A couple of weeks ago, Covered California reported that as of December 7th, over 486,000 residents were taking advantage of their newly-expanded & enhanced state ACA subsidies:

...More than 486,000 individuals have been determined eligible for the new state subsidy, including about 23,000 in the 400 to 600 percent range of the federal poverty level, which could extend to an individual making up to $74,940 and family of four with a household income of up to $154,500. Of those in this income range who have signed up through Covered California, 44 percent have been found eligible for the state financial assistance.

...If I'm following correctly, the total breakout is:

  • 777,000 = either 138 - 200% FPL or not eligible for any subsidies
  • 463,000 = 200 - 400% FPL; receiving both federal & state subsidies
  • 23,000 = 400-600% FPL; receiving state subsidies only

The press release also broke out the household average for the new/expanded subsidies:

Your Health Idaho, the states' ACA exchange, reminds residents who completed their enrollment applications that they still have until midnight tonight to actually select a policy:

Last chance to #GetCovered!
For those Idahoans who submitted an application for 2020 health insurance coverage by December 16, you have one more day to pick a plan! Do not wait! Find your perfect plan today at YourHealthIdaho.org!

— Your Health Idaho (@YourHealthIdaho) December 23, 2019

The lastest 2020 Open Enrollment Period data was released last week by most of the exchanges, including HealthCare.Gov, Covered California, Connect for Health Colorado, Access Health CT, Maryland Health Connection and the Washington HealthPlan Finder. When combined with the existing data from the MA Health Connector, MNsure, New York State of Health and the brand-new Nevada Health Link, we should now have over 95% of the total 2020 Open Enrollment QHP selections locked in.

Update 12/23: I've updated the text and graph to include the final numbers from Minnesota & Nevada.

This is by no means the final version of The Graph for 2020, of course; there's still no data at all from the District of Columbia, Idaho, Rhode Island or Vermont, and the deadline is still days, weeks or even a month away for nine states.

Having said that, with the Week 7 HC.gov Snapshot Report being released earlier this afternoon, this is a good time to pause and take a look at how the 2020 Open Enrollment Period is shaping up. Remember, even HC.gov's total will change slightly when the dust settles...they're still missing the final 3 hours of the extended Open Enrollment Period (I'm guessing perhaps 30,000 more?), plus an unknown number of "callbacks" to people who were unable to get through on 12/15 but left their contact information (perhaps another few thousand?).

This just in via the Washington HealthPlanFinder:

Washington Healthplanfinder Reminds Customers to Make First Premium Payment

  • Payment options available online and by phone or mail through insurance companies.

Washington Health Benefit Exchange (Exchange) is reminding customers who selected a plan during 2020 open enrollment to make the first month’s premium payment to their health insurance company.

“It is critical that customers make their first premium payment associated with their 2020 health insurance coverage,” said Pam MacEwan, chief executive officer at the Exchange. “This simple action will prevent unintended loss of health coverage or delays in accessing care in the new year.”

Normally the Weekly HC.gov Snapshot Reports are released on Wednesdays. This week it was delayed until Friday in order to include the extra 2 1/2 days:

  • The final official day (Dec. 15th) fell on a Sunday this year
  • The additional 36 hour extension from 3pm on Monday 12/16 - midnight Eastern on Wednesday 12/18*

Not only is "Week 7" actually 9.5 days, but the final week of Open Enrollment also always includes a last-minute enrollment surge as people scramble to beat the deadline (both the original and the extension). In addition, it's also traditionally the week that CMS adds all of the auto-renewals to the report for current enrollees who neither actively selected a policy for 2020, nor did they cancel their coverage for the new year.

As a result of these factors, the numbers for Week 7 understandably dwarf each of the previous snapshot reports:

Week 7, Dec 8-17, 2019

via DC Health Link by email:

Healthcare Open Enrollment Going Strong in Washington, DC!

  • DC Residents Can Sign Up for Quality Affordable Coverage Through Jan 31, 2020

WASHINGTON, DC – District of Columbia residents still have more than six (6) weeks to sign up for quality, affordable health insurance through DC Health Link, the District’s state-based health insurance exchange established under the Affordable Care Act. While the final deadline has passed for individuals across the country to sign up for health insurance through the federal marketplace (HealthCare.gov), DC Health Link’s Open Enrollment for individuals and families continues on until January 31, 2020.  

via MNsure by press release:

Monday is Your Last Chance to Enroll in Private Health Coverage Through MNsure

December 20, 2019

ST. PAUL, Minn.—Minnesotans have until 11:59 p.m. on Monday, December 23, to enroll in health insurance coverage through MNsure for 2020.

"MNsure stands ready to help Minnesotans in the final days of open enrollment," said MNsure CEO Nate Clark. "The time to get enrolled is right now—don't lose out on your opportunity to get coverage in the new year."

MNsure will have extended Contact Center hours beginning tomorrow: 

  • Saturday, December 21: 10 a.m. to 6 p.m. 
  • Sunday, December 22: 10 a.m. to 8 p.m. 
  • Monday, December 23: 8 a.m. to midnight

Most people qualify for financial help. Minnesotans can see their estimated eligibility for financial help by using MNsure's plan comparison tool.

Please note, this deadline does not apply to Medical Assistance or MinnesotaCare recipients or members of federally recognized Indian tribes. More information about renewing eligibility and reporting changes for Medical Assistance or MinnesotaCare. 

Just another quick update from AccessHealthCT:

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

Stats as of December 20, 2019:

Qualified Health Plans (QHP):

  • Net Total QHP Enrollment: 104,439
  • 2020 OE Acquisition Summary: 21,001

Overall Volume

  • Unique Website Visitors: 185,869
  • Calls Handled: 183,637

Medicaid: Completed applications/redeterminations processed through the integrated eligibility system: 40,496

This was as of 12/20. They'll have to have added another 6,627 people to beat last year's total of 111,066.

As a reminder, Access Health CT has extended their Open Enrollment deadline by a full month, to January 15th:

Access Health CT Extends 2020 Health Insurance Open Enrollment Period

via Connect for Health Colorado:

More than 153,000 Coloradans Enrolled in Health Insurance So Far; Less than Four Weeks Remain to Enroll for 2020 Coverage

DENVER — More than 153,000 Coloradans signed up for a health insurance plan through Connect for Health Colorado’s Marketplace by Dec. 18, 2019. Approximately 68 percent of applicants qualify for financial help to lower monthly premium costs.

“I am encouraged by the pace of sign-ups so far,” said Connect for Health Colorado® CEO Kevin Patterson.  “However, it’s not too late to get covered for 2020. I urge you to take advantage of the final deadline and all the support we offer by visiting our site, giving us a call, or finding local help in your community.”

The Open Enrollment period in Colorado ends Wednesday, Jan. 15, 2020. Residents who sign up for a health insurance plan by the deadline will receive a Feb. 1, 2020 coverage start date.

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.

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