"If you have a pre-existing condition...heart disease; diabetes; breast cancer...they're coming for you. If you love someone who has a pre-existing condition...they're coming for you. If you're under the age of 26 on your parents' coverage...they're coming for you."

Wednesday night's Vice-Presidential debate between Kamala Harris and Mike Pence wasn't as bad as last week's dumpster fire of a Presidential "debate" between Donald Trump and Joe Biden. The questions were mostly better, and neither Pence nor Harris screamed at each other. On the other hand, the moderator did a terrible job of cutting Pence off when he ran over his time limit or interrupted Harris, and just as importantly, Pence flat-out refused to answer most of the questions at all, often instantly changing the subject to whatever he happened to feel like talking about with zero pushback from moderator Susan Page.

The Delaware Insurance Dept. has posted the approved 2021 individual market rates and it's about as unexciting as you can imagine: There's a single carrier in the state (Highmark BCBS), which asked for a 0.5% average premium reduction and was approved for...a 1.0% average premium reduction. Unsubsidized Delaware enrollees will average around $80 in savings per year.

In early August, the Arkansas Insurance Dept. posted the preliminary 2021 rate filings for the individual & small group market. At the time, the carriers were requesting average increases of 7.0% for ACA indy market plans and a slight drop of 0.3% for the small group market.

The approved rate filings have now been published, and the increases have been cut in half on the individual market to just 3.4%, while the small group market is slightly lower still (-0.4%) due to a revision in the estimated number of current enrollees:

2021 Minnesota health insurance rates continue to show stability for another year; expanded consumer choice across the state

ST. PAUL, Minn.—The Minnesota Department of Commerce announced final 2021 Minnesota health insurance rates today, which will remain stable across the state. For the 2021 plan year, 80 counties have three or more health insurance companies offering plans on the exchange, compared to just 31 counties with three or more in 2020. Ninety-seven percent of Minnesotans buying health insurance through MNsure will have an average of 30 different qualified health plans and three or more carriers to choose from.

Five health insurance companies are partnering with MNsure for the 2021 plan year: BluePlus, HealthPartners, Medica, UCare, and newly added Quartz, a Madison-based insurer offering plans in some southeastern Minnesota counties. Quartz will be offering 14 qualified health plans on the exchange. Additionally, dental plans will be available from Delta Dental and Dentegra.

The data below comes from the GitHub data repositories of Johns Hopkins University, except for Rhode Island, Utah and Wyoming, which come from the GitHub data of the New York Times due to the JHU data being incomplete for these three states. Some data comes directly from state health department websites.

Note that a few weeks ago I finally went through and separated out swing districts. I'm defining these as any county which where the difference between Donald Trump and Hillary Clinton was less than 6 percentage points either way in 2016. There's a total of 198 Swing Counties using this criteria (out of over 3,200 total), containing around 38.5 million Americans out of over 330 million nationally, or roughly 11.6% of the U.S. population.

With these updates in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Saturday, October 3rd (click image for high-res version). Blue = Hillary Clinton won by more than 6 points; Orange = Donald Trump won by more than 6 points; Yellow = Swing District

November 3rd is just 33 days away. At least 2.2 million Americans have already voted as of this writing. The #TexasFoldEm Trump/GOP lawsuit to strike down the entire ACA is scheduled to be heard by the Supreme Court on November 10th...and Donald Trump, Mitch McConnell & Lindsey Graham are pushing as hard as possible to ram through ultra-right wing ideologue and anti-ACA zealot Amy Coney Barrett as quickly as they can.

Meanwhile, 1,000 people are still dying and 40,000 or so are still testing positive for COVID-19 each day.

Needless to say, tensions are high and Democrats have a much weaker hand when it comes to saving the ACA from oblivion than they did a couple of weeks ago.

So, as the clock ticks down to both 11/03, 11/10 and 1/20, both GOP Senate Majority Leader Mitch McConnell and Democratic Senate Minority Leader Chuck Schumer are playing a few mostly symbolic cards along the way.

On Tuesday evening, Sept. 29th, Schumer made the first move:

It was a little over a year ago that New Jersey legislators passed, after some last-minute drama, a bill to follow in the footsteps of Nevada and split off from the federal ACA exchange, HealthCare.Gov (there's actually a dozen other states which also operate their own full state-based exchanges as well, but 11 of them were never hosted by the federal exchange in the first place. The exception is Idaho, which was hosted by HC.gov for one year before splitting off, but that was always their plan from the start).

New Jersey's ACA portal website, Get Covered NJ, has actually been live for two enrollment periods already, but until now it was just that--an information portal only. The actual healthcare policy shopping/enrollment process was still handled through HealthCare.Gov.

Pennsylvania launches new state-based health insurance marketplace, Pennie

  • Pennie replaces Healthcare.Gov and will improve access to coverage and increase affordability

Harrisburg, PA – September 22, 2020 – Today, Pennsylvania announced, Pennie, the new state-based health insurance marketplace for 2021 coverage. Pennie is available to all Pennsylvanians and aims to improve the accessibility and affordability of individual market health coverage. It is also the only place that connects Pennsylvanians to financial assistance to reduce the cost of coverage and care.

Pennie was created by Act 42 of 2019, passed unanimously by both chambers of the General Assembly and signed into law by Governor Tom Wolf on July 2, 2019.

New Insurance Carrier Joins Idaho Exchange, Record Number of Plans Available in 2021

  • Preview plans and prices beginning Oct. 1 at YourHealthIdaho.org

BOISE, Idaho – Your Health Idaho, the state health insurance exchange, announced today that Idahoans will have a record number of medical and dental plans and a new insurance carrier to choose from in 2021.

Regence, which currently sells small group and individual plans off-exchange in Idaho, will offer medical coverage through Your Health Idaho for the first time in 2021. The addition of Regence brings the total number of insurance carriers on the Idaho exchange to seven.

“We are pleased to welcome Regence to Your Health Idaho,” said Pat Kelly, Your Health Idaho Executive Director. “Adding another regional insurance carrier means even more choice for Idahoans and continued local control for the Idaho marketplace.” 

Beginning Oct. 1, Idahoans can preview the 136 medical and 13 dental plans that will be available in 2021 online at www.YourHealthIdaho.org. 

The data below comes from the GitHub data repositories of Johns Hopkins University, except for Rhode Island, Utah and Wyoming, which come from the GitHub data of the New York Times due to the JHU data being incomplete for these three states. Some data comes directly from state health department websites.

Note that a few weeks ago I finally went through and separated out swing districts. I'm defining these as any county which where the difference between Donald Trump and Hillary Clinton was less than 6 percentage points either way in 2016. There's a total of 198 Swing Counties using this criteria (out of over 3,200 total), containing around 38.5 million Americans out of over 330 million nationally, or roughly 11.6% of the U.S. population.

With these updates in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Saturday, September 26th (click image for high-res version). Blue = Hillary Clinton won by more than 6 points; Orange = Donald Trump won by more than 6 points; Yellow = Swing District

 

(sigh) Back on August 7th (an eternity ago), the "Big News" of the day was that Donald Trump was supposedly going to "pursue a major executive order requiring health insurance companies to cover pre-existing conditions for all of its customers."

As I, and everyone else who has the slightest clue about how health insurance or the law works noted:

THE AFFORDABLE CARE ACT ALREADY REQUIRES HEALTH INSURANCE CARRIERS TO COVER PRE-EXISTING CONDITIONS, AND DONALD TRUMP AND THE REPUBLICAN PARTY ARE CURRENTLY IN FEDERAL COURT TRYING TO STRIKE DOWN THE AFFORDABLE CARE ACT.

ANY reporter/media outlet which reports/tweets about Trump's XO "ordering" insurance companies to "cover pre-existing conditions" without mentioning that THE ACA ALREADY DOES THIS and TRUMP IS SUING TO STRIKE DOWN THE ACA is guilty of journalistic malpractice.

There's a lot to unpack in this press release from Covered California:

Covered California Hits Record Enrollment, Providing Important Lessons for the Nation on Meeting Americans’ Health Care Needs During the Pandemic and Major Economic Downturn

  • Covered California’s investments in marketing and outreach, along with consumer-first polices, helped it reach a record enrollment of 1.53 million people.
  • The record enrollment was bolstered by 289,000 people who signed up for coverage during the COVID-19 special-enrollment period, including 21 percent who were previously uninsured and likely ineligible to enroll under federal rules.

That's roughly 61,000 Californians who were able to enroll in ACA exchange policies specifically due to CA having an open SEP (that is, no requirement of coverage loss/etc. to do so).

 

The Texas Fold'em lawsuit to strike down the ACA (officially called "Texas vs. U.S.", "Texas vs. Azar" or, more recently, "CA vs. TX") is scheduled for oral arguments before the U.S. Supreme Court on November 10th, 2020...exactly one week after Election Day.

A few hours after Supreme Court Justice Ruth Bader Ginsburg passed away Friday evening, I posted an entry which opened with the following sentence:

I'm assuming that the death of Supreme Court Justice Ruth Bader GInsburg doesn't change the date of the hearing; presumably it will be heard by the 8 other SCOTUS justices or (God help us) by all 9 if Mitch McConnell is able to ram through Trump's appointee in record time (November 10th is just 53 days away).

The data below comes from the GitHub data repositories of Johns Hopkins University, execpt for Rhode Island, Utah and Wyoming, which come from the GitHub data of the New York Times due to the JHU data being incomplete for these three states. Some data comes directly from state health department websites.

A reminder that I made two important changes to the spreadsheet last week:

  • First, the Johns Hopkins Github archive has finally started breaking out New York City's data into the five separate boroughs/counties
  • Second, I've finally gone through and separated out swing districts. I'm defining these as any county which where the difference between Donald Trump and Hillary Clinton was less than 6 percentage points either way in 2016. There's a total of 198 Swing Counties using this criteria (out of over 3,200 total), containing around 38.5 million Americans out of over 330 million nationally, or roughly 11.6% of the U.S. population.

With these updates in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Saturday, September 19th (click image for high-res version). Blue = Hillary Clinton won by more than 6 points; Orange = Donald Trump won by more than 6 points; Yellow = Swing District

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