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Charles Gaba @charles_gaba
, 18 tweets, 8 min read Read on Twitter
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 nationally due to the mandate being repealed.…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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