Charles Gaba's blog

As I and many others have been warning about for the past year or so, the upcoming so-called "work requirements" (aka "paperwork hell" requirements) of last year's Big Ugly Bill are ramping up in January...and in fact have already begun in Nebraska. A few days ago the Centers for Medicare & Medicaid Services (CMS) published their "final rule" with the reporting and exemption regulations which every state which has expanded Medicaid under the Affordable Care Act will be required to follow...and, as expected, it's likely to be a disaster.

Via Selena Simmons-Duffin of NPR:

Advocates for people with serious illnesses, like cancer and HIV, say the strict Medicaid work rules that the Trump administration released this week are likely to put ongoing treatments in jeopardy.

IMPORTANT: See the original post in this series for an explanation of the methodology.

Regular readers know that I've been obsessing over the massive increases in both gross as well as net premiums for ACA health insurance policy enrollees being caused by the combination of Congressional Republicans allowing the enhanced federal tax credits to expire as well as other Trump Regime policy changes for well over a year and a half now.

IMPORTANT: See the original post in this series for an explanation of the methodology.

Regular readers know that I've been obsessing over the massive increases in both gross as well as net premiums for ACA health insurance policy enrollees being caused by the combination of Congressional Republicans allowing the enhanced federal tax credits to expire as well as other Trump Regime policy changes for well over a year and a half now.

IMPORTANT: See the original post in this series for an explanation of the methodology.

Regular readers know that I've been obsessing over the massive increases in both gross as well as net premiums for ACA health insurance policy enrollees being caused by the combination of Congressional Republicans allowing the enhanced federal tax credits to expire as well as other Trump Regime policy changes for well over a year and a half now.

IMPORTANT: See the original post in this series for an explanation of the methodology.

Regular readers know that I've been obsessing over the massive increases in both gross as well as net premiums for ACA health insurance policy enrollees being caused by the combination of Congressional Republicans allowing the enhanced federal tax credits to expire as well as other Trump Regime policy changes for well over a year and a half now.

IMPORTANT: See the original post in this series for an explanation of the methodology.

Regular readers know that I've been obsessing over the massive increases in both gross as well as net premiums for ACA health insurance policy enrollees being caused by the combination of Congressional Republicans allowing the enhanced federal tax credits to expire as well as other Trump Regime policy changes for well over a year and a half now.

IMPORTANT: See the original post in this series for an explanation of the methodology.

Regular readers know that I've been obsessing over the massive increases in both gross as well as net premiums for ACA health insurance policy enrollees being caused by the combination of Congressional Republicans allowing the enhanced federal tax credits to expire as well as other Trump Regime policy changes for well over a year and a half now.

IMPORTANT: See the original post in this series for an explanation of the methodology.

Regular readers know that I've been obsessing over the massive increases in both gross as well as net premiums for ACA health insurance policy enrollees being caused by the combination of Congressional Republicans allowing the enhanced federal tax credits to expire as well as other Trump Regime policy changes for well over a year and a half now.

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

February 2026 Key Findings

Medicaid and CHIP Enrollment

• In February 2026, 74.9 million individuals were enrolled in Medicaid and CHIP.
• 67.7 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
• 39.2 million adults were enrolled in Medicaid, and there were 35.7 million Medicaid child and CHIP enrollees.

Total Medicaid/CHIP enrollment in December 2025 dropped about 1.2% from January 2026, or by around 918,000 people.

Hoo boy. the Washington Insurance Dept isn't burying the lede here:

Thirteen health insurers request average 22.4% rate increase for 2027 individual market

OLYMPIA, Wash. — Thirteen health insurance companies have requested an average rate change of 22.4% for Washington state’s 2027 individual health insurance market. Insurers base requested rate changes on assumptions made about the services their policyholders will use and the cost to deliver that care.

“I know the requested rate changes will be difficult for individuals and families,” said Insurance Commissioner Patty Kuderer. “We’re going to spend the next several months reviewing every assumption made by the insurers to make sure their requests are justified.”

Fourteen insurance companies offered individual plans last year. One of those plans — Providence Health Plan, which had 254 enrollees — will not offer coverage in 2027.