Over the past few months, I've written overviews of the preferred Big Healthcare Reform proposals from several of the Democratic Presidential candidates:

A few weeks ago I noted the following press release from Democratic Virginia Governor Ralph Northam, just ahead of the critical state legislative elections:

It took me a couple of days to post this, but it's an important development, especially on the cusp of the Virginia legislative election next month which could flip both the state House and Senate to the Democrats; thanks to Esther Ferington for the heads up:

Governor Northam Signs Executive Directive to Ensure Access to Affordable, Quality Health Care Coverage for All Virginians

“Health coverage should be both meaningful and affordable, but unfortunately, policies from Washington threaten to increase the number of families who are uninsured or underinsured,” said Governor Northam. “It’s more important than ever that we identify and implement policies at the state level that control costs and ensure that Virginians can afford to buy health insurance that covers their health care needs.”

Disclosure: HealthSherpa has a banner ad on this site...for the following reasons:

  • Their website only sells ACA-compliant plans.
  • They display all of them equally (as opposed to hiding or favoring one over another).
  • They only sell them on-exchange (if you're eligible for ACA subsidies you get them through HS's site as well)
  • They make it easy to enroll fro Medicaid/CHIP if the enrollee isn't eligible for a subsidized ACA policy.

It's really, really important to me to make the above very clear, for the following reasons as laid out by Tara Straw of the Center on Budget & Policy Priorities:

This was posted by NJ Governor Phil Murphy a week ago but it's still noteworthy, especially considering that NJ is in the process of splitting off from HC.gov onto their own full ACA exchange next year as Nevada just did:

Governor Murphy and New Jersey Department of Banking and Insurance Kick Off ACA Open Enrollment Period

Governor Announces Strengthened ACA Efforts, including $3.1 Million to Support Outreach and Enrollment Efforts and Bolstered Get Covered NJ Awareness Campaign

TRENTON – Governor Phil Murphy, joined by Department of Banking and Insurance (DOBI) Commissioner Marlene Caride and enrollment assisters from across the state, today announced Navigator grant awards totaling $1.1 million to provide enrollment assistance to residents shopping for health coverage during the six-week open enrollment window. DOBI plans to release approximately $500,000 more in grants in the coming days.

HEALTHCARE TOWN HALL: A PLAN FOR OAKLAND COUNTY

Please join us for a Health Care Forum with Andy Meisner. We will be focusing on the issues and proposed solutions for Oakland County.

November 12th, 6:30pm in Room 218 at West Bloomfield High School, 4925 Orchard Lake Road, West Bloomfield

Panelists include:

This just in via MNsure (Minesota's ACA exchange):

MNsure update on first week of open enrollment

ST. PAUL—MNsure CEO Nate Clark issued the following statement recapping the first full week of open enrollment:

“MNsure has seen strong and steady interest during the first week of open enrollment. Minnesotans have six weeks left to sign up for their 2020 coverage. Remember, MNsure is the only place Minnesotans can get access to tax credits that could lower premium costs. We’ve also got a statewide network of assisters who offer free, in-person help so consumers can be sure they’re finding the health care plan that meets their needs.”

Open enrollment figures will be released next Wednesday (11/13) at MNsure’s public board meeting at 1 p.m.

By the numbers: As of end of day, November 7

 

Please watch this interview with Hillary Clinton. The whole thing is worth watching, but the portion about healthcare policy and the best route forward starts at around 9:20 in and runs less than 7 minutes, to 16:00 (It's supposed to be cued up to exactly 9:20 but you may have to scrub forward to get to it depending on your device).

Please take 6 minutes and 40 seconds out of your day to actually listen to the words which are coming out of her mouth.

UPDATE: Full, verbatim transcript by yours truly:

Andrew Ross Sorkin: “I want to talk to you a little bit about healthcare, because I know it’s an issue that you care about deeply and have thought a lot about.”

Hillary Clinton: “I have.”

Sorkin: “Because we seem to be in a very divided world, not just among two different parties, but even within the Democratic Party. Medicare for All versus a Public Option. You look at what Elizabeth Warren presented last week, and you think...what?”

*("Week One" is a misnomer...see highlighted explanation below)

This Just In from the Centers for Medicare & Medicaid...

Federal Health Insurance Exchange Weekly Enrollment Snapshot: Week 1

Week 1, November 1-November 2, 2019

In week one of the 2020 Open Enrollment, 177,082 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday. Consequently, week one was only two days long this year - from Friday to Saturday.

Every week during Open Enrollment, the Centers for Medicare & Medicaid Services (CMS) will release enrollment snapshots for the HealthCare.gov platform, which is used by the Federally-facilitated Exchange and some State-based Exchanges. These snapshots provide point-in-time estimates of weekly plan selections, call center activity, and visits to HealthCare.gov or CuidadoDeSalud.gov.

About a year and a half ago, U.S. Senator Tammy Baldwin (D-WI) introduced a bill which would cut down on ACA premiums considerably for younger enrollees by beefing up the subsidy formula for the so-called "Young Invincible" population: Adults between 18 - 34 years old. Last week, she re-introduced the bill along with U.S. Representative Don McEachin (D-VA).

While the bill, titled the "Advancing Youth Enrollment Act", wouldn't have nearly as much impact on premiums or enrollment as the more expansive ACA 2.0 bills I've been promoting (H.R. 1868 & 1884 in the House; S.1213 in the Senate), anything which reduces premiums for more people without reducing patient protections or coverage standards is always a good thing in my book, so I'm happy to give Baldwin's bill another shout-out:

The Advancing Youth Enrollment Act lowers health care costs while maintaining critical ACA protections

In 2015, Republican Matt Bevin campaigned for governor on two major healthcare-related platforms:

  • Eliminate the state's perfectly-functioning, award-winning, highly-praised and beloved ACA exchange, "kynect" for no particular reason other than spite.
  • Eliminate the state's ACA Medicaid expansion program, which as of this writing provides around 480,000 low-income Kentuckians with healthcare coverage.

For some inexplicable reason, voters in Kentucky elected him regardless. Once he got into office, he did indeed make good on the first promise, shutting down the state's perfectly good ACA exchange platform and shifting KY to the federal exchange at HealthCare.Gov.

When it came to eliminating Medicaid expansion, on the other hand, he found it to be a little bit tougher than expected; actually pulling the plug on nearly half a million people's healthcare coverage proved to be a tougher nut to crack than he thought.

via the Idaho Statesman:

About 35,000 Idaho residents have signed up for Medicaid under expanded coverage in the first few days it has been offered, state officials said Monday.

The Department of Health and Welfare said that's more than a third of the estimated 91,000 people who are eligible. The agency started taking applications Friday, and it is tracking numbers on its website.

That's the good news. Of course, Republican legislators couldn't leave well enough alone:

Voters authorized Medicaid expansion last year with an initiative that passed with 61% of the vote after years of inaction by state lawmakers. But lawmakers earlier this year added restrictions requiring five waivers from the U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services.

...Most recently, Idaho last month submitted a waiver requiring patients to get referrals from primary physicians before they can get family planning services such as birth control, abortions or pregnancy care.

The original purpose of this website was, of course, to do real-time (or close to real-time) tracking of how many people actually select Qualified Health Plans (QHPs) via the ACA exchanges.

Every year I start out with a "blank" with my projections for how I think the upcoming Open Enrollment Period (OEP) will play out. For 2020, however, I'm just overlaying 2019's enrollment patterns on the graph (for both the federal and state exchanges) to see how things play out year over year.

There's some important things to keep in mind for the 2020 OEP:

A few weeks ago, I said the following about Sen. Elizabeth Warren regarding healthcare policy:

  • I'm generally supporting Elizabeth Warren in the Democratic Primary (not a full endorsement, but I've been strongly leaning her way for awhile now)...

HOWEVER, for the time being at least, that seems to be where she's decided to lay her marker, so it is what it is.

(Note: Since then, I've publicly stated that I'm now leaning more towards Sen. Kamala Harris who was always my strong #2 choice. This doesn't mean I no longer like Warren--the two have simply swapped places in my #1 and #2 column.)

 

I'm very pleased to see this.

I've made quite a bit of fuss about California expanding availability of ACA financial subsidies to those earning 400 - 600% of the Federal Poverty Line ($75K for a single person, $154K for a family of four). The subsidies aren't massive for most people, but for hundreds of thousands of Californians--especially older folks earning between 400 - 450% FPL--this is a huge savings. In addition, they're sweetening the subsidies somewhat for those already receiving ACA tax credits.

The only real concern I had about this is whether enough people in California know about it. Just like with reinstating the mandate penalty (which California has also done this year), expanding & enhancing ACA subsidies isn't gonna cause a spike in enrollment if no one knows they're available. A lot of people who might have checked into it in prior years isn't likely to bother taking another look if they don't know that the income cut-off threshold has gone up, and many others have never bothered trying in the first place because they "heard somewhere" that they won't qualify.

This press release came out last week but I covered all the other state-based exchange Open Enrollment press releases so I figured I should include this one as well:

Covered California for Small Business Announces Expanded Choices and an Average Rate Change of 4.1 Percent for 2020

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