As regular readers know, each year I analyze hundreds of insurance carrier rate filings for the following year, then crunch the numbers to get an estimate of how much average premiums will increase (or in a few cases, decrease!) statewide.
As they also know, last year and again this year I've expanded on this by breaking out the portion of the annual rate increase which can be tied directly to sabotage efforts by the Trump Administration and Congressional Republicans. For 2018, this boiled down to roughly 17 points of the total nationwide increase being sabotage-related. It varied greatly by state, carrier and plan, but nationally, I estimated that without last year's ACA sabotage efforts, average premiums would have gone up around 11% instead of around 28%.
Back in mid-April, I crunched a bunch of numbers and concluded that around 6.5 million people enrolled in unsubsidized ACA-compliant individual market policies are, on average, paying an additional $960/year ($80/month) for their policies this year due specifically to last year's sabotage efforts by Donald Trump and Congressional Republicans. This is separate from other factors such as medical trend and the reinstatement of the ACA carrier tax. The actual 2018 "Trump Tax" ranges from as little as almost nothing at all in Vermont and North Dakota to as high as $1,500 per enrollee in Mississippi and Pennsylvania.
The 2018 sabotage impact was mainly due to 1) CSR reimbursement funding being cut off; 2) uncertainty over individual mandate enforcement; and 3) a mish-mash of Open Enrollment changes including cutting the time window in half, slashing marketing/assistance budgets by 90% and 40% respectively and so forth.
A few days ago I noted that I had seriously misunderstood the Congressional Budget Office's individual market premium projections in the event the ACA's individual mandate is repealed: Yes, it'd be ugly, but not nearly as bad as I thought, although they still expect up to 13 million people to lose coverage as a result.
While I have my own doubts about some of the CBO's assumptions, there can be no doubt that premiums would increase substantailly, millions of people would end up without healthcare coverage, and the $25 billion in Medicare cuts do appear to be locked in if the GOP's bill were to become law: