Get Covered 2021!


Nearly every state (+DC) has re-opened enrollment on their respective ACA exchanges in response to both the ongoing COVID-19 pandemic and the American Rescue Plan (ARP), which substantially expands and enhances premium subsidies to millions of people!

If you've never enrolled in an ACA healthcare policy before, or if you looked into it years ago but weren't impressed, please give it another shot now. Thanks to the ARP (and some other reasons), it's a whole different ballgame this spring & summer.

Here's 10 important things to understand when you #GetCovered:

CMS Logo

via CMS:

HHS Encourages States to Educate Eligible Immigrants about Medicaid Coverage

Today, the US Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS) issued an informational bulletin to states’ Medicaid and Children’s Health Insurance Program (CHIP) agencies reaffirming that the 2019 Public Charge Final Rule – “Inadmissibility on Public Charge Grounds” – is no longer in effect and states should encourage their eligible immigrant populations to access public benefits related to health and housing. 

Pandemic of the Unvaccinated


Let's be clear: There's a good ~48 million or so children under age 12 who haven't been approved to take the COVID-19 vaccine yet, roughly 14% of the population. There's also perhaps 8 - 9 million Americans age 12+ who are immunocompromised or have serious allergic reactions to vaccinations, meaning the vaccine would have no effect on them or they can't take it at all. Combined, that's around 17% of the total U.S. population who can't get vaccinated, leaving it up to the other 83% of us who can to do so.

Yes on 2 (Missouri Medicaid Expansion)

August 2020:

We did it!

Missouri just voted #YesOn2 to expand Medicaid, and now, because of YOUR vote, over 230,000 hardworking people will have access to life-saving healthcare!

— YesOn2: Healthcare for Missouri (@YesOn2MO) August 5, 2020

March 2021:

Republican lawmakers blocked Medicaid expansion funding from reaching the Missouri House floor on Wednesday, posing a setback for the voter-approved plan to increase eligibility for the state health care program.

COVID-19 Vaccine

A few weeks ago I posted a look at the county-level COVID-19 vaccination rate outliers...the counties which don't fit the main pattern of heavily-Trump counties having low vaccination rates and heavily-Biden counties having high vaccination rates.

At the time, I sliced all 3,100+ counties across all 50 states + DC into 9 regions based on a 3x3 grid:

  • Vaccination rates: Under 40%, 40-60%, over 60%
  • Trump 2020 vote: Under 40%, 40-60%, over 60%

I then dug deeper into two of these: Low-Trump/Low-Vaxx counties and High-Trump/High-Vaxx counties.

I found 77 counties in the first category...the population in 62 of which is more than 40% Black (and another 7 are majority Native American).

At the opposite corner, there were only 4 of which includes The Villages, the massive, MAGA retirement community. I didn't have much insight into the other 3.

COVID-19 Vaccine

I was planning on only updating the county-level vaccination graph monthly, but given the attention this has received via high-profile folks like David Frum and Paul Krugman, I've decided to post updates weekly.

With the more aggressive Delta variant now spreading quickly among the unvaccinated in the U.S., 85% of the total population seems to indeed be the more likely threshold which will be needed to achieve herd immunity.

As a reminder:

MNsure Logo

MNsure may have ended their "no reason needed" Special Enrollment Period (SEP) a few days ago, but anyone qualifying for a traditional SEP is still eligible...and this year, that includes anyone who's on unemployment at any point during 2021:

Did You have Unemployment Income in 2021? You may Qualify for Health Insurance with a $0/Month Premium 

July 20, 2021

ST. PAUL, Minn.—Minnesotans who received unemployment income at any time in 2021 now can access extremely low-cost health insurance through MNsure.

The new benefits were implemented as part of the American Rescue Plan legislation enacted earlier this year. New federal subsidies for private health insurance on MNsure act as an instant discount for consumers, lowering the cost for monthly premiums. Some Minnesotans can find a plan with a premium as low as $0 per month.


Every year, I spend months tracking every insurance carrier rate filing for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease.

Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need. The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier:

  • How many effectuated enrollees they have enrolled in ACA-compliant individual market policies;
  • What their average projected premium rate change is for those enrollees (assuming 100% of them renew their existing policies, of course); and
  • Ideally, a breakout of the reasons behind those rate changes, since there's usually more than one.

Usually I begin this process in late April or early May, but this year I've been swamped with other spring/summer projects: My state-by-state Medicaid Enrollment project and my state/county-level COVID-19 vaccination rate project.


(Updated as of 7/18/21)

For nearly a year, I posted a weekly analysis of the 100 U.S. counties (out of over 3,100 total) which had the highest cumulative rates of COVID-19 cases and deaths per capita. In addition, I also included a running graph which compared the ratio of COVID cases & deaths per capita between blue and red counties to track how this changed over time.

The results were extremely telling: In the early days of the pandemic back in March/April 2020, the blue counties were devastated for a variety of reasons, including heavy population density, the fact they were mostly located along the coasts (usually in cities with major international ports/airport hubs), and so forth. Democrats tend to live in heavily-populated urban areas, while Republicans are prone to live in more sparsely-populated rural areas, so this made sense.

For the first few months, both case and death rates were running as much as 4-5x higher in counties which voted solidly for Hillary Clinton in 2016/Joe Biden in 2020 than in those which voted for Trump in either 2016 or 2020.