Greetings everyone. I asked our good friend Charles Gaba, a well-known health care data analyst, to return to our community at Hopium Chronicles for an update on what he’s seeing in the data five months into our first year of the huge health care cuts of the Big Ugly Bill. For years, Charles tracked good news about the impact of the ACA and Medicaid expansion - rising enrollment numbers, falling premiums, and expanding coverage. Now he is essentially running the same analysis in reverse, tracking how many people are losing coverage, how much premiums and deductibles are going up, and how many insurance carriers and clinics are pulling out of markets. Gaba warns that the ACA may be heading toward what he calls a “half death spiral,” where the individual market does not collapse entirely, but effectively becomes a high risk pool serving only the sickest and most desperate, much like the broken state-based high risk pools that existed before the ACA. He also flags that starting around September and October, tens of millions of Medicaid enrollees will begin receiving notices about coming changes that start in January, which he expects to create significant political and human shock in the days heading into the November elections... while the CBO projects 15 million people currently on Medicaid will lose their coverage in the coming years due to these barbaric cuts. The initial steps in that process will begin this September. As we discuss in the episode, this was a deliberate policy choice made to fund tax cuts for the wealthy. These cuts are falling hardest on farmers, rural communities, older working people, and anyone who is self employed or runs a small business. The weakening of the individual market will also make it harder for people to start new businesses, sapping some of the dynamism out of our economy, which of course benefits large, established corporations. Republicans cut almost $1 trillion of out American health last summer, and we now have enough data to understand the impact it is having on families across the country this year. As expected it’s ugly, and it is going to get worse in months and years to come. Keep working hard all. We have a country to save, and elections to win, together - Simon
