Charles Gaba's blog

On April 14th, Covered California reported that 58,000 residents had enrolled in ACA exchange coverage during their COVID-19 Special Enrollment Period, of which roughly 20,000 did so via standard SEPs (losing coverage, moving, getting married/divorced, etc), while an additional 38,000 took advantage of the COVID-specific SEP.

On April 28th, they announced that the number was up to 84,000 new ACA exchange enrollees, averaging around 2.5x as many as enrolled via standard Special Enrollment Periods during the same period a year ago.

Today they issued another update:

Covered California Sees More Than 123,000 Consumers Sign Up for Coverage During the COVID-19 Pandemic

Note: I've been distracted by my county-level COVID19 tracking project for the past couple of weeks, so I'm posting a series of entries on various ACA/healthcare policy developments which I've missed along the way.

Back in 2016, many health insurers which had been losing money hand over fist on the ACA individual market (in spite of many making record profits in other divisions) decided to bail on the ACA market entirely. Of these, the biggest shocks to the system were Aetna, Humana and UnitedHealthcare, each of which pulled out of multiple states, and UHC bailing was the biggest blow of all:

Note: I've been distracted by my county-level COVID19 tracking project for the past couple of weeks, so I'm posting a series of entries on various ACA/healthcare policy developments which I've missed along the way.

I've missed a lot of stuff while busy diving down the rabbit hole of my county-level COVID-19 spreadsheet tracking project. This happened last week so I guess it's old news by now, but it's still both a sign of the times as well as of how hypocritical so many Republicans are about the Affordable Care Act:

Sen. John Cornyn (R-Texas) sat down for an interview yesterday with PBS Austin's Judy Maggio, who raised concerns about "holes in the safety nets" affecting many Texans. Specifically, the host noted that as more people lose their jobs during the pandemic, they're also losing their health security. Maggio asked the Senate Republican about possible federal efforts for those who are now "wondering what they're going to do for health insurance."

Cornyn's response was ... unexpected.

I've made major progress in updating and revising my breakout of COVID-19 cases and fatalities at not just the state level but the county level, and should now be able to post updated summaries of the worst-hit counties on a weekly basis.

Due to the sheer volume of data involved, I've had to separate out the states into two separate spreadsheets:

All data below is up to date as of Saturday, May 16th, although due to variances in when different states report the data, some of the data may be from a day earlier. The counties are color-coded depending on whether they voted for Donald Trump (orange) or Hillary Clinton (blue) in 2016.

Annnnnd we're off! In the middle of a deadly global pandemic which has already killed more than 85,000 Americans and completely disrupted the entire U.S. healthcare system, private insurance carriers still have to go about preparing their annual premium rate change filings for 2021. This is a long, complicated process which begins a good nine months before the new plans and prices are actually enrolled in.

The task of setting 2020 premiums was the first time since the ACA went into effect which was relatively calm for insurance carrier actuaries. Unlike setting rates for 2014 or 2015, they weren't dealing with a complete overhaul of the entire insurance industry. Unlike 2016-2017, they weren't dealing with the prospect of ACA premiums being crippled for 3/4 of the country (via King v. Burwell) or the fallout of the Risk Corridor Massacre. Unlike 2018, they weren't dealing with how to deal with CSR rembursements being cut off or the entire ACA being repealed by Congress. Unlike 2019, they didn't have the unknown impact of the individual mandate being repealed to consider.

Every year, I spend months painstakingly tracking every insurance carrier rate filing for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease.

Carriers jump in and out of the market, their tendency repeatedly revise their requests, and the confusing blizzard of actual filing forms which sometimes make it next to impossible to find the specific data I need. The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier:

Believe it or not, even though Delaware is a fairly solidly blue state in Presidential elections, two of the three counties there (it's pretty small) voted for Donald Trump in 2016. Here's how the state's cases have shifted over time between New Castle County (the largest of the three, which voted for Clinton) and the other two counties which voted for Trump:

This is almost a complete reversal, with New Castle going from 2/3 of all cases at the beginning of April to just 1/3 today:

A few weeks ago, I posted a detailed analysis of how the COVID-19 virus has been spreading throughout Wisconsin. I noted that while the outbreak originally spread quickly in the more urban/blue-leaning areas, that has gradually changed over time, with the virus spreading to the rest of the state--including rural, conservative-leaning areas--at a faster rate while it slowed down in the urban areas.

It's time to check in to see whether that trend has continued...and sure enough, it has. Here's what this trend looks like visually:

A few weeks ago, I posted a detailed analysis of how the COVID-19 virus has been spreading throughout my home state of Michigan. I noted that while the outbreak originally spread quickly in Detroit and the more densely-populated Metropolitan Detroit region (Wayne, Oakland and Macomb counties), that has gradually changed over time, with the virus spreading to the rest of the state--including rural, conservative-leaning areas--at a faster rate while it slowed down in the urban areas.

It's time to check in to see whether that trend has continued...and sure enough, it has:

On March 20th, the Vermont Health Connect ACA exchange joined other state-based exchanges in launching a formal COVID-19 Special Enrollment Period.

On April 15th, just ahead of the original SEP deadline, they bumped it out by a month:

Due to the COVID-19 emergency, Vermont Health Connect has opened a Special Enrollment Period until May 15, 2020. During this time, any uninsured Vermonter can sign up for a Qualified Health Plan through Vermont Health Connect. Qualified families can also get financial help paying for coverage.. Please call us at 1-855-899-9600 to learn more.

Well, today, with the revised deadline approaching, I took a look and sure enough, they've bumped it out another month:

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