Thank you, Jonathan, for this dispassionate & super valuable report. These last few days have been so depressing, with the DC political commentary class relentlessly spewing their hot takes on Platner, racing to make judgments & to label it a “scandal,” DC’s favorite thing. It was therefore with particular relief to listen to & read some actual evaluation of policy approaches, where they differentiate and where they don’t & how they might differ in effectiveness. Michiganders are blessed with what seem like 3 smart, thoughtful candidates. What you didn’t quite share with us - & it may have been deliberate - is your own personal take, from speaking with them, from knowing them to whatever extent you do, from speaking with others who have worked with them. It’s a hard choice. Listening to them, I’d want all 3 in the Senate, working together in their own separate ways.
As a Michigander, I am really not feeling great about this. I don’t even care about their policy positions, because any major Democratic legislation will be ruled unconstitutional by the corrupt Roberts court. So the only thing that matters to me is electability. Michigan needs to help the Senate get to D+2, and that’s it. (D+2 because of, as JVL reminds us, the near-certainty that Fettershit will change parties after the election).
I was originally for McMorrow, but she has run a dreadful campaign and shown staggeringly poor judgement. Stevens is a tool, plain and simple. Nobody wants her pragmatic, across-the-aisle blocking and tackling anymore (as the article points out), and her support from AIPAC is a huge liability. El-Sayed is very progressive in a purple state, which is also a liability. And in a close race, I think the last name is triggering for closet racists. It shouldn’t be, but if it comes down to a 10,000-vote difference, then I’m worried.
Goddammit, I don’t want Mike Rogers as one of my senators.
Issues like Medicare for All which will take decades of negotiation to accomplish, and campaign finance reform which will face Presidential vetoes and a hostile Supreme Court and probably require a Constitutional Amendment, need to be cast aside in favor of actionable legislation that can help the American people NOW.
Only modest bipartisan legislation can hope to have any benefits for the American people.
Democrats need to campaign against Republicans' failure to assert Congressional power against the executive branch. It isn't Trump. It is the failure of Republicans to try and limit Trump and make him adhere to the Constitution and the law. The message to voters isn't so much that Trump is awful (which almost everyone already knows) but the Republicans can't or won't control him. Promise to reign Trump in and work with him where they can and put their foot down where they must.
BUT to do even that much they must first have a majority in both houses of Congress so run the candidate in the general election that is more likely to win by less than 1%.
i'm appalled that citizens seeking office can be quoted with the following language: “If you’re for a public option, you actually don’t want to guarantee shit,” El-Sayed said. I think i'm going to stop swearing as of this moment, because it has reached a point of unlimited use and casual ugliness. There are far more ugly and frightening aspects lurking within this candidacy; but the casual ugliness is a spike on the graph that has grabbed me by the throat.
Prediction: El Sayed wins the primary as Stevens and McMorrow split the more moderate Democratic primary voters and Rogers wins the general election. Another Democratic circular firing squad election ensuring the Republicans keep the Senate.
Great article by Cohn, giving us a nuanced look at all 3 candidates. Most articles about this race are fatalistic in one way or another and it is nice to have quality journalism here.
My pick is Abdul El Sayed. He is speaking to the frustrations of voters who are upset with the status quo. He is going to deep red places, meeting with rural voters, and speaking about issues that resonate across the political spectrum. He is not running a traditional far left campaign, it is very much a populist and working class campaign.
We need to dispell with the political wisdom that a purple state automatically requires the most moderate campaign. A lot of moderates and swing voters hold a range of conflicting views but the most consistent is a desire for change. That's why you get Obama to Bernie to Trump voters, it's constant rage at a political class they feel has failed them. Abdul's campaign is working at speaking to those people.
Since your discussion with the candidates touches on health care, I feel I should update your readers on the progress of what is being found out about the coverage drops from the lapsing of the ACA expanded subsidies that happened 1/1/26, at the insistence of the Republicans.
There is, in fact, some news--we can see more or the expected propaganda response to the large coverage drops, involving two or the expected participants: Dr. Oz and the Paragon Health Institute.
So, here is a key part of it: a Washington Post editorial, linking to a brand new Paragon Health Institute Report, and you can also find Dr. Oz (I'll link you to him in a Paragon video farther down.)
Trump and the Republicans made the ACA expanded subsidies lapse on 1/1/26, and data is starting to roll in that about 3 to 5 million of the roughly 24 million who had ACA on-exchange coverage n 2025 will wind up losing coverage.
As well, information has been leaked that CMS knows about the losses, and was preparing a propagandistic response, indicating falsely that the coverage drops are mostly due to the administration's successful cracking down on ACA fraud. (Further, Charles Gaba caught that some data usually released in the past on coverage numbers has not been released.)
"The Paragon Health Institute is a conservative think tank founded by Brian Blase, who served as a White House health care adviser during President Donald Trump’s first term. Paragon’s report (https://paragoninstitute.org/wp-content/uploads/securepdfs/2026/06/The_Persistent_Obamacare_Enrollment_Fraud_RELEASE_V1.pdf ) on improper ACA enrollment, co-written by Blase and four others, is neither anti-immigrant fearmongering nor partisan rage bait. In fact, it paints red states in the worst light.
The five states with the highest estimates of improper enrollees (Florida, Texas, Georgia, South Carolina and North Carolina) all voted for Trump in 2024. The report says the incentives are strongest for enrollment fraud in states that did not expand Medicaid under the ACA, which tend to be red states."
...
"Here’s how the fraud works: The federal government provides subsidies up to the full premium for health coverage bought on the ACA exchanges for people with incomes between 100 to 150 percent of the federal poverty line. Unscrupulous intermediaries, such as brokers and agents, lie about the income or existence of applicants, who are then improperly approved for subsidies that go directly from the federal government to insurers. Those intermediaries receive commissions for signing up these phantom “customers.”Paragon researchers used Census Bureau data on the number of adults making between 100 to 150 percent of the federal poverty line in each state, minus the number of people covered by Medicare or Medicaid, to estimate the maximum number who could be eligible for the largest ACA subsidies. They found that the number of people who signed up for ACA coverage in the 2026 open enrollment window exceeded the maximum eligible population in 28 states, totaling 6.2 million improper enrollees nationwide.
Florida, where the scam seems to have been scaled most lucratively, had more than 3 million exchange enrollments in 2026 despite an estimated eligible population of 636,000. Thirteen states had enrollments in excess of 200 percent of the estimated eligible population.
The exact nature of the fraud can take many forms. Sometimes intermediaries sign up real people without their knowledge. Sometimes individuals misrepresent their income to qualify for subsidies, which the federal government did too little to punish for too long. Sometimes intermediaries enroll people already receiving coverage through Medicaid in duplicate coverage through the ACA. Sometimes they fabricate applications entirely.
From prior comments of mine that I linked to, if you trace through, you can find that Paragon's analysis last year, showing vast fraud due to "phantom enrollees", was questioned by major organizations with large technical staffs, and, as well, other conservative analysts.
And, as well, that it produced a graph that I'm pretty sure is erroneous, used by both John Thune and Mike Johnson, to justify not extending the ACA expanded subsidies. (Based on an erroneous cost-growth finding.)
One can see an issue with the Paragon research and recommendations even in just the WP quoted text. The fraud problem is worse in states which did not expand Medicaid.
Well, of course! You give people with an income below 100% of the Federal Poverty Level no legal option to be health insured unless they drop themselves to dirt poor in both income and assets to qualify for traditional Medicaid, and, duh, some will try cheating, and put their income over 100% of FPL to be health insured! (That is precisely what Medicaid non-expansion does. Again, duh!)
How Paragon and Republicans can not recommend that all states that have not expanded Medicaid do so, to repair both the incredibly inequity and rightful rage, and the incentive to fraud, is hard to fathom.
(This kind of thing is what makes it pretty clear to me that many policy analysts, Ph.D. in econ or not, are not smart enough to handle the problems we expect them to be able to handle!)
Another case: in Paragon recommending, and in fact allowing to happen, the lapse of the ACA expanded subsidies, without proposing a correction over the returned 400% FPL subsidy cliff, you have some people having to pay incredibly unaffordable amounts of money if their income nudges them above the cliff.
we see (caught by both Charles Gaba and me) about 280,000 people unexpectedly with incomes just a bit below the 400% of FPL subsidy cliff.
So, of course, many of them will have cheated to get there. This is what we expect in response to a rightful outrage at an incompetent policy hurting them so badly!
(Really, with some of the Ph.D.’s in various disciplines, you can’t tell if the problem is they can’t think very well, or if they can think, but their goal is simply propaganda.
From my limited experience, I’ve been able to detect that many Ph.D.’s even in quantitative areas, can’t analyze competently. At this point, a Ph.D. in physics or pure math might possibly certify an ability to reason adequately. I need more data on those fields. Other Ph.D.’s do not!)
OK, after reading the PARAGON REPORT, here is what I see.
From the data in the report, Paragon really had difficulty defending what is apparently happening with large coverage loss, but they did the best they can, so I quote:
“Because of the expiration of the COVID-era subsidy boosts and the buildup of substantial improper and phantom enrollment, enrollment attrition will likely return closer to pre-COVID patterns. Assuming an 18 percent decline from this year’s open enrollment in 2026 would result in average monthly effectuated enrollment of about 19 million people in 2026—an amount still 90 percent higher than the pre-COVID average.”
So, while citing of “the buildup of substantial and improper phantom enrollment”, they are also pointing out a loss in eventual 2026 effectuated enrollment (“effectuated” means people who actually paid premiums) of 19 million, which is maybe 4 million down from the same number in 2025.
(This large drop numbers is what the CBO said would happen, and has also been reported by Charles Gaba, KFF, and the New York Times, using various non CMS sources, because CMS has not yet released that data.)
So, the 4 million drop is fully consistent with numerous people facing higher premiums, many living paycheck to paycheck in the very-low 1005-150% FPL income zone, and people in other income zones, dropping coverage.
Still, despite that, Paragon put in:
“Allowing the enhanced COVID-era ACA subsidy boosts to expire was a prudent policy change. The exchanges remain heavily subsidized, particularly for lower-income enrollees, and the underlying ACA subsidy structure continues to provide substantial premium assistance. In http://HealthCare.gov states, taxpayers still cover roughly 94 percent of premiums for the median subsidized enrollee, while nearly 70 percent of enrollees face monthly premiums below $100. The evidence presented in this report suggests that the exchange market remains saturated with subsidies, particularly for individuals claiming income between 100 and 150 percent FPL.”
(I would call these last two quoted paragraphs the expected propagandistic response.)
I might as well also toss in, that looking at the early 2026 data, they didn’t find much drop in fraud due to the administration’s anti-fraud activities. Quoting: “While the number of improper enrollees declined by about 250,000 from the 2025 open enrollment period, improper enrollment as a percentage of total enrollment held steady at about 27 percent of all enrollees.”
BONUS CONTENT: I have a recent Youtube of Dr. Brian Blase, who heads up Paragon, discussing things with Dr. Oz and a few others, here: https://www.youtube.com/watch?v=yKOoQNtgMFQ
(I’ve watched most of it, and I find it helpful, because I’m trying to figure out how well Dr. Blase has a grip on the analytical issues, and, as well, how much he’s just being a propagandist.
In the interchange with Dr. Oz, I caught two cases where Dr. Blase chose very propagandistic misleading framings, so he clearly does some propaganda.
I will attempt to point the particular cases out later, when I have some time.)
—
Also, I should point out, that although we have the misleading propagandistic response (within the Paragon report above) to the drop by millions in those enrolled on-exchange in 2026 vs 2025, we actually don’t have the data yet from CMS. (We have the propagandistic response, but not the data it is a response to. We do have the data from numerous other non-CMS sources, but not from CMS! And, we would usually have it from CMS. The data release seems to have been suppressed.)
"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."
Unfortunately, this increases the likelihood of a Rogers win in Michigan. It’s an evenly split state - the west side of the state has a lot of population that doesn’t vote D anymore. And the Trump R Party is putting up bad candidates. And now one of them will be carrying the flag and hurting Michiganders.
Abdul is also doing the work of meeting with voters in Michigan to try to win their support. I met with a volunteer for his campaign last week because he wanted to find out what farmers are concerned about in Michigan and then he held a meeting in our town a few days ago that I unfortunately wasn’t able to attend because of illness in our house, but from what I’ve heard some of the local well known farmers did attend, so they at least were willing to hear him out. I haven’t seen anything from Stevens campaign and McMorrow has been supposed to come to our town but that never happened, and they certainly didn’t do any outreach to local farmers. He also went to the local mosque, since our small town has the second highest percentage of Muslim population in the state outside Dearborn. I know there is a lot of worry about how electable he would be in Michigan, but I also know a lot of people who were Trump voters but also liked Bernie because they are fed up with how things work and nothing ever changes to help them, so if he is putting in the effort in this way, I don’t think it’s impossible for him to win statewide the way people from outside Michigan seem to think.
Yes, a few years ago when Bernie was running for president, my cousin in Wisconsin who is very conservative and was disgusted with the presentation of the panel of contenders, told me she was thinking of voting for Bernie. I cheered her on.
You totally missed Steven’s Involvement with Aipak and support for Israel. Which is missing a lot. Even our beloved Mallory initially took Aipak money, then recognized her error. McMorrow will definitely be back. She positioned herself badly, but next time she will reject the Dems slow plodding routes to peace in Gaza. Both national and international issues are critical. Bernie Sanders called the game before others slowly got on board. I am a boomer but these are very much the millennial positions.
The question. Like every state, Michigan has literally 2 parts , but in fact three. Southern lower Michigan is largely Democratic. It’s also where the most people live. Middle of the state starts turning red, but with a lot less bodies. We have time to promote El-Sayed.
I really liked Mallory before she started her senate campaign and seems to have decided to just take the safe way and stick to centrist positions. Abdul hasn’t been afraid to take stances that he actually believes in and thinks will help us. I think that is what a lot of people are looking for, and he is also doing the work of meeting with voters as well, even in rural areas like mine.
Why? Abdul is running a campaign that seems similar to Platner’s in many respects, as far as policies they talk about and what they want to do, and he doesn’t have the baggage Platner does. Yes, he isn’t a white guy, but Michigan did elect Obama twice, and the same people who won’t vote for Abdul because of his last name are also absolutely convinced that Obama was secretly a Muslim and didn’t vote for him either, so I don’t think it is going to necessarily stop people for voting for him other than those who were already unreachable for Democrats anyway.
Maine is to the left of Michigan, *AND* has much more of a history of being friendly to "quirky" outsider candidates.
Platner also flattened all opposition, which shows his chops as a candidate whether he's my cup of tea or not (see Josh Marshall's excellent writeup on TPM, which I agree with entirely - he's a much better writer than me).
AES is a candidate wholly of the very online left, which is very happy to chase the "Genocide Joe" horseshoe theory folks and tell the consiserable numbers of upper-middle class/suburban MI voters (that have turned the state blue recently) to get bent. That's...an odd strategy for a state that sees lots and lots of 51/49 type elections.
I am a 2008 Obama-stan, and I'd still throw myself on a live grenade for him. Don't see any Obama in AES. If anything, McMorrow is the "Obama lane" candidate. I don't see any way she'd lose a 2026 general, but she might be dead in the water in the primary now (because it's been so successfully hyper-factionalized).
Stevens has electoral liabilities of her own, in that she seems to relish telling the left to get bent. Also not a great electoral strategy, in my view. She's probably 70/30 to win the general in 2026, but leave a lot of hard feelings in her wake.
AES would be a true coinflip, hoping that the wave is large enough to pull him across the line. You're turning a slam dunk into a 50/50, mostly for optics.
tl/dr, I know. But this whole primary seems to me like a full-on factional battle, like often happens in states where the general is a fait accompli. Doing it in a state like Michigan just seems insane to me.
The way it's been done before doesn't seem to be working so let's try something new. You can agree or disagree but that's what voters think and it could vault El-Sayed into the winners circle.
"This is the essence of the case for the Stevens candidacy: She will listen to every constituent group"
Unless that constituent group is a group of Michigan citizens demanding an end to their tax dollars being used to commit war crimes. Then, it's perfectly acceptable to treat said conatituent group as entirely irrelevant and unnecessary to political victory!
Thank you, Jonathan, for this dispassionate & super valuable report. These last few days have been so depressing, with the DC political commentary class relentlessly spewing their hot takes on Platner, racing to make judgments & to label it a “scandal,” DC’s favorite thing. It was therefore with particular relief to listen to & read some actual evaluation of policy approaches, where they differentiate and where they don’t & how they might differ in effectiveness. Michiganders are blessed with what seem like 3 smart, thoughtful candidates. What you didn’t quite share with us - & it may have been deliberate - is your own personal take, from speaking with them, from knowing them to whatever extent you do, from speaking with others who have worked with them. It’s a hard choice. Listening to them, I’d want all 3 in the Senate, working together in their own separate ways.
As a Michigander, I am really not feeling great about this. I don’t even care about their policy positions, because any major Democratic legislation will be ruled unconstitutional by the corrupt Roberts court. So the only thing that matters to me is electability. Michigan needs to help the Senate get to D+2, and that’s it. (D+2 because of, as JVL reminds us, the near-certainty that Fettershit will change parties after the election).
I was originally for McMorrow, but she has run a dreadful campaign and shown staggeringly poor judgement. Stevens is a tool, plain and simple. Nobody wants her pragmatic, across-the-aisle blocking and tackling anymore (as the article points out), and her support from AIPAC is a huge liability. El-Sayed is very progressive in a purple state, which is also a liability. And in a close race, I think the last name is triggering for closet racists. It shouldn’t be, but if it comes down to a 10,000-vote difference, then I’m worried.
Goddammit, I don’t want Mike Rogers as one of my senators.
Rogers lost to Slotkin by 0.34% last time around.
By all means Democrats should FAFO this election.
Issues like Medicare for All which will take decades of negotiation to accomplish, and campaign finance reform which will face Presidential vetoes and a hostile Supreme Court and probably require a Constitutional Amendment, need to be cast aside in favor of actionable legislation that can help the American people NOW.
Only modest bipartisan legislation can hope to have any benefits for the American people.
Democrats need to campaign against Republicans' failure to assert Congressional power against the executive branch. It isn't Trump. It is the failure of Republicans to try and limit Trump and make him adhere to the Constitution and the law. The message to voters isn't so much that Trump is awful (which almost everyone already knows) but the Republicans can't or won't control him. Promise to reign Trump in and work with him where they can and put their foot down where they must.
BUT to do even that much they must first have a majority in both houses of Congress so run the candidate in the general election that is more likely to win by less than 1%.
i'm appalled that citizens seeking office can be quoted with the following language: “If you’re for a public option, you actually don’t want to guarantee shit,” El-Sayed said. I think i'm going to stop swearing as of this moment, because it has reached a point of unlimited use and casual ugliness. There are far more ugly and frightening aspects lurking within this candidacy; but the casual ugliness is a spike on the graph that has grabbed me by the throat.
Prediction: El Sayed wins the primary as Stevens and McMorrow split the more moderate Democratic primary voters and Rogers wins the general election. Another Democratic circular firing squad election ensuring the Republicans keep the Senate.
I'm for runoffs if no candidate achieves 50% in primaries and general elections.
Great article by Cohn, giving us a nuanced look at all 3 candidates. Most articles about this race are fatalistic in one way or another and it is nice to have quality journalism here.
My pick is Abdul El Sayed. He is speaking to the frustrations of voters who are upset with the status quo. He is going to deep red places, meeting with rural voters, and speaking about issues that resonate across the political spectrum. He is not running a traditional far left campaign, it is very much a populist and working class campaign.
We need to dispell with the political wisdom that a purple state automatically requires the most moderate campaign. A lot of moderates and swing voters hold a range of conflicting views but the most consistent is a desire for change. That's why you get Obama to Bernie to Trump voters, it's constant rage at a political class they feel has failed them. Abdul's campaign is working at speaking to those people.
Since your discussion with the candidates touches on health care, I feel I should update your readers on the progress of what is being found out about the coverage drops from the lapsing of the ACA expanded subsidies that happened 1/1/26, at the insistence of the Republicans.
There is, in fact, some news--we can see more or the expected propaganda response to the large coverage drops, involving two or the expected participants: Dr. Oz and the Paragon Health Institute.
So, here is a key part of it: a Washington Post editorial, linking to a brand new Paragon Health Institute Report, and you can also find Dr. Oz (I'll link you to him in a Paragon video farther down.)
https://www.washingtonpost.com/opinions/2026/06/05/aca-enrollment-fraud-is-worst-states-that-didnt-expand-medicaid/
This is the new Paragon Health Institute Report
https://paragoninstitute.org/wp-content/uploads/securepdfs/2026/06/The_Persistent_Obamacare_Enrollment_Fraud_RELEASE_V1.pdf .
BACKGROUND:
Trump and the Republicans made the ACA expanded subsidies lapse on 1/1/26, and data is starting to roll in that about 3 to 5 million of the roughly 24 million who had ACA on-exchange coverage n 2025 will wind up losing coverage.
As well, information has been leaked that CMS knows about the losses, and was preparing a propagandistic response, indicating falsely that the coverage drops are mostly due to the administration's successful cracking down on ACA fraud. (Further, Charles Gaba caught that some data usually released in the past on coverage numbers has not been released.)
(The information sources on this summarized in a comment earlier on Krugman: https://paulkrugman.substack.com/p/unlocked-repost-curing-us-health-0b3/comment/266503150 .)
And then, catching a rather obscure New York Times story, I think I caught the propagandistic response starting, involving Dr. Oz and associates.
(As in this comment on Bernstein: https://econjared.substack.com/p/why-are-people-so-damn-mad/comment/261555717 ; yes, my comments can be kind of rabbit holes, as are the two linked to!)
But then, the puzzlement. I could detect no further propagandistic response.
But then, the Washington Post editorial.
https://www.washingtonpost.com/opinions/2026/06/05/aca-enrollment-fraud-is-worst-states-that-didnt-expand-medicaid/
(I have analyzed the relevant points of the new Paragon report a bit farther below.)
But first, since some are behind a paywall on the WP, let me give the main quotes, with the key links from the WP editorial:
"A new report (links to WP article: https://www.washingtonpost.com/politics/2026/06/02/conservative-group-alleges-6-million-were-fraudulently-enrolled-aca/ ) estimates that 6 million people are improperly enrolled in health coverage through the Affordable Care Act, costing taxpayers $25 billion annually. The scale of the fraud might seem implausible, but the evidence supporting it is compelling."
...
"The Paragon Health Institute is a conservative think tank founded by Brian Blase, who served as a White House health care adviser during President Donald Trump’s first term. Paragon’s report (https://paragoninstitute.org/wp-content/uploads/securepdfs/2026/06/The_Persistent_Obamacare_Enrollment_Fraud_RELEASE_V1.pdf ) on improper ACA enrollment, co-written by Blase and four others, is neither anti-immigrant fearmongering nor partisan rage bait. In fact, it paints red states in the worst light.
The five states with the highest estimates of improper enrollees (Florida, Texas, Georgia, South Carolina and North Carolina) all voted for Trump in 2024. The report says the incentives are strongest for enrollment fraud in states that did not expand Medicaid under the ACA, which tend to be red states."
...
"Here’s how the fraud works: The federal government provides subsidies up to the full premium for health coverage bought on the ACA exchanges for people with incomes between 100 to 150 percent of the federal poverty line. Unscrupulous intermediaries, such as brokers and agents, lie about the income or existence of applicants, who are then improperly approved for subsidies that go directly from the federal government to insurers. Those intermediaries receive commissions for signing up these phantom “customers.”Paragon researchers used Census Bureau data on the number of adults making between 100 to 150 percent of the federal poverty line in each state, minus the number of people covered by Medicare or Medicaid, to estimate the maximum number who could be eligible for the largest ACA subsidies. They found that the number of people who signed up for ACA coverage in the 2026 open enrollment window exceeded the maximum eligible population in 28 states, totaling 6.2 million improper enrollees nationwide.
Florida, where the scam seems to have been scaled most lucratively, had more than 3 million exchange enrollments in 2026 despite an estimated eligible population of 636,000. Thirteen states had enrollments in excess of 200 percent of the estimated eligible population.
The exact nature of the fraud can take many forms. Sometimes intermediaries sign up real people without their knowledge. Sometimes individuals misrepresent their income to qualify for subsidies, which the federal government did too little to punish for too long. Sometimes intermediaries enroll people already receiving coverage through Medicaid in duplicate coverage through the ACA. Sometimes they fabricate applications entirely.
Fabricated applications and applications submitted without a person’s knowledge are best for insurers, since fake people or people who don’t know they have coverage never file claims. The insurers, which deny any wrongdoing, get all the government subsidies with none of the costs. Previous Paragon research (https://paragoninstitute.org/paragon-prognosis/the-rise-of-phantom-obamacare-enrollees-biden-covid-credits-drive-massive-increase-in-individual-market-enrollees-with-no-medical-claims/ ) has found that 40 percent of individual market patients had zero claims in 2024, far higher than the 15 to 25 percent norm in ACA exchanges before the expanded subsidies."
--
From prior comments of mine that I linked to, if you trace through, you can find that Paragon's analysis last year, showing vast fraud due to "phantom enrollees", was questioned by major organizations with large technical staffs, and, as well, other conservative analysts.
And, as well, that it produced a graph that I'm pretty sure is erroneous, used by both John Thune and Mike Johnson, to justify not extending the ACA expanded subsidies. (Based on an erroneous cost-growth finding.)
One can see an issue with the Paragon research and recommendations even in just the WP quoted text. The fraud problem is worse in states which did not expand Medicaid.
Well, of course! You give people with an income below 100% of the Federal Poverty Level no legal option to be health insured unless they drop themselves to dirt poor in both income and assets to qualify for traditional Medicaid, and, duh, some will try cheating, and put their income over 100% of FPL to be health insured! (That is precisely what Medicaid non-expansion does. Again, duh!)
How Paragon and Republicans can not recommend that all states that have not expanded Medicaid do so, to repair both the incredibly inequity and rightful rage, and the incentive to fraud, is hard to fathom.
(This kind of thing is what makes it pretty clear to me that many policy analysts, Ph.D. in econ or not, are not smart enough to handle the problems we expect them to be able to handle!)
Another case: in Paragon recommending, and in fact allowing to happen, the lapse of the ACA expanded subsidies, without proposing a correction over the returned 400% FPL subsidy cliff, you have some people having to pay incredibly unaffordable amounts of money if their income nudges them above the cliff.
The the non-extension of the expanded subsidies, as it was done, produces a gross inequity, which will produce rightful outrage. And, what has happened: as here; https://normspier828307.substack.com/p/aca-2026-enrollment-after-expanded-1df
we see (caught by both Charles Gaba and me) about 280,000 people unexpectedly with incomes just a bit below the 400% of FPL subsidy cliff.
So, of course, many of them will have cheated to get there. This is what we expect in response to a rightful outrage at an incompetent policy hurting them so badly!
(Really, with some of the Ph.D.’s in various disciplines, you can’t tell if the problem is they can’t think very well, or if they can think, but their goal is simply propaganda.
From my limited experience, I’ve been able to detect that many Ph.D.’s even in quantitative areas, can’t analyze competently. At this point, a Ph.D. in physics or pure math might possibly certify an ability to reason adequately. I need more data on those fields. Other Ph.D.’s do not!)
Whoops--out of space. I have continued the comment as a reply to this comment. Here: https://www.thebulwark.com/p/issues-that-could-decide-michigan-senate-race-interviews-mcmorrow-stevens-el-sayed/comment/272097272 , if you can't find it.
(Comment continuation)
--
OK, after reading the PARAGON REPORT, here is what I see.
From the data in the report, Paragon really had difficulty defending what is apparently happening with large coverage loss, but they did the best they can, so I quote:
“Because of the expiration of the COVID-era subsidy boosts and the buildup of substantial improper and phantom enrollment, enrollment attrition will likely return closer to pre-COVID patterns. Assuming an 18 percent decline from this year’s open enrollment in 2026 would result in average monthly effectuated enrollment of about 19 million people in 2026—an amount still 90 percent higher than the pre-COVID average.”
So, while citing of “the buildup of substantial and improper phantom enrollment”, they are also pointing out a loss in eventual 2026 effectuated enrollment (“effectuated” means people who actually paid premiums) of 19 million, which is maybe 4 million down from the same number in 2025.
(This large drop numbers is what the CBO said would happen, and has also been reported by Charles Gaba, KFF, and the New York Times, using various non CMS sources, because CMS has not yet released that data.)
So, the 4 million drop is fully consistent with numerous people facing higher premiums, many living paycheck to paycheck in the very-low 1005-150% FPL income zone, and people in other income zones, dropping coverage.
Still, despite that, Paragon put in:
“Allowing the enhanced COVID-era ACA subsidy boosts to expire was a prudent policy change. The exchanges remain heavily subsidized, particularly for lower-income enrollees, and the underlying ACA subsidy structure continues to provide substantial premium assistance. In http://HealthCare.gov states, taxpayers still cover roughly 94 percent of premiums for the median subsidized enrollee, while nearly 70 percent of enrollees face monthly premiums below $100. The evidence presented in this report suggests that the exchange market remains saturated with subsidies, particularly for individuals claiming income between 100 and 150 percent FPL.”
(I would call these last two quoted paragraphs the expected propagandistic response.)
I might as well also toss in, that looking at the early 2026 data, they didn’t find much drop in fraud due to the administration’s anti-fraud activities. Quoting: “While the number of improper enrollees declined by about 250,000 from the 2025 open enrollment period, improper enrollment as a percentage of total enrollment held steady at about 27 percent of all enrollees.”
BONUS CONTENT: I have a recent Youtube of Dr. Brian Blase, who heads up Paragon, discussing things with Dr. Oz and a few others, here: https://www.youtube.com/watch?v=yKOoQNtgMFQ
(I’ve watched most of it, and I find it helpful, because I’m trying to figure out how well Dr. Blase has a grip on the analytical issues, and, as well, how much he’s just being a propagandist.
In the interchange with Dr. Oz, I caught two cases where Dr. Blase chose very propagandistic misleading framings, so he clearly does some propaganda.
I will attempt to point the particular cases out later, when I have some time.)
—
Also, I should point out, that although we have the misleading propagandistic response (within the Paragon report above) to the drop by millions in those enrolled on-exchange in 2026 vs 2025, we actually don’t have the data yet from CMS. (We have the propagandistic response, but not the data it is a response to. We do have the data from numerous other non-CMS sources, but not from CMS! And, we would usually have it from CMS. The data release seems to have been suppressed.)
Specifically, Charles Gaba reported some time ago (here: https://charlesgaba.substack.com/p/cms-posts-january-2026-medicaid-chip that the usual reporting of the data by CMS has been stopped:
"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."
Unfortunately, this increases the likelihood of a Rogers win in Michigan. It’s an evenly split state - the west side of the state has a lot of population that doesn’t vote D anymore. And the Trump R Party is putting up bad candidates. And now one of them will be carrying the flag and hurting Michiganders.
Abdul is also doing the work of meeting with voters in Michigan to try to win their support. I met with a volunteer for his campaign last week because he wanted to find out what farmers are concerned about in Michigan and then he held a meeting in our town a few days ago that I unfortunately wasn’t able to attend because of illness in our house, but from what I’ve heard some of the local well known farmers did attend, so they at least were willing to hear him out. I haven’t seen anything from Stevens campaign and McMorrow has been supposed to come to our town but that never happened, and they certainly didn’t do any outreach to local farmers. He also went to the local mosque, since our small town has the second highest percentage of Muslim population in the state outside Dearborn. I know there is a lot of worry about how electable he would be in Michigan, but I also know a lot of people who were Trump voters but also liked Bernie because they are fed up with how things work and nothing ever changes to help them, so if he is putting in the effort in this way, I don’t think it’s impossible for him to win statewide the way people from outside Michigan seem to think.
Yes, a few years ago when Bernie was running for president, my cousin in Wisconsin who is very conservative and was disgusted with the presentation of the panel of contenders, told me she was thinking of voting for Bernie. I cheered her on.
Michigander here. If El-Sayed wins the D primary, Michigan will vote for Mike Rogers.
You totally missed Steven’s Involvement with Aipak and support for Israel. Which is missing a lot. Even our beloved Mallory initially took Aipak money, then recognized her error. McMorrow will definitely be back. She positioned herself badly, but next time she will reject the Dems slow plodding routes to peace in Gaza. Both national and international issues are critical. Bernie Sanders called the game before others slowly got on board. I am a boomer but these are very much the millennial positions.
The question. Like every state, Michigan has literally 2 parts , but in fact three. Southern lower Michigan is largely Democratic. It’s also where the most people live. Middle of the state starts turning red, but with a lot less bodies. We have time to promote El-Sayed.
I really liked Mallory before she started her senate campaign and seems to have decided to just take the safe way and stick to centrist positions. Abdul hasn’t been afraid to take stances that he actually believes in and thinks will help us. I think that is what a lot of people are looking for, and he is also doing the work of meeting with voters as well, even in rural areas like mine.
I'm considerably more worried about holding Michigan than I am flipping Maine. Ugh.
Why? Abdul is running a campaign that seems similar to Platner’s in many respects, as far as policies they talk about and what they want to do, and he doesn’t have the baggage Platner does. Yes, he isn’t a white guy, but Michigan did elect Obama twice, and the same people who won’t vote for Abdul because of his last name are also absolutely convinced that Obama was secretly a Muslim and didn’t vote for him either, so I don’t think it is going to necessarily stop people for voting for him other than those who were already unreachable for Democrats anyway.
Maine is to the left of Michigan, *AND* has much more of a history of being friendly to "quirky" outsider candidates.
Platner also flattened all opposition, which shows his chops as a candidate whether he's my cup of tea or not (see Josh Marshall's excellent writeup on TPM, which I agree with entirely - he's a much better writer than me).
AES is a candidate wholly of the very online left, which is very happy to chase the "Genocide Joe" horseshoe theory folks and tell the consiserable numbers of upper-middle class/suburban MI voters (that have turned the state blue recently) to get bent. That's...an odd strategy for a state that sees lots and lots of 51/49 type elections.
I am a 2008 Obama-stan, and I'd still throw myself on a live grenade for him. Don't see any Obama in AES. If anything, McMorrow is the "Obama lane" candidate. I don't see any way she'd lose a 2026 general, but she might be dead in the water in the primary now (because it's been so successfully hyper-factionalized).
Stevens has electoral liabilities of her own, in that she seems to relish telling the left to get bent. Also not a great electoral strategy, in my view. She's probably 70/30 to win the general in 2026, but leave a lot of hard feelings in her wake.
AES would be a true coinflip, hoping that the wave is large enough to pull him across the line. You're turning a slam dunk into a 50/50, mostly for optics.
tl/dr, I know. But this whole primary seems to me like a full-on factional battle, like often happens in states where the general is a fait accompli. Doing it in a state like Michigan just seems insane to me.
The way it's been done before doesn't seem to be working so let's try something new. You can agree or disagree but that's what voters think and it could vault El-Sayed into the winners circle.
I'm 71 and the way things used to be done hasn't worked for quite a while but especially since the orange things takeover of the Republican party .
"This is the essence of the case for the Stevens candidacy: She will listen to every constituent group"
Unless that constituent group is a group of Michigan citizens demanding an end to their tax dollars being used to commit war crimes. Then, it's perfectly acceptable to treat said conatituent group as entirely irrelevant and unnecessary to political victory!