Charles Gaba's blog

The data below comes from the GitHub data repositories of Johns Hopkins University, except for Utah, which comes from the GitHub data of the New York Times due to JHU not breaking the state out by county but by "region" for some reason.

Important:

  • Every county except those in Alaska lists the 2020 Biden/Trump partisan lean; Alaska still uses the 2016 Clinton/Trump results (the 2020 Alaska results are only available by state legislative district, not by county/borough for some reason...if anyone has that info let me know)
  • I define a "Swing District" as one where the difference between Biden & Trump was less than 6.0%. FWIW, there's just 187 swing districts (out of over 3,100 total), with around 33.7 million Americans out of 332 million total, or roughly 10.2% of the U.S. population.
  • For the U.S. territories, Puerto Rico only includes the case breakout, not deaths, which are unavailable by county equivalent for some reason.

With those caveats in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Thursday, April 20th, 2021 (click image for high-res version).

  • Blue = Joe Biden won by more than 6 points
  • Orange = Donald Trump won by more than 6 points
  • Yellow = Swing District (Biden or Trump won by less than 6 points)

Quick: Run a Google search for "Obamacare" or "Health Insurance" and see what the first listings which come up are. The odds are pretty high that the first listing won't be HealthCare.Gov, Pennie.com, CoveredCA.com or any of the other state-based ACA exchanges. In fact, the first link which comes up probably won't even be for Blue Cross Blue Shield, Molina or Centene (the actual health insurance carriers themselves).

It's far more likely that the most prominent sites to come up in Google's paid search listings will be third-party health insurance brokers. If you click on the link, you may be taken to a legitimate health insurance broker authorized to sell on-exchange ACA policies...or you may be taken to a fly-by-night quasi-legal outfit which either pushes junk plans or simply resells your contact info to fourth-party scammers. In many cases, they may even include the terms "Obamacare" or "ACA" baked into their names:

I've noted before that enrollment in Michigan's ACA Medicaid expansion program, "Healthy Michigan", has risen sharply over the past year since the COVID-19 pandemic hit; it's up by over 1/3 since last February.

However, it's also worth noting that non-ACA Medicaid enrollment has also jumped significantly since the pandemic arrived. I've dug into data from the Centers for Medicare & Medicaid, the Kaiser Family Foundation and Michigan's Health Dept. archives and put together the graph below, showing that non-ACA Medicaid enrollment has risen from around 1.66 million Michiganders in February 2020 to over 1.92 million today, a 16% increase.

Combined, total Medicaid enrollment is up by around 21% to over 2.82 million as of April 2021.

I should also note that in addition to this, 267,000 Michiganders enrolled in ACA exchange coverage during the 2021 Open Enrollment Period, of which a good 90% (240,000)paid their first monthly premium based on past ACA data. At the time I noted that around 83% were subsidized, or perhaps 200,000.

Around half the 50 states (+DC) expanded Medicaid under the Affordable Care Act starting in 2014. Since then, roughly half of the remaining states have also done so, either via executive order by the Governor, a new state legislature coming around or, most frequently, via statewide ballot initiative.

Idaho is an example of the latter: In November 2018, voters in Idaho (along with Utah and Nebraska) passed a ballot proposal to fully expand Medicaid under the ACA. After some legal wrangling, the state officially launched Medicaid expansion starting in January 2020, with more than 35,000 Idahoans signing up within the first few days of being allowed to do so.

Your Health Idaho Logo

This Just In from Your Health Idaho:

Final Deadline for 2021 Health Insurance is April 30

  • Last Chance for Idahoans to Receive Enhanced Subsidies

BOISE, Idaho – Your Health Idaho, the state health insurance exchange, announced the final day to enroll in 2021 health insurance, without a Qualifying Life Event, is April 30.

“This is the last chance for Idahoans to take advantage of the increased tax credits and enroll in 2021 coverage,” said Pat Kelly, Your Health Idaho Executive Director. “These savings can be significant for Idaho families who may have thought health insurance was out of reach prior to the American Rescue Plan Act.”

I've confirmed that unlike other state exchanges which have bumped out their deadlines repeatedly, Your Health Idaho explicitly does not intend on extending this deadline out again: April 30th is the final deadline.

After extending the special enrollment period deadline from March 31, exchange officials are urging Idahoans to apply for savings from a health insurance tax credit and make their final plan selection by 11:59 p.m. (MT) on Friday, April 30.

Nevada Health Link Logo

via Nevada Health Link:

Nevada Health Link Announces Health Insurance Savings Through the American Rescue Plan Act

  • Nevadans seeking health coverage can access increased or expanded subsidies and premium savings, healthcare tax credits, expanded COBRA protections and increased plan options

CARSON CITY, Nev. (April 16, 2021) – Nevada Health Link, the online health insurance marketplace operated by the state agency, the Silver State Health Insurance Exchange (Exchange), is offering even bigger coverage savings to eligible uninsured and insured off-Exchange Nevadans. These new enhancements are in accordance with the newly-enacted American Rescue Plan Act (ARPA or American Rescue Plan) of 2021 passed by Congress and signed into law by President Biden on March 11, 2021.

The Urban Institute has come out with a brand-new analysis which projects the impact of making the ACA subsidies which have been expanded & enhanced temporarily under the American Rescue Plan permanent. In other words, this is what they expect the real-world impact would be if Congress were to finally #KillTheCliff and #UpTheSubs permanently (as opposed to for just 2021 - 2022), as I and other healthcare activists been pushing for for years now.

A couple of weeks ago, I used the COVID Special Enrollment Period (SEP) data I had for HealthCare.Gov through the end of March, combined with limited SEP data from some state-based ACA exchanges, to extrapolate out a rough estimate of how many new Qualified Health Plan (QHP) selections may have happened since the new "Spring 2021 Special Enrollment Period" was launched on February 15th, 2021.

At the time, I estimated that perhaps 15,800 people per day on average had newly enrolled in ACA exchange policies as of the end of March, or roughly 710,000 nationally. This included the 528,000 confirmed enrollees via HealthCare.Gov, plus another 183,000 or so via the 15 state-based exchanges.

via Pennie:

Savings to the Rescue – Pennie is Now Open with Increased Savings

  • Pennie Customers Can Now See Savings When Shopping for Health Coverage
  • Uninsured Pennsylvanians will be able to receive significant savings in health coverage as a result of the American Rescue Plan

Harrisburg, PA – April 16 – As a result of the recent American Rescue Plan, also known as the COVID-19 relief package, provisions specific to the Affordable Care Act have impacted the way health insurance is available in Pennsylvania. These provisions include significant impacts, including an increase in savings, for Pennsylvanians seeking individual market coverage and those already enrolled through Pennie, as well as those who may lose their employment and rely on COBRA to maintain their employer coverage. Pennie is excited to announce that these savings are now available at pennie.com for those looking to enroll in quality, affordable coverage.

Get Covered NJ Logo

via Get Covered NJ:

Good news! More financial help is now available through Get Covered New Jersey

New Federal and State Savings

The federal government recently passed a COVID-19 relief bill, the American Rescue Plan Act of 2021, which was signed into law by President Biden on March 11, 2021. The new law will reduce health insurance premiums by providing more financial help to eligible consumers who purchase a plan through Get Covered New Jersey. The State of New Jersey is also providing more financial help to lower health insurance costs for residents enrolling at Get Covered New Jersey.

More people than ever will qualify for financial help. If you did not qualify for financial help before because your income was too high, you may qualify under the state and federal changes. If you already receive financial help, you will likely be eligible for additional premium reductions. These new changes make coverage more affordable at many income levels.

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