Charles Gaba's blog

Political battles are usually won based on appealing to emotion, not to facts, policy or logic.

However, you should still have those facts at your disposal for two reasons: First, they still help you craft appeals to emotion. Second, they also help you craft the actual policy. Besides, I'm a data guy; my primary job is to help put facts & policy into easily-understandable context.

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.

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.

via NY State of Health:

  • Republican-Passed Bill Would Gut New York’s Healthcare System 
  • Estimated Loss of $13.5 Billion Every Year, Devastating Our Healthcare System 
  • 1.5 Million New Yorkers To Lose Healthcare Coverage and Become Uninsured; Over $3 Billion in Losses for New York’s Hospitals

Governor Kathy Hochul today was joined by the Democratic Leader of the U.S. House of Representatives Congressman Hakeem Jeffries and leaders in the health care and labor sectors to sound the alarm on the detrimental effects of several healthcare provisions already passed by the House of Representatives in the Republican budget reconciliation bill. These provisions collectively amount to an annual loss of nearly $13.5 billion for New Yorkers and our healthcare sector, jeopardizing healthcare access for millions of New Yorkers and threatening the state’s hospitals and healthcare providers. 

“Republicans in Washington have made it abundantly clear that they are determined to dismantle the social safety net that millions of New Yorkers rely on to secure their basic necessities,” Governor Hochul said. “They are specifically targeting essential and life-saving programs such as Medicaid and food stamps with the consequence that everyday Americans will bear the brunt of this attack. I am committed to utilizing litigation and other appropriate tools to safeguard and protect New Yorkers.” 

Hot off the presses via the New York Dept. of Financial Services:

MVP Health Plan, Inc.

Generally, once a year MVP files for a change to the current premium rates on file for their products based on a review of the adequacy of the rate level. Premiums need to be sufficient to cover all medical and pharmacy claims submitted from covered members, cover the administrative cost of operations, Federal and New York State taxes/assessments levied and New York State statutory reserve requirements.

MVP is proposing a premium rate adjustment effective January 1, 2026. Policyholders will be charged the proposed premium rates upon renewal in 2026 pending New York State’s Department of Financial Services review. There are 13,062 policyholders and 19,125 members currently enrolled in Individual MVP Health Plan, Inc. plans. The proposed premium rate adjustment represents an average increase of 8.00%. Premium changes will vary by plan design.

Premium rates are changing due to the following reasons:

The Musk/Trump Regime has published an update to the official Medicaid/CHIP enrollment data:

January 2025 Key Findings

Medicaid and CHIP Enrollment

  • In January 2025, 78.8 million individuals were enrolled in Medicaid and CHIP.
    • 71.4 million individuals were enrolled in Medicaid, and 7.3 million individuals were enrolled in CHIP.
    • 41.4 million adults were enrolled in Medicaid, and there were 37.4 million Medicaid child and CHIP enrollees.

Medicaid and CHIP Applications Received

The Centers for Medicare & Medicaid Services just published updated enrollment data for Medicare, adding February 2025 to the data archive.

So far, after a 2-month initial delay, the Musk/Trump Regime has been posting updated Medicare enrollment data roughly once per month. We'll see if that continues.

Whether the data posted since January 20, 2025 is accurate or not, I can't say for certain, but at least they're updating it...and so far, at least, I don't see anything in their monthly reports which is setting off any obvious red flags.

In any event, according to the latest report, as of February 2025:

via the Office of the Washington Insurance Commissioner:

OLYMPIA, Wash. — Fourteen health insurers have requested an average rate change of 21.2% for Washington state's 2026 Individual Health Insurance Market. Insurers base their requested rate changes on assumptions they make about the services their policyholders will use and the cost to deliver that care. The health plans and proposed rate changes are currently under review by the Office of the Insurance Commissioner.

Wellpoint Washington, Inc. is new to the market and plans to sell in Grays Harbor, King and Spokane counties. 

Over the past month or so, as Congressional Republicans have pulled out all the stops in their attempt to ram through their budget bill which would gut Medicaid and ACA exchange enrollment (along with SNAP and numerous other desperately-needed social aid programs), you may have noticed that they keep using an oddly specific talking point:

Mike Johnson: Medicaid Is Not for 29-Year-Old Males Sitting on Their Couches Playing Video Games

--CNN, February 27, 2025

Mike Johnson on Medicaid: "What we've talked about is returning work requirements ... you return the dignity of work to young men who need to be out working instead of playing video games all day. We have a lot of fraud, waste, and abuse in Medicaid."

Welp. House Republicans did indeed follow through with passing their horrific (and disgustingly-titled) "One Big Beautiful Bill" Act which will effectively repeal the bulk of the ACA without officially repealing it, and that's just for starters.

The final vote was 215 - 214, with every Republican except a handful voting for it (and the two who voted against it openly admitted to the NY Times that they would have voted for it if their votes had been needed), and every Democrat voting against it. There were 2 Republican "no" votes...but both of those were only because they wanted the final bill to be even more draconian.

The Congressional Budget Office projected the bill, if enacted, will result in at least 13.7 million more Americans losing healthcare coverage (and that was based on a prior version of the bill; the new version is even more extreme).

There's so many awful things included in the bill, many of which are of course healthcare-related, and it would take hundreds of blog entries to discuss them all...but I want to focus on one in particular.

The following letter was just sent to both Republican House Speaker Mike Johnson and Democratic House Minority Leader Hakeem Jeffries:

Dear Speaker Johnson and Leader Jeffries:

For over a decade, State-Based Marketplaces have provided private health coverage to tens of millions of Americans, ensuring their health, well-being, and economic security. The Americans who depend on the Marketplaces include working parents, small business owners, farmers, gig workers, early retirees, and lower and middle-class individuals of all ages, political views, and backgrounds who drive our local economies and make both our rural and urban communities thrive.

The legislation under consideration in the House will severely impact the ability of these millions of Americans to continue to access this coverage and the health and financial security they depend on today. This will make for a sicker, less financially secure American public and strain hospitals and health care providers by increasing uncompensated care.

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