The midterms are over, and the Democrats won back the U.S. House, so the ACA is (mostly) safe at last, right?

Well...maybe. In addition to the ongoing regulatory sabotage by the Trump Administration to undermine, weaken and generally piss all over the law as much as possible, there's also still a little thing called Texas vs. Azar, aka the #TexasFoldEm federal lawsuit. Oral arguments were held way back in early September, and right-wing Judge O'Connor claimed that he'd rule on a preliminary injunction "quickly" afterwards.

Well, today is November 18th, and there's been nary a peep from Judge O'Connor. Does 75 days later count as "quickly"? In judiciary time, I suppose it might.

via Christine Stewart of CT News Junkie (11/15/18):

Access Health Enrollment Off To Steady Start

HARTFORD, CT — The number of customers purchasing plans through Connecticut’s insurance exchange is around what it was last year in the first two weeks of open enrollment.

Since Nov. 1, 12,777 customers have shopped and purchased a plan for 2019, according to Access Health CT officials. That means about 85,000 enrollees have yet to renew into a 2019 policy.

...Traffic on the website is trending about 18 percent higher than it was at this time last year, according to Access Health CT’s Director of Technical Operations and Analytics Robert Blundo.

...An estimated 60 percent of customers are picking plans that are different from their plan in 2018 and that’s compared to only 18 percent who were changing their plans last year. It also means there are a higher percentage of customers using brokers to help them make a decision about the health plan that’s right for them.

This is welcome news...

Illinois Senate voted unanimously to override the Governor's veto of a bill to limit short-term health plans to 6 months. Protecting consumers and insurance markets from long-term short-term plans does not appear to be a partisan issue. https://t.co/fJ4NVV4LRQ

— Dania Palanker (@DaniaPal) November 15, 2018

FULL DISCLOSURE: HealthSherpa has a paid banner ad at the top of ACASignups.net.

As I noted last week, HealthSherpa is indeed a paying advertiser on the site. However, since they happen to specialize specifically in selling ACA-compliant individual market policies through the ACA exchange (they're an authorized 3rd-party online brokerage), they're also an excellent "finger on the pulse" of Open Enrollment data, providing more-detailed weekly data than CMS usually does; I'd be posting their stats whether they were an advertiser or not.

According to HS's latest blog post, they've enrolled 78,684 people in ACA exchange plans for 2019 in the "first two weeks". I don't know if "two weeks" means as of November 14th or as of November 10th as CMS defines it (they run "weeks" from Sunday - Saturday, so Week 1 only included 3 days this year).

 

Hey, remember this? That's Zombie-Eyed Granny Starver Paul Ryan and his motley crew yucking it up right after voting to strip away healthcare coverage from 23 million people on May 4, 2017 by passing the American Health Care Act (AHCA), which not only most repealed the ACA but also gutted Medicaid spending and a bunch of other nasty stuff.

Well, what goes around comes around, which the House Democrats clearly knew at the time; as you can hear in the video, they were actually singing "Hey, hey, goodbye!" to the House Republicans immediately after the vote, because they knew exactly what the consequences would be of passing that pile of elephant poop.

Sure enough, exactly 551 days later, the 2018 Midterm Elections caused a Big Blue Wave to crash over the House GOP.

Week 2 via CMS:

Week 2, Nov 4-10, 2018

In week two of the 2019 Open Enrollment, 804,556 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday. Consequently, the cumulative totals reported in this snapshot reflect one fewer day than last year.

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 Exchanges 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.

The final number of plan selections associated with enrollment activity during a reporting period may change due to plan modifications or cancellations. In addition, the weekly snapshot only reports new plan selections and active plan renewals and does not report the number of consumers who have paid premiums to effectuate their enrollment.

This Just In via MNsure, Minnesota's ACA exchange...

More than 97,000 Minnesotans have signed up for private health plans through MNsure since the start of open enrollment
Open enrollment runs until January 13, 2019

ST. PAUL, Minn.—Today MNsure announced that over 97,000 Minnesotans have signed up for private health plan coverage through MNsure during the first two weeks of open enrollment.

MNsure's open enrollment runs until January 13, 2019. For coverage that begins January 1, 2019, Minnesotans must enroll by December 15, 2018.

“We are excited with our smooth start to open enrollment and that over 97,000 Minnesotans have signed up for private health plans,” said CEO Nate Clark. “With rates decreasing from 7 to 27 percent across the state, we encourage Minnesotans to visit MNsure.org to see if they can save.”

BY THE NUMBERS—

Over at Bloomberg News, Aziza Kasumov has written up what is, for the most part, an excellent profile of a middle-class family who crystalize the single biggest real flaw in the design of the Affordable Care Act (as opposed to the bullshit ones made up by opponents over the years): Those enrolled in individual market policies who earn more than 400% of the Federal Poverty Level (around $48,000/year for an individual, or $98,000 for a family of four):

David and Maribel Maldonado seem the very definition of making it in America. David arrived in the U.S. from Mexico as a small child...His wife Maribel, whose family is also from Mexico, worked as a hairstylist while caring for the couple’s two children. David’s annual salary reached about $113,000 by the time the children were in their teens. It was more than enough to live in a pretty suburban house outside Dallas, take family vacations, go to restaurants and splurge at the nearby mall. And to afford health insurance.

The bold-faced bit above has some relevance later in the story.

With the 2018 Midterm Elections mostly out of the way (there's still at least 7 statewide races which haven't been called yet in Georgia, Florida and Arizona which are currently in the process of various counts, recounts and/or run-off elections), the Democratic Party has indeed retaken the U.S. House of Reprentatives by a solid margin, adding anywhere from 33 - 40 House seats when they only needed a net gain of 23 to take control. Starting in January, the House Democrats will be able to vote on and pass pretty much whatever bills they want, presumably under the leadership of Nancy Pelosi as Speaker of the House.

Last year, the Washington Health Benefit Exchange reported enrolling roughly 4,500 new ACA exchange enrollees in the first 8 days, which was a whopping 53% increase over 2017. This was in addition to what I estimated was roughly 13,000 current enrollees actively renewing their existing policies or switching to a different one, for a total of perhaps 17,500 QHP selections.

This year, the WA exchange hasn't posted any official press release yet, but the Seattle Times claims that they've already enrolled over 190,000 people:

Despite changes to the Affordable Care Act during the past couple of years, local health-insurance officials are optimistic that the state’s health-insurance exchange will flourish in 2019.

Since enrollment for 2019 began Nov. 1, about 190,000 people have signed up for health insurance through the Washington Health Benefit Exchange, which is about 5 percent more than the same period last year.

Press Release: NY State of Health Drives Home the Importance of Affordable Health Coverage with Ridesharing Partnerships
Nov 9, 2018

Collaborations with Lyft, Uber, Independent Drivers Guild Reach Drivers Across NYS 

ALBANY, NY (November 9, 2018) – NY State of Health, the state’s official health plan Marketplace, today announced it is partnering again during the Open Enrollment Period with ridesharing companies Lyft and Uber, and with the Independent Drivers Guild. Through the partnership, tens of thousands of drivers throughout New York State will be urged to visit the Marketplace to shop for and enroll in quality, affordable health insurance. Open Enrollment for 2019 coverage began November 1. Consumers must enroll by December 15, 2018 for coverage beginning January 1, 2019.

MNsure, Minnesota's ACA exchange, posted a Week One enrollment update yesterday, and while it's generally positive, there's not much in the way of the key data I'm always seeking:

MNsure Update on First Week of Open Enrollment
November 8, 2018

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

“This year’s open enrollment continues to go smoothly with consistently low wait times throughout the first week. With lower rates across the state, we have seen a steady stream of Minnesotans signing up for health coverage. We encourage Minnesotans to visit MNsure.org to see if they are eligible for exclusive tax credits that could lower their monthly premiums.”

This year to date, MNsure has renewed more people into coverage than ever before. Open enrollment figures will be released next Wednesday (11/14) at MNsure’s public board meeting at 1 p.m.

By the numbers 
As of end of day, November 7 

FULL DISCLOSURE: HealthSherpa has a paid banner ad at the top of ACASignups.net.

A year ago, I posted the following about HealthSherpa:

Here's the Wikipedia entry for HealthSherpa:

HealthSherpa is a California-based technology company focused on connecting individuals with health coverage. The site was initially developed as an alternative to research plans from Healthcare.gov, and now provides individual health, dental and vision benefits to both part-time employees and retirees. As of February 2017, over 800,000 people have been enrolled in individual health coverage through HealthSherpa.

First, I want to clarify that I'm not shilling for HealthSherpa here. They aren't paying me for this post. I have no idea whether their customer service is awesome or sucks or anything like that.

About a year ago I did a little back-of-the-envelope number crunching regarding the insanely stupid way in which the Affordable Care Act handles the Hyde Amendment.

In U.S. politics, the Hyde Amendment is a legislative provision barring the use of federal funds to pay for abortion except to save the life of the woman, or if the pregnancy arises from incest or rape. Legislation, including the Hyde Amendment, generally restricts the use of funds allocated for the Department of Health and Human Services and consequently has significant effects involving Medicaid recipients. Medicaid currently serves approximately 6.5 million women in the United States, including 1 in 5 women of reproductive age (women aged 15–44).

One of the biggest stories playing out nationally in the aftermath of the 2018 election is the Georgia gubernatorial election saga, in which corrupt-as-hell Republican Secretary of State Brian Kemp currently holds a narrow lead (50.3% vs. 48.7%) over former Democratic minority leader of the Georgia House of Representatives Stacey Abrams.

Under Georgia law, if no candidate ends up with more than 50% of the total vote, the top two candidates move on to a run-off election, so if Kemp's lead ends up dropping by around 13,000 more votes as the thousands of remaining ballots are counted, it's on to a run-off between the two.

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