Charles Gaba's blog

Back in July, just ahead of the 2nd Democratic Presidential Candidate Debate here in Detroit, I laid out what my question would be (If I could only ask one question) for the various candidates.

The wording of the first part varied somewhat depending on the candidate's position on healthcare policy, but the second part was identical for each. Here's how I worded it for Bernie Sanders:

"Senator, you've long been a staunch advocate of moving to a universal, mandatory, single-payer healthcare system which you call "Medicare for All", and have publicly rejected any proposal which includes cost sharing at the point of service or which continue to allow private major medical plans as not being acceptable.

However, until this year you were also a co-sponsor of Senator Warren's "Consumer Health Insurance Protection Act", or CHIPA, which amounts to a robust ACA 2.0 bill, and until recently you were also a co-sponsor of Senator Schatz's "State Public Option Act" which amounts to a Medicaid buy-in plan.

In March 2019, Linda J. Blumberg, Matthew Buettgens, John Holahan and Clare Wang Pan of the Urban Institute ran a detailed analysis to determine what the impact on healthcare coverage would be in every state if the Texas vs. U.S. lawsuit (aka Texas vs. Azar or #TexasFoldEm) caused the Patient Protection & Affordable Care Act (ACA) to be repealed with immediate effect.

They also attempted to calculate how much federal funding every state would lose each year if the ACA were to be repealed as a result of the absurd Texas vs. U.S. (aka #TexasFoldEm) lawsuit.

Nationally, they concluded that the U.S uninsured rate would increase by nearly 20 million people, while the 50 states (+DC) would collectively lose out on nearly $135 billion in federal funding.

Here's my original post on yesterday's 5th Circuit Court of Appeals ruling in the absurd Texas vs. U.S. (aka Texas Fold'em) lawsuit.

The bottom line for What This Means is:

  • The ACA remains the law of the land and likely will remain that way for at least another year.
  • Having stated the above, the ACA is still indeed very much in jeopardy. Going forward, the case will follow one of two possible routes:
    • Officially, it's supposed to go back to the judge who ruled against the ACA in the first place a year ago to "reconsider" which parts of it can be "saved"...after which it would then go back to the 5th Circuit Court of Appeals, and then to the U.S. Supreme Court. That full process could take well over a year.​​​​​​​
    • However, it's possible that the Supreme Court will intervene and agree to take the case up instead of it going to the original judge first, which is what the defending states are now requesting. This full process...could still take up to a year, although it's conceivable that a final ruling would be issued before the election.

Well, as if Impeachment Day wasn't tense and historic enough already, the 3-judge panel of the 5th Circuit Court of Appeals has finally issued their decision on the Texas vs. U.S. (aka Texas vs. Azar, aka Texas Fold'em) lawsuit intended to strike down the entire Affordable Care Act:

Before KING, ELROD, and ENGELHARDT, Circuit Judges. JENNIFER WALKER ELROD, Circuit Judge:

This just in from Covered California:

Covered California Releases New Enrollment Data and Issues Reports on Five Years of Improving Affordability, Access and Accountability

  • Covered California announced that there are more than 230,000 new plan selections during the current open enrollment period – up approximately 16 percent over this time last year. More than 1.15 million people have also renewed their coverage.
  • In addition, more than 540,000 people will receive new state subsidies that will make quality health care coverage more affordable in 2020.
  • The agency also released two extensive reports that detail Covered California’s impacts on lowering costs and assuring quality care in its implementation of the Affordable Care Act.
  • Since 2013, California has reduced its uninsured rate by more than any other state in the nation has by expanding Medi-Cal, investing in marketing and outreach and keeping costs low for consumers.
  • California’s individual market consistently ranks among the healthiest in the nation, helping unsubsidized consumers save about $1,550 annually in 2018 on their premiums compared to consumers in the federal marketplace.
  • Covered California’s open-enrollment period runs through Jan. 31. Consumers must sign up before the end of Dec. 20 for their coverage to start on Jan. 1. California is one of 10 state marketplaces that are still open for business, representing 28 percent of Americans.

I actually already reported this yesterday, but it's good to have the formal press release as well, which includes additional details:

Nevadans Who Started Their Enrollment Applications on or Before the Dec. 15 Deadline Have Until Dec. 20 to Complete Applications for Coverage that Begins on Jan. 1 2020

Carson City, Nev. – The Silver State Health Insurance Exchange (Exchange), Nevada’s state agency that helps individuals obtain budget-appropriate health coverage through the online marketplace, Nevada Health Link, has extended its Open Enrollment deadline to 11:59 p.m. PST Friday, Dec. 20 for consumers who started the application process on or before the Dec. 15 midnight Open Enrollment deadline.

"We recognize the enrollment process for health insurance can be time-consuming. That’s why we are giving consumers five extra days to complete their application to purchase plans for coverage that begins Jan. 1, 2020," said Heather Korbulic, executive director, Silver State Health Insurance Exchange.

via MNsure by press release:

Less Than a Week to Enroll; MNsure's Open Enrollment Period Ends December 23

ST. PAUL, Minn.—Minnesotans have until 11:59 p.m. on Monday, December 23, to enroll in coverage through MNsure. After that date, Minnesotans will only be able to enroll in private health insurance coverage through MNsure if they qualify for a special enrollment period.

"Anyone with questions or who needs help enrolling should phone our Contact Center or reach out to a MNsure-certified assister,” said MNsure CEO Nate Clark. “We’re here to help. Don't wait until the last minute—get covered today!”

MNsure will have extended Contact Center hours leading up to the deadline: 

via the Maryland Health Connection press release:

158,600 MARYLANDERS ENROLLED THROUGH MARYLAND HEALTH CONNECTION

  • 2020 enrollment total largest in four years

BALTIMORE (DEC. 17, 2019) – A total of 158,600 Marylanders enrolled in private health coverage for 2020 on Maryland Health Connection, the largest enrollment in four years on the state-based health insurance marketplace.

That was 1,637 more enrollees than a year ago when 156,963 enrolled. It was also the largest enrollment on the health insurance marketplace since 2016 when 162,652 enrolled. Enrollments for 2020 coverage grew in 20 of 24 jurisdictions.

The 45-day open enrollment period for the coming plan year began Nov. 1 and ended Sunday. A few hundred additional enrollments will be completed this week for consumers who had begun the process but hadn’t finished by Sunday night.

via Connect for Health Colorado:

Connect for Health Colorado Extends Enrollment Deadline for January Coverage to Dec. 18, 2019 

DENVER –  To help as many people as possible get Jan. 1, 2020 coverage, Connect for Health Colorado is pleased to announce that the deadline to get coverage on Jan. 1 has been extended. Coloradans have until 11:59 p.m. on Wednesday Dec. 18, 2019 to sign up for a health insurance plan that starts on Jan. 1, 2020.

To sign up for coverage that begins Jan. 1, 2020, Coloradans must take the following steps: 

1. Complete an application and select a health insurance plan online at ConnectforHealthCO.com, over the phone at 855-752-6749, or by working with a certified enrollment expert by 11:59 p.m. on Wednesday, Dec. 18.

OK, this isn't much of an extension, since the DCHealthLink.com exchange already lets people enroll as late as January 31st...but it's still important:

DC Health Link didn’t have any website issues on Sunday 12/15, but we know that news for other states may have caused confusion.

You now have until December 18 to sign up for a plan that starts January 1.

Visit DCHealthLink.com

#GetCoveredDC
#StayCoveredDC 

In response to tremendous pressure after yesterday's major technical issues at HealthCare.Gov, CMS Administrator Seema Verma just announced that the deadline for people to #GetCovered in the 38 states which host their ACA enrollment platform with HealthCare.Gov will indeed be extended by 2 days:

We at @CMSGov want to ensure a seamless shopping experience for everyone seeking coverage, so starting at 3 pm ET today, we are extending the marketplace #OpenEnrollment deadline until 3 am ET December 18! https://t.co/HmVdpJlX2C

— Administrator Seema Verma (@SeemaCMS) December 16, 2019

(I originally misread this as being a 3-day extension, but it's only 2 days, since it runs through midnight Pacific Time on Tuesday.)

OK, this is about as obscure of an "announcement" as I can imagine: Per a heads up from Louise Norris, if you visit the Washington HealthPlan Finder website this morning, there's a simple message at the top reading:

 

There's still time to get covered. Sign up by Dec. 30 to get coverage that starts Feb 1st.

That's it. There's no link to a press release, there's nothing in their "news announcements" archive, and as of this writing there's no tweet from their Twitter account announcing it...just that simple text message.

I'll update if/when there's a formal announcement, but until then...it appears that Washington State residents do indeed have another 16 days to #GetCovered after all, even if they'll face a one-month gap in coverage.

UPDATE: Confirmed:

Still need to sign up in a health plan? You're in luck!

Enroll in a plan from now through Dec. 30 at 8pm to receive coverage starting Feb. 1, 2020. #GetCoveredWA

Just another quick update from AccessHealthCT:

As of today, their press release page states the following:

Stats as of December 13, 2019:

Qualified Health Plans (QHP):

  • Net Total QHP Enrollment: 102,589
  • 2020 OE Acquisition Summary: 15,067

Overall Volume

  • Unique Website Visitors: 157,591
  • Calls Handled: 152,733

Medicaid: Completed applications/redeterminations processed through the integrated eligibility system: 35,231

This was as of 12/13, so it's missing the last 2 days of Open Enrollment signups. They would have to have added another 8,500 people in the final two days in order to beat last year's total of 111,066.

Dammit, I took a couple of hours off to rewatch The Force Awakens with my kid (in anticipation of The Rise of Skywalker coming out this week), and look what happens...

HealthCare.Gov is not letting people login to enroll. This is the second outage, the first lasted 15 minutes. We're 8 minutes into the second. Last time this happened, 100k people could not enroll. @CMSGov must extend the deadline.

— Joshua Peck (@JoshuaFAPeck) December 15, 2019

When I loaded the site, I got the same error screen...but when I refreshed, the login screen came back up again.

This just in from Covered California, CA's ACA exchange:

Due to high call volume and enrollment demand, @CoveredCA will extend the deadline for Jan. 1 coverage through midnight next Friday, Dec. 20. That means consumers have an extra 5 days to sign up for #ACA #healthcare coverage for all of 2020. Check rates.

— Covered California News (@CoveredCAnews) December 13, 2019

ALERT: The deadline to enroll in health insurance starting January 1 has been extended to midnight on December 20. Don't wait and get covered!

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