I am accumulating by today 5/15/26 this historical narrative:
1)Gaba reports in multiple posts, from non-federal sources, including state exchanges and an actuarial consulting firms, on a pattern of millions of the 24 million people who had ACA on-exchange coverage in 2025 apparently losing coverage, factoring in non-payment of premiums and later drops.
“Until now, the summary report also included a brief mention of total effectuated ACA marketplace enrollment in Qualified Health Plans (QHPs), rounded off to the nearest 100,000. As of December effectuated enrollment was ~21.8 million people.
However, starting this month, this data point is missing...and that’s not by accident; it includes this footnote:
As of the January 2026 data, Marketplace enrollment data are no longer included in this report but will be available separately soon.”
4) Gaba does the post on which this comment is appended, pointing to reporting by former Washington Post health reporter Paige Winfield Cunningham that CMS data, not released, (“leaked” I guess is the term) is showing high-loss-of-coverage information similar to those in the Gaba posts and New York Times article. The reporting also indicates that CMS is preparing to indicate the coverage drops are due mainly to the administration's successful attack on ACA fraud.
Here is where I add stuff:
5) On 5/13/26, there is a small, obscure NY Times article stating, on fraud allegations, a mention of Dr. Brian Blase's Paragon Health Institute, and Dr. Oz, with
' “There is something clearly wrong,” Dr. Oz said at a recent event hosted by the Paragon Institute, a conservative health policy think tank. '
8) On Paragon Health Institute, #1 Paragon was involved in fraud assertions on the ACA last year, which it attributed largely to the ACA expanded subsidies.
These have been impugned by several organizations with large research staffs. Here is one case:
"It is therefore imperative that policymakers understand that Paragon developed these allegations using inaccurate data, dubious assumptions, and an apparent lack of understanding of how health insurance actually works."
Other impugnments of that research asserting fraud are to be found here:
"Obamacare Plan Premiums Have Increased Nearly 2x Faster than Employer-Based Premiums Since 2014"
was used by Senate Leader John Thune as justification for not extending the ACA expanded subsidies a few months ago, on the day the Senate voted not to extend the subsidies. (Here: https://www.youtube.com/watch?v=FWmkb_rdUrI&t=287s .)
The same graph was also used a few days by House Speaker Mike Johnson, in this tweet:
The thing about this graph is that I'm pretty sure it's wrong. (An omission of direct-to-insurer payments for cost-sharing reductions, that existed only from 2014 to 2017, as an ACA cost, and a shifting up by one year of employer-plan costs.)
I have a more details on this, with an attempt to correct what I think are the errors, showing the tracked ACA plan cost rising only a little more, or a little less, than employer plans, on a page on my own post on it, here:
(though, they seem to not have let my Paragon graph links get in, so I am a bit disappointed at some lost information. Maybe the comment containing them will appear later.)
I see Paige Winfield Cunningham, who wrote the article you reference, is no longer at the Washington Post.
I wonder what happened. Was she terminated in the recent downsizing there? She was one of few reporters over there who had a grip on the health insurance system. (I'm not sure there are any left. I may cancel my WaPo subscription, if it proves to be worthless.)
I don't know how Charles finds all of the important information so quickly. (I have a theory that he has about 80 well-chosen "Google Alerts" set up, but I really don't know!)
--
(Incidentally, just for fun, I think I may try and start a rumor that Charles does all of this: his Substack, the tables and calculations and graphs for the Substack, the websites, on an iPhone. 😊)
I am accumulating by today 5/15/26 this historical narrative:
1)Gaba reports in multiple posts, from non-federal sources, including state exchanges and an actuarial consulting firms, on a pattern of millions of the 24 million people who had ACA on-exchange coverage in 2025 apparently losing coverage, factoring in non-payment of premiums and later drops.
2)One of the Gaba posts (https://charlesgaba.substack.com/p/cms-posts-january-2026-medicaid-chip ) gives a hint of federal data delay or suppression with:
“Until now, the summary report also included a brief mention of total effectuated ACA marketplace enrollment in Qualified Health Plans (QHPs), rounded off to the nearest 100,000. As of December effectuated enrollment was ~21.8 million people.
However, starting this month, this data point is missing...and that’s not by accident; it includes this footnote:
As of the January 2026 data, Marketplace enrollment data are no longer included in this report but will be available separately soon.”
3) On 5/1/26, the NY Times has a nice article on the number losing coverage, mainly citing items that Gaba subscribers already know about, but it’s still nice that they got it to a much wider audience: (https://www.nytimes.com/2026/05/01/business/obamacare-enrollment-decline.html )
4) Gaba does the post on which this comment is appended, pointing to reporting by former Washington Post health reporter Paige Winfield Cunningham that CMS data, not released, (“leaked” I guess is the term) is showing high-loss-of-coverage information similar to those in the Gaba posts and New York Times article. The reporting also indicates that CMS is preparing to indicate the coverage drops are due mainly to the administration's successful attack on ACA fraud.
Here is where I add stuff:
5) On 5/13/26, there is a small, obscure NY Times article stating, on fraud allegations, a mention of Dr. Brian Blase's Paragon Health Institute, and Dr. Oz, with
' “There is something clearly wrong,” Dr. Oz said at a recent event hosted by the Paragon Institute, a conservative health policy think tank. '
(here: https://www.nytimes.com/2026/05/13/us/politics/vance-medicaid-fraud-california.html .)
6) Some of us, or, well, me at least, go: Dr. Oz? Paragon Health Institute? That suggests sloppy analysis and/or propaganda.
7) On Dr. Oz: https://acasignups.net/26/02/09/which-dr-oz-once-again-proves-himself-be-gaslighting-disingenuous-grifter with the video version, and technical details, for those who need them, here: https://normspier828307.substack.com/p/cost-sharing-reductions-silver-loading
8) On Paragon Health Institute, #1 Paragon was involved in fraud assertions on the ACA last year, which it attributed largely to the ACA expanded subsidies.
These have been impugned by several organizations with large research staffs. Here is one case:
The American Hospital Association:
(https://www.aha.org/news/blog/2025-08-28-setting-record-straight-separating-fact-fiction-health-insurance-marketplace-fraud ) where they state:
"It is therefore imperative that policymakers understand that Paragon developed these allegations using inaccurate data, dubious assumptions, and an apparent lack of understanding of how health insurance actually works."
Other impugnments of that research asserting fraud are to be found here:
https://normspier828307.substack.com/p/who-are-the-economic-advisors-who-5ef
and, the general seeping into the Republican rhetoric of Paragon’s propagandistic term “phantom enrollees / ghost enrollees” is documented here:
https://normspier828307.substack.com/p/who-are-the-economic-advisors-who
9) Paragon Health Institute #2
A graph, prepared by Paragon, labelled:
"Obamacare Plan Premiums Have Increased Nearly 2x Faster than Employer-Based Premiums Since 2014"
was used by Senate Leader John Thune as justification for not extending the ACA expanded subsidies a few months ago, on the day the Senate voted not to extend the subsidies. (Here: https://www.youtube.com/watch?v=FWmkb_rdUrI&t=287s .)
The same graph was also used a few days by House Speaker Mike Johnson, in this tweet:
https://x.com/SpeakerJohnson/status/2000690200008139250?s=20
This is the graph:
https://paragoninstitute.org/paragon-pic/obamacare-plan-premiums-have-increased-nearly-2x-faster-than-employer-based-premiums-since-2014/ .
The thing about this graph is that I'm pretty sure it's wrong. (An omission of direct-to-insurer payments for cost-sharing reductions, that existed only from 2014 to 2017, as an ACA cost, and a shifting up by one year of employer-plan costs.)
I have a more details on this, with an attempt to correct what I think are the errors, showing the tracked ACA plan cost rising only a little more, or a little less, than employer plans, on a page on my own post on it, here:
.https://normspier828307.substack.com/p/senate-republican-leader-john-thune
10) This connected-dots configuration of the administration and Republicans moving into propaganda mode I have plopped down not just here, but I got into a NY Times comment, on topic, today: https://www.nytimes.com/2026/05/15/opinion/trump-data-war-on-numbers.html#permid=151136410
(though, they seem to not have let my Paragon graph links get in, so I am a bit disappointed at some lost information. Maybe the comment containing them will appear later.)
I see Paige Winfield Cunningham, who wrote the article you reference, is no longer at the Washington Post.
I wonder what happened. Was she terminated in the recent downsizing there? She was one of few reporters over there who had a grip on the health insurance system. (I'm not sure there are any left. I may cancel my WaPo subscription, if it proves to be worthless.)
Thanks for the great work! As always.
I don't always say "thanks," but I never take it for granted.
I don't know how Charles finds all of the important information so quickly. (I have a theory that he has about 80 well-chosen "Google Alerts" set up, but I really don't know!)
--
(Incidentally, just for fun, I think I may try and start a rumor that Charles does all of this: his Substack, the tables and calculations and graphs for the Substack, the websites, on an iPhone. 😊)
Thanks so much!
Wonderful, important reporting, Charles!