A month ago I posted an analysis which gave a general idea of how much more various households will have to pay in health insurance premiums if the expanded financial subsidies provided by the American Rescue Plan (ARP) are allowed to expire at the end of this year.

Again, here's what the subsidy tables look like under the ACA itself and under the American Rescue Plan. The premium caps are the maximum percent of household income which a household has to pay for the benchmark Silver plan at various income ranges:

I've been posting weekly looks at the rate of COVID-19 cases & deaths at the county level since the point at which every U.S. adult could theoretically have received 2 COVID vaccination doses nearly a year ago, broken out by partisan lean (i.e, what percent of the vote Donald Trump received in 2020), as well as by the vaccination rate of each county in the U.S. (nonpartisan).

For a long time I used July 1st, 2021 as my start point, but in December I decided to back this up to May 1st, 2021 instead. Pinning down an exact date for this is a bit tricky since a) different populations were made eligible at different points in 2021, and b) it takes 3-4 weeks after getting your first vaccination dose before you can get the second one, but May 1st is what I've finally settled on. This doesn't really change things much, however.

As always, here's my methodology:

COVID-19 Vaccine

Methodology reminders:

  • I go by county residents who have received the 2nd COVID-19 shot only (or 1st in the case of the J&J vaccine).
  • I base my percentages on the total population via the 2020 U.S. Census including all ages (i.e., it includes kids under 12).

I originally wrote about this issue back in 2017.

As explained in this Health Affairs article by Katie Keith and Timothy Jost:

The final Senate compromise, which was adopted as part of the ACA, largely reinforces the Hyde Amendment, which has been included in annual Congressional appropriations legislation since the 1970s and prohibits the use of federal funds for abortion services unless the pregnancy is a result of rape or incest, or would endanger the woman’s life (non-Hyde abortions).

The ACA allows the coverage of abortion services through the marketplaces but includes a number of restrictions and requirements that insurers must follow before covering non-Hyde abortions. Many, though not all, of these restrictions are outlined in Section 1303 of the ACA, which includes specific rules related to the coverage of abortion services by Qualified Health Plans (QHPs) and has been the subject of previous litigation. In particular, Section 1303:

Washington State

One of the most inane restrictions of the ACA in my view, as I noted in my "If I Ran the Zoo" wish list back in 2017, is that it doesn't allow undocumented immigrants to enroll in ACA marketplace health plans ("Qualified Health Plans" or QHPs).

I don't just mean that they aren't eligible for federal financial subsidies--that's a prohibition which I can at least understand, even if I don't agree with it. I mean that they aren't allowed to enroll in ACA exchange-based QHPs even at full price, as noted in Section 1312(f)(3):

(3) Access limited to lawful residents.--If an individual is not, or is not reasonably expected to be for the entire period for which enrollment is sought, a citizen or national of the United States or an alien lawfully present in the United States, the individual shall not be treated as a qualified individual and may not be covered under a qualified health plan in the individual market that is offered through an Exchange.

And here...we...go...

Every year, I spend months painstakingly 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:

 

I haven't written much about the ACA's Basic Health Plan (BHP) program for awhile, aside from noting that it's well past time for the Centers for Medicare & Medicaid Services (CMS) to start including BHP enrollment in their official Open Enrollment Period reports, seeing how over a million people in Minnesota & New York now have healthcare coverage via BHP policies.

As a refresher, here's Louise Norris' summary explainer:

Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.

Hot on my announcement that I've been asked to join the board of directors of Doctors For America, I have some less pleasant personal news to report as well: After dodging it for nearly 2 1/2 years and obsessively tracking cases & fatalities connected to it for most of that time, I finally tested positive for COVID-19 myself a few days ago.

I actually started feeling slightly off about two weeks ago, but I also happened to get my 4th vaccination shot (or 2nd booster, if you prefer) right around the same time, so for the first few days I just assumed I was having stronger-than-usual side effects from the shot.

By last Wednesday, it was clearly something more serious, but a home-based COVID test came back negative so I figured it was just a really nasty head cold + seasonal allergies. By Friday my wife was also experiencing symptoms and she ended up having a miserable Mother's Day weekend...while I was starting to recover.

Doctors for America Logo

From the Doctors for America (DFA) website:

Doctors for America mobilizes doctors and medical students to be leaders in putting patients over politics on the pressing issues of the day to improve the health of our patients, communities, and nation.

We believe:

CMS Logo

via the Centers for Medicare & Medicaid Services:

Today, the Centers for Medicare & Medicaid Services (CMS) announced that Tennessee and South Carolina can begin offering Medicaid and Children’s Health Insurance Program (CHIP) coverage for 12 months postpartum to an estimated 22,000 and 16,000 pregnant and postpartum individuals, respectively, through a new state plan opportunity made available by the American Rescue Plan.

Tennessee and South Carolina join Louisiana, Michigan, Virginia, New Jersey, and Illinois in extending Medicaid and CHIP coverage from 60 days to 12 months postpartum. CMS is also working with another nine states and the District of Columbia to extend postpartum coverage for 12 months after pregnancy, including California, Indiana, Kentucky, Maine, Minnesota, Oregon, New Mexico, Pennsylvania, and West Virginia. As a result of these efforts, as many as 720,000 pregnant and postpartum individuals across the United States could be guaranteed Medicaid and CHIP coverage for 12 months after pregnancy. 

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