Way back in October 2013, I launched the ACA Signups project as a light, nerdy hobby thing which was only supposed to last around six months, through the end of the first ACA Open Enrollment Period (March 31, 2014). Instead...well, let's just say that it's more than seven years later and I'm still doing this.

The reality is that The Graph itself doesn't serve a whole lot of useful function anymore. The enrollment patterns were erratic the first couple of years but have since settled into a pretty predictable...if not downright boring pattern for both the federal and state exchanges. The main reason I keep doing it each year is mostly out of tradition these days; after all, without The Graph, there wouldn't be an ACA Signups and I wouldn't have become a healthcare policy wonk in the first place.

Access Health CT, Connecticut's ACA exchange, is posting updates to their Open Enrollment Period (OEP) numbers every Friday. Last week they reported 99,406 Qualified Health Plan (QHP) selections during the first 6 days of the 2021 OEP, which sounds more impressive than it is, since 98,127 of those are current enrollees having their auto-renewals front-loaded; only 1,279 of them are actually new enrollees. Nothing wrong with that, of course.

This week, they report that they have 99,952 total QHP selections, of which 2,696 are new. On the surface this sounds off...shouldn't it be 100,823 total? I'm pretty sure the reason for the discrepancy is that not every current enrollee actually renews/re-enrolls for the following year. The exchange plugs them in as renewing, but they can still go in and actively cancel their renewal, which reduces the total a bit. In this case, it sounds like 871 current enrollees have done so over the past week. This gives a net increase of 546 over the past week, or 78 per day.

The Washington ACA exchange has reported their initial numbers, and like Connecticut, the top figure is a bit misleading: 182,000 Washingtonians enrolled in the first four days!...except that, again, 99% of these are current exchange enrollees having their auto-renewals front-loaded:

Washington Healthplanfinder reminds Washingtonians that open enrollment has started, encouraging those seeking health coverage to visit WAhealthplanfinder.org to shop, choose, and save on health and dental coverage.

“Our focus remains on encouraging customers to review their options and sign up for coverage that meets their needs,” said Exchange Chief Executive Officer, Pam MacEwan. “The 2021 open enrollment period has begun, and residents should use this opportunity to access coverage that will last them all year.”

Every Open Enrollment Period (OEP) for for the past several years, the Centers for Medicare & Medicaid (CMS) have issued a Weekly Snapshot Enrollment Report including the top-line Qualified Health Plan (QHP) enrollment data via HealthCare.Gov for that week along with the cumulative totals. They normally post these reports, which run Sunday - Saturday, on the following Wendesday...but yesterday came and went without one being released this year.

Given the insanity surrounding last week's Presidential election (along with the results) and the ongoing COVID19 pandemic, I was beginning to wonder whether they'd bother issuing those reports at all. Fortunately, they followed through late this afternoon:

Week 1, November 1-November 7, 2020

In week one of the 2021 Open Enrollment period, 818,365 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday. 

This is kind of interesting. It looks like the Nevada Health Link (NV's state-based ACA exchange) is offering something new this year:

Nevada Health Link connects consumers to VSP Individual Vision Plans, in time for Open Enrollment 2021

Carson City, Nev. – The Silver State Health Insurance Exchange (Exchange), the state agency that connects Nevadans to Qualified Health Plans (QHPs) through the online State Based Exchange (SBE), known as Nevada Health Link, announces a partnership with VSP® Individual Vision Plans, an offering of VSP Vision Care, the only national not-for-profit vision benefits company.

The Open Enrollment Period for 2021 insurance plans runs from Nov. 1, 2020 through Jan. 15, 2021. Health plans offered through Nevada Health Link are ideal for Nevadans who don’t qualify for Medicare or Medicaid but still need financial assistance; those who don’t have employee-sponsored health insurance, including independent contractors and gig workers; and anyone seeking comprehensive, quality and affordable plans.

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Way back in October 2013, when the first ACA Open Enrollment Period (OEP) launched, there were infamously massive technical problems with the federal exchange (HealthCare.Gov) as well as some of the state-based exchanges (such as those in Massachusetts, Maryland, Oregon, Nevada and Hawaii).

Over the next few years, some of those exchange websites were replaced with brand-new ones (MA & MD). Some of the states scrapped theirs altogether and moved onto the mothership at HC.gov (OR, HI & NV, although Nevada has since split back off onto their own exchange again, and seems to have gotten it right this time).

Last Friday, Access Health CT, Connecticut's state-based ACA exchange, posted their first 2021 Open Enrollment Period data numbers, and the first QHP enrollment number looks pretty eye-popping at first glance: 99,406 Nutmeggers enrolled in the first 6 days! Wow! Only around 108,000 enrolled throughout the entire 2020 OEP, so that's pretty impressive...

...except that I'm pretty sure that  99% of this figure consists of automatic renewals of their existing exchange enrollees. The next number down, 1,279, is their "2021 OE Acquisition Summary" number. In other words, it looks like Access Health CT has 98,127 people currently enrolled in exchange plans who have been auto-renewed for 2021, plus another 1,279 new enrollees who actually signed up in the first six days.

The timing of this press release is a little odd; it came out on November 9th, even though the 2021 ACA Open Enrollment Period actually launched on November 1st. In fact, in California specifically, they've been allowing existing enrollees to actively renew/re-enroll for 2021 since October 1st!

Given the insanity of this year's Presidential election on November 3rd, along with the ongoing COVID19 pandemic, I can hardly blame CoveredCA for the delay, however; after all, this is the first Open Enrollment update I've posted since it kicked off on Nov. 1st as well...

Anyway, via the Covered California newsroom:

Covered California Officially Launches Open Enrollment with Millions of Masks to Encourage Californians to “Get Covered/Stay Covered” and a New Ad Campaign

So, the idiotic, asinine and otherwise absurd GOP-brought, Trump-supported lawsuit to strike down the Patient Protection & Affordable Care Act finally had its (presumably final) day in court today...the United States Supreme Court, that is.

Here's my live-tweeting of the proceedings. I missed the first ten minutes of it and didn't tweet out everything, but this captures most of the Q&A.

Defending the ACA were California Solicitor General Michael Mongan and Donald Verrilli, who is the former U.S. Solicitor General, and who was working on behalf of the House Democrats, I believe. For the plaintiffs, you had the Texas Solicitor General, Kyle Hawkins and Acting U.S. Solicitor General Jeffrey Wall (note the "acting" descriptor...Trump has tons of unconfirmed appointees...)

Remember, there are three main questions for the SCOTUS to consider about the lawsuit:

Last night I threw together my very first online ACA seminar for about 40 people (plus an unknown number of Facebook Live viewers, assuming I set that up correctly). It runs about two hours; the first half was pretty much an updated version of my normal "3-Legged Stool" explainer.

For the second half, however, I was joined by University of Michigan law professor & ACA expert Nicholas Bagley who helped explain the intricacies of the absurd CA v. TX lawsuit to strike down the entire Patient Protection & Affordable Care Act (aka "TX v. Azar", "Tx. v. U.S." or, as I prefer to call it, "Texas Fold'em".

If you have two hours to kill, you can watch the whole thing here! If you want to skip past the ACA 101 stuff and go straight to Bagley & I discussing the lawsuit ahead of this morning's Supreme Court oral arguments, that starts at around the 70 minute mark.

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