporation. 

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