As I noted a few days ago, I spent most of last week in Washington, DC attending the Families USA healthcare policy conference and meeting with staffers for a dozen or so House Democrats. My main goal in those meetings was to encourage as many House members as possible to sign on as cosponsors of what I've termed the "ACA 2.0" bills.

As a reminder, the main House ACA 2.0 bill, H.R. 1884, was also broken out into a dozen or so smaller, standalone bills. The smaller one I'm most focused on is H.R. 1868, which eliminates the ACA's 400% FPL income cap for subsidy eligibility and also beefs up the underlying subsidy formula.

Until my meetings, H.R. 1868 had 36 cosponsors including the lead sponsor, Rep. Lauren Underwood of Illinois...and hadn't had any new cosponsors sign on since October. H.R. 1884, meanwhile, had 160 cosponsors including the lead sponsor, Rep. Frank Pallone of New Jersey...but hadn't had anyone sign on since last August.

California and New York have both released updated 2020 Open Enrollment numbers, so I figured I'd update my spreadsheet one more time before the final data is released. This time I've included a smaller secondary table at the bottom which adjusts the Federal and State-based exchange numbers for Nevada.

OFFICIALLY, HealthCare.Gov enrollment is down nearly 128,000 people this year, but that's not fair because Nevada broke off of HC.gov onto their own full state-based exchange platform this year. When you adjust for that, HC.gov is only down 119,000 people for the remaining 38 states. Meanwhile, the state-based exchanges are officially down 2,900 at the moment, but again, with Nevada joining them, they're actually down around 8,900.people.

That leaves the missing enrollment data from five states. Rhode Island and Vermont haven't released any data...I'm assuming they'll both be very close to last year (call it at least 33,000 and 24,000 respectively). I'm assuming New York + DC will be good for perhaps 3,000 more enrollees combined in their final days. And California will likely tack on another 30,000 or so in their final 2 days of Open Enrollment.

With one day left to go before the 2020 ACA Open Enrollment Period wraps up in California, the largest state ACA exchange in the country issued one more update and call to action:

Covered California Sees Thousands of People Enroll Each Day as it Approaches Friday’s Final Day of Open Enrollment

  • More than 364,000 consumers have newly enrolled during the current open-enrollment period, which ends at midnight on Friday, Jan. 31
  • More than 33,000 people have enrolled since Monday, an average of more than 11,000 people per day.
  • California passed two new laws for 2020, one that requires Californians to have health insurance or face a penalty, while the other offers new financial help – for the first time – to eligible consumers purchasing coverage.

Open enrollment is the one time when people can sign up for health insurance in the individual market without needing a qualifying life event.

I'm a bit late on this one. It was reported a week or so ago but was officially introduced today:

Trump administration finalizing Medicaid block grant plan targeting Obamacare

  • The plan is guaranteed to enrage critics and invite attacks from Democrats in an election year.

The Trump administration is finalizing a plan to let states convert a chunk of Medicaid funding to block grants, even as officials remain divided over how to sell the controversial change to the safety net health program.

CMS Administrator Seema Verma plans to issue a letter soon explaining how states could seek waivers to receive defined payments for adults covered by Obamacare's Medicaid expansion, according to seven people with knowledge of the closely guarded effort. An announcement is tentatively slated for the end of next week, more than one year after Verma and her team began developing the plan.

New York State of Health is doing their best to calm people down as much as possible:

Fact Sheet:: What you Need to Know About the New Federal Public Charge Rule and Health Insurance

Updated 1/29/20

When does the new Public Charge rule go into effect?

  • The Supreme Court decided on January 27, 2020, to allow the rule to take effect.

Does enrolling in free or low-cost health insurance make me a Public Charge?

  • Most health insurance coverage is not a factor in the new Public Charge test. Only federally-funded Medicaid is included, and even for this program there are several exempt groups of people who are excluded under the rule, including pregnant women and children under 21. Additionally, asylees, refugees, and visa holders who are victims of trafficking and other crimes, among others, are entirely exempt from the Public Charge rule.

The following programs are not included in the Public Charge rule:

Last March I wrote an analysis of H.R.1868, the House Democrats bill that comprises the core of the larger H.R.1884 "ACA 2.0" bill. H.R.1884 includes a suite of about a dozen provisions to protect, repair and strengthen the ACA, but the House Dems also broke the larger piece of legislation down into a dozen smaller bills as well.

Some of these "mini-ACA 2.0" bills only make minor improvements to the law, or make improvements in ways which are important but would take a few years to see obvious results. Others, however, make huge improvements and would be immediately obvious, and of those, the single most dramatic and important one is H.R.1868.

The official title is the "Health Care Affordability Act of 2019", but I just call both it and H.R.1884 (the "Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019") by the much simpler and more accurate moniker "ACA 2.0".

Last March I wrote an analysis of H.R.1868, the House Democrats bill that comprises the core of the larger H.R.1884 "ACA 2.0" bill. H.R.1884 includes a suite of about a dozen provisions to protect, repair and strengthen the ACA, but the House Dems also broke the larger piece of legislation down into a dozen smaller bills as well.

Some of these "mini-ACA 2.0" bills only make minor improvements to the law, or make improvements in ways which are important but would take a few years to see obvious results. Others, however, make huge improvements and would be immediately obvious, and of those, the single most dramatic and important one is H.R.1868.

The official title is the "Health Care Affordability Act of 2019", but I just call both it and H.R.1884 (the "Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019") by the much simpler and more accurate moniker "ACA 2.0".

Hmmm...looks like there was some sort of data breach at AccessHealthCT:

A Small Number Of Access Health CT Consumers Will Receive Mail This Week About Their Personal Information And Should Review Carefully

HARTFORD, Conn. (January 28, 2020)—Approximately 1,100 Access Health CT consumers will be receiving an ORANGE ENVELOPE in the mail this week. It is important that consumers review this information carefully as they will need to take action to enroll in free services being offered to help protect their personal information that may have been compromised in a data breach.

“Access Health CT takes the privacy and security of consumers’ personal information seriously, and it is making this public notice in an abundance of caution,” said Chief Executive Officer of Access Health CT, James Michel. “We apologize for any inconvenience to consumers and we remain steadfast in our commitment to keep our consumers’ best interests as our number one priority.”

I just received the final 2020 Open Enrollment report from the Massachusetts Health Connector (via email, no link):

Here’s where we are:

  • We have 290,105 January enrollments
  • 22,493 February and March enrollments
  • 7,014 plans selected
  • For a total of 319,612

New enrollments currently total 57,044.

I wish every ACA exchange would break out their numbers this way. Simple and to the point, but also with relevant details...not only "renewals vs. new" but also how many are enrolled for January vs. February or March coverage and even how many have/haven't paid yet! The last is a bit unfair since Massachusetts is one of only two states, I believe, which actually handle premium payments (Rhode Island does as well...Washington State used to but doesn't anymore).

Here's what's truly impressive: Massachusetts is the only state to increase their ACA exchange enrollment each and every year for six years running:

This just in from the New York State of Health ACA exchange:

Press Release: New Yorkers Have More Time to Get Covered in 2020: NY State of Health Open Enrollment Deadline Extended to February 7

  • Enroll Now for Affordable, High-Quality Health Coverage in 2020
  • Free, In-Person Enrollment Help is Available: Click Here to Find a NY State of Health Certified Assistor

ALBANY, N.Y. (January 28, 2020) – NY State of Health, the state’s official health plan Marketplace, announced that consumers will have an additional week to enroll in a Qualified Health Plan (QHP) for 2020. The Open Enrollment deadline has been extended until February 7 to give consumers more time to enroll. NY State of Health’s Customer Service Center representatives and in-person assistors are available to help individuals find the best plan for themselves and their families.

Huh. That's unexpected.

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