Well, today I received a likely answer which is depressing but not surprising at all: According to my sources, there isn't any technical, logistical, personnel or support reasons why HealthCare.Gov couldn't launch a formal COVID-19 Special Enrollment Period at any time. The only logical conclusion is that the White House has decided not to allow one for political reasons.
...The more people who come to rely on the Affordable Care Act--especially the ACA exchange operated by the Trump Administration itself--the more difficult it's going to be to justify the Trump Administration continuing to support a lawsuit with the sole purpose of attempting to have the ACA struck down by the Supreme Court...which they're continuing to try and do even in the middle of a pandemic.
Over the next week or so, more and more of the 13 state-based ACA exchanges announced just such a COVID-19 SEP; eventually 12 out of 13 state-based exchanges did so (Idaho is the odd man out), and eventually even the health insurance industry (which is normally opposed to allowing exceptions to the official Open Enrollment Period) were onboard with a COVID SEP. Two weeks ago I was 95% certain that HC.gov would be announcing one at any moment.
And then...nothing. Nothing last week. Nothing yesterday. Nothing as of this writing.
The worsening coronavirus outbreak may be stretching the limits of the U.S. health care system and overwhelming state governments, but that isn’t deterring a group of 18 state attorneys general from plowing ahead with a lawsuit that could overturn the Affordable Care Act within a year—a move that could disrupt the health care system at a time of deep crisis.
This fall, Texas Attorney General Ken Paxton is slated to argue in the U.S. Supreme Court on behalf of 17 Republican attorneys general—and against 21 Democratic attorneys general—that Obamacare is unconstitutional and must be struck down immediately.
Nearly seven years ago I made my mark in the world by becoming known as the Obamacare Enrollment Guy here at ACASignups.net.
I’m still posting updates, of course, but lately, about 95% of what I’m writing about and analyzing, like everyone else in the country, is related to the ongoing COVID-19 pandemic.
As I noted back on March 11th, this time around I’m not the one doing the hard work of actually gathering the data itself. Several other outlets/organizations have taken up the grim task of keeping a running tally of how many people have tested positive for coronavirus, how many are hospitalized, how many have died and how many have recovered.
The following memo has been floating around Twitter since last night. I was concerned that it might be a hoax, but this response Tweet from the official Henry Ford Health System account can only be interpreted as confirming that it's very real...just not public as of yet. It appears to be a legitimate internal policy memo being prepared in the event of a worst-case scenario:
With a pandemic, we must be prepared for worst case. With collective wisdom from our industry, we crafted a policy to provide guidance for making difficult patient care decisions. We hope never to have to apply them. We will always utilize every resource to care for our patients.
Late last night, the U.S. Senate finally voted to approve a massive $2 TRILLION bailout/recovery bill in response to the Coronavirus pandemic. After a lot of haggling and drama, the final bill ended up passing unanimously, 96 - 0 (four Republican Senators weren't able to vote at all...due to being in self-isolation because of Coronavirus). It's expected to be quickly passed by unanimous consent in the House today and will presumably be signed by Donald Trump before nightfall.
And like that, the largest emergency economic influx bill in history is done.
There's a lot of explainers and thinkpieces being written about the bill as a whole...which elements are good, which are bad, which are flat-out offensive (especially the ~$500 billion in corporate giveaways, which still ended up in the final bill although they supposedly have some sort of oversight over which companies receive them and under what conditions), but my focus is of course on the healthcare aspects, and especially what it means for enrollment in ACA exchange plans and Medicaid via ACA expansion.
I live around half an hour from both the hospitals she refers to (one is in Novi, the other in Southfield). Michigan has the fifth-highest number of confirmed cases and the eighth-highest per capita (as of this writing, we have around 2,300 confirmed cases of COVID-19), at 1 confirmed case per 4,300 residents.As of this writing, 43 Michigan coronavirus patients have died.
The video is about 7 minutes long, but I implore you to watch the entire thing. For those who can't view or hear it, i've transcribed it verbatim below.
For several years now, I've been urging Congress to upgrade the Affordable Care Act via a series of major improvements. Most notable among these is the need to #KillTheCliff...that is, to eliminate the so-called "Subsidy Cliff" which kicks in for ACA individual market enrollees who earn more than 400% of the Federal Poverty Line (roughly $50,000 for a single adult or $103,000 for a family of four).
As I've explained many tmes, the ACA's subsidy structure works pretty well for those earning between 100 - 200% FPL, and is at least acceptable for those earning 200 - 400% FPL (in fact, thanks to #SilverLoading, it works quite well for most of that population as well). The real problem kicks in above 400% FPL (and to a lesser extent below 138% FPL for those living in the 14 states which still haven't expanded Medicaid). In addition, the subsidy formula still doesn't make policies truly affordable for many of those receiving them.
In short, both the upper- & lower-bound Subsidy Cliffs need to be eliminated, and the underlying formula needs to be strengthened as well.
For a couple of weeks now, I've been posting constant updates as one state-based ACA exchange after another has announced a COVID-19-specific Special Enrollment Period in light of the ongoing pandemic crisis. Until now, though, there's been two ACA exchanges which haven't made such an announcement. One is the Big One, HealthCare.Gov, which hosts a whopping 38 states and which is facing increasing pressure to do so.
The other...is Idaho. Specifically, Your Health Idaho, the state's ACA exchange.
If you scroll allllllllll the way down to Pages 1,088 - 1,090, there are two provisions which relate directly to the Affordable Care Act's Advance Premium Tax Credits for exchange enrollees:
SEC. 103. RESTORATION OF LIMITATIONS ON RECONCILIATION OF TAX CREDITS FOR COVERAGE UNDER A QUALIFIED HEALTH PLAN WITH ADVANCE PAYMENTS OF SUCH CREDIT.
(a) IN GENERAL.—Section 36B(f)(2)(B)(i) of the Internal Revenue Code of 1986 is amended to read as follows:
Today is the 10th Anniversary of the signing of the Patient Protection & Affordable Care Act. On March 23rd, 2010, President Barack Obama signed the bill into law, although it would be another 3 years and 9 months before most of the major provisions would go into effect: ACA exchange policies, Advance Premium Tax Credits and Cost Sharing Reduction subsidies, Medicaid expansion in most states (although a few got an early start via special waivers and conversion of existing programs), and so forth.
You may notice that I referred to it as the Patient Protection & Affordable Care Act. I, like most people, tend to shorthand the name as simply "the Affordable Care Act" or "the ACA", but the truth is that it's the patient protection part which received the most attention during the Great ACA Repeal Debacle of 2017...and which has once again come front & center in the spring of 2020.
Even so, the 10th Anniversary of the signing of the Patient Protection & Affordable Care Act is coming up this Monday, so I figured I should take a moment to note the continuing trendline between the Federally Facilitated Marketplace (FFM) (HealthCare.Gov) and the State-based Marketplaces (SBMs). There have been as many as 15 or as few as 12 depending on the year.
The first table below lists the official number of Qualified Health Plans which were selected by Americans during the official Open Enrollment Periods for the first seven years they've occured. The blue cells represent states which operated their own full SBMs that year. This has changed over the years as follows:
There's only two reasons why limited-time Open Enrollment Periods exist in the first place:
1. To help prevent people from gaming the system & causing premiums to skyrocket by waiting until they're sick/injured to sign up
2. To help goad/spur people into action (deadlines are proven to be very effective at getting people off their butts)
The thing is, this is a pandemic. "Ensuring a stable risk pool" isn't exactly a top priority for anyone at this particular moment, and the economic consequences of this disaster are going to be rampant for quite awhile no matter what anyway. Right now the top priority should be making certain as many people are covered as possible. And "deadly global pandemic" is likely to be pretty "inspirational", I'd imagine.
MNsure Announces Special Enrollment Period for Uninsured Minnesotans in Response to Growing COVID-19 Concerns
ST. PAUL, Minn.—Today MNsure announced a 30-day special enrollment period (SEP) for qualified individuals who are currently without insurance, in response to the potential growth of coronavirus (COVID-19) cases. This SEP that begins Monday, March 23, and runs through April 21, will allow uninsured individuals 30 days to enroll in health insurance coverage through MNsure.org.
“As more cases of COVID-19 are diagnosed throughout the state, we want to make sure every Minnesotan has the security of health insurance to ensure they can get the care they need if they contract this serious illness,” said MNsure CEO Nate Clark. “Uninsured Minnesotans can come to MNsure.org to sign up for coverage.”
Governor Tim Walz recently declared a peacetime emergency in response to the pandemic and stressed the importance of all Minnesotans to take care to avoid the spread of COVID-19.
California Responds to COVID-19 Emergency by Providing Path to Coverage for Millions of Californians
Covered California Expands Special Enrollment and Medi-Cal Seeks Waivers to Encourage Coverage
Effective immediately, anyone uninsured and eligible to enroll in health care coverage through Covered California can sign up through the end of June.
The Department of Health Care Services announces new steps to help those eligible for Medi-Cal sign up easily and get immediate coverage.
The moves come amid widespread disruption in the lives and livelihoods of Californians as public health officials seek to reduce the spread of COVID-19.
All medically necessary screening and testing for COVID-19 are free of charge, and all health plans available through Medi-Cal and Covered California offer telehealth options.
These actions build on increased state subsidies and the implementation of a state penalty, both of which took effect in January 2020
No one has been shouting from the rooftops louder than I have for HHS Secretary Alex Azar or CMS Administrator Seema Verma to join nearly all of the state-based ACA exchanges in announcing an official Special Enrollment Period (SEP) in light of the ongoing Coronavirus pandemic, and I'm still urging them to do so as soon as possible. The federal ACA exchange, HealthCare.Gov, hosts ACA enrollment for 38 states representing around 75% of the national population, so this is a pretty big deal.
Having said that, it's important to keep in mind that even without a COVID-19-specific SEP, many people already qualify to enroll in ACA-compliant healthcare coverage anyway, whether they're currently uninsured or because they're about to be...or because their personal circumstances are about to change. And none of these have anything to do with the COVID-19 crisis, although it's certainly going to cause a whole lot more people to qualify for two of those changes:
The State of Vermont has made temporary changes to assure that Vermonters have access to health insurance. Please visit https://t.co/dXz4Cd2yQm for more information
Last week I noted that House Democrats introduced the Families First Coronavirus Response Act, which includes a whole mess of important measures to deal with the economic and public health crisis fallout of the global pandemic. This act is by no means all that's needed, but it's an important start. The bill included, among other things, additional/emergency funding for:
Earlier today at the White House Task Force Press Briefing, the Centers for Medicare & Medicaid Services (CMS) announced that all elective surgeries, non-essential medical, surgical, and dental procedures be delayed during the 2019 Novel Coronavirus (COVID-19) outbreak.
As more healthcare providers are increasingly being asked to assist with the COVID-19 response, it is critical that they consider whether non-essential surgeries and procedures can be delayed so they can preserve personal protective equipment (PPE), beds, and ventilators.
“The reality is clear and the stakes are high: we need to preserve personal protective equipment for those on the front lines of this fight,” said CMS Administrator Seema Verma.
I've only written about Montana State Auditor (which includes acting as the Insurance Commissioner, as far as I can tell) Matt Rosendale a couple of times before. The first was in October/November 2017, when he pulled a cynical, disingenuous dick move by deliberately framing a non-profit insurance carrier into losing money for purely political reasons:
Montana commissioner chides insurance companies for raising rates, despite earlier offers to help
BOZEMAN — Montana's insurance commissioner chided two companies for raising rates on health insurance policies offered under the Affordable Care Act after federal subsidies ended, despite earlier telling them they could modify their rates if circumstances changed, the Bozeman Daily Chronicle reported.
...Matt Rosendale said he was "extremely disheartened" that PacificSource and the Co-op increased their premiums, adding that he had been assured by the companies that with or without the cost-sharing reduction payments they would be able to honor the rates they first submitted.
via the Colorado Dept. of Regulatory Agencies Insurance Division, it looks like Connect for Health Colorado is about to go ahead and establish their own COVID-19 Special Enrollment Period after all (this is from an internal draft document...the dates could still change, and it's not 100% guaranteed that they'll go ahead with it yet):
DEPARTMENT OF REGULATORY AGENCIES Division of Insurance 3 CCR 702-4 LIFE, ACCIDENT AND HEALTH
DRAFT Emergency Regulation 20-E-02
CONCERNING ESTABLISHING A SPECIAL ENROLLMENT PERIOD FOR ENROLLMENT IN AN INDIVIDUAL HEALTH BENEFIT PLAN RELATED TO COVID-19
...This emergency regulation is promulgated and adopted by the Commissioner of Insurance under the authority of §§ 10-1-108(7)(a), (7)(b)(III), 10-1-109(1), 10-16-105(2)(b), 10-16-105.7(3)(a)(II)(G), 10-16-105.7(3)(b)(II)(F),10-16-108.5(8), and 10-16-109, C.R.S.
UPDATE 4/13: As I expected, the Nevada Health Link board just extended their existing #COVID19 Special Enrollment Period deadline out until May 15th:
The @NVHealthLink Board of Directors just approved of an extension to our Exceptional Circumstance Special Enrollment Period through May 15, 2020. If you or anyone you know needs insurance NOW is the time to get connected - https://t.co/7szDKShOd7 or call us at 1-800-547-2927 pic.twitter.com/Jlbpm2QXEw
One week ago, in light of the growing COVID-19 crisis, I noted that California, the District of Columbia and Maryland were each offering Special Enrollment Periods which had nothing whatsoever to do with the pandemic.
California's SEP is for uninsured residents who didn't know that the state had reinstated the individual mandate penalty and expanded financial subsidies to those earning 400-600% of the Federal Poverty Line; DC is offering one for those who didn't know they had also reinstated the mandate penalty; and Maryland passed a clever law last year which lets residents check a box when they file their state taxes if they're uninsured which tells the state to contact them to help them enroll.
I concluded that:
...as far as I know, there's nothing preventing other state-based exchanges from establishing Special Enrollment Periods for the coronavirus crisis if they want to.
Louisiana's 2020 Presidential primary was scheduled for April 4th, but the other day Democratic Governor John Bel Edwards and Republican Secretary of State Kyle Ardoin agreed to reschedule it for June 20th...which is actually later than the last previously-scheduled primary in the U.S. Virgin Islands on June 6th:
The presidential primary elections in Louisiana slated for April will be delayed by two months, the latest in a series of dramatic steps government leaders have taken to slow the spread of the new coronavirus.
Secretary of State Kyle Ardoin, Republican, and Gov. John Bel Edwards, a Democrat, both said Friday they would use a provision of state law that allows them to move any election in an emergency situation to delay the primary.
The presidential primary elections, initially scheduled for April 4th, will now be held June 20th. Ardoin said in a press conference he does not know of any other states that have moved elections because of the new coronavirus, or COVID-19.
NY State of Health and New York State Department of Financial Services Announce Special Enrollment Period for Uninsured New Yorkers, as Novel Coronavirus Cases Climb
TO CLARIFY: In pretty much all cases below, when it comes to restaurants, "shut down" refers to dining in only; they're pretty much all still allowing delivery/carryout orders.
Coronavirus emergency launches one-month special enrollment period
As part of the state’s overall response to the coronavirus, and in an effort to prioritize health and safety, Maryland Health Connection opened a new special enrollment period for uninsured Marylanders.
When will the special enrollment period begin?
The coronavirus emergency special enrollment period will begin Monday, March 16, and end Wednesday, April 15. Coverage will begin April 1, 2020, regardless of when a health plan is selected during that time period.
Special Enrollment Period (SEP) Available to Purchase Coverage through HealthSource RI as a Part of the State’s Response to COVID-19
Special Enrollment Period will be available through April 15, 2020
EAST PROVIDENCE, R.I. (March 14, 2020) — HealthSource RI has adopted a limited-time Special Enrollment Period (SEP), following Governor Raimondo’s State of Emergency declaration in response to the potential growth of Coronavirus (COVID-19). This SEP will allow uninsured Rhode Islanders to purchase coverage through April 15, 2020. Coverage will begin on the first of the month following the application.
Today, the Centers for Medicare & Medicaid Services (CMS) is posting Frequently Asked Questions (FAQs) on Essential Health Benefits (EHB) Coverage in response to the 2019 Novel Coronavirus (COVID-19) outbreak. This action is part of the broader, ongoing effort by the White House Coronavirus Task Force to ensure that all Americans – particularly those at high-risk of complications from the COVID-19 virus – have access to the health benefits that can help keep them healthy while helping to contain the spread of this disease.
“Amid a serious outbreak like this one, Americans understandably crave the security and peace of mind that comes from understanding exactly how they will be covered.” said CMS Administrator Seema Verma. “Today’s guidance aims to give it to them. Working closely with states and issuers around the country, the Trump Administration will continue to provide pertinent information to strengthen the nation’s response and keep Americans informed.”
Host: "Before I let you go, I want to ask you one more time: Are there gonna be people in this country who don't get a ventilator if they need one? Are you concerned that the actual physical equipment that is needed to serve the people who will get sick is out there...can you reassure everyone that there is not a shortage of ventilators or ICO units?"
Verma: "And that's why the President has taken such a bold and decisive action, right? We're not waiting for this to get worse, we're not waiting for this to be a crisis in our healthcare systems, and that's why the mitigation strategies that he announced last night, limiting travel from Europe, not allowing that, umm...you know, we've given travel advisories on cruise ships. That's why we're taking all of this action, because we don't want to put stress on the healthcare system."
Host: (pause) "...OK...that's not a...direct answer to the question..."
Governor Whitmer Announces Statewide Closure of All K-12 School Buildings; School building closures will last Monday, March 16 through Sunday, April 5
Today, Governor Gretchen Whitmer announced that in order to slow the spread of Novel Coronavirus (COVID-19) in Michigan, she is ordering the closure of all K-12 school buildings, public, private, and boarding, to students starting Monday, March 16 until Sunday, April 5. School buildings are scheduled to reopen on Monday, April 6.
As of tonight, the number of presumptive positive cases of COVID-19 in Michigan is 12.
This one, simple graphic instantly explains everything you need to understand about why "social distancing", including the massive cancellations of practically every large (or even medium-sized) public event is happening at a frighteningly fast rate even as I'm typing this.
The NBA? Shut down. Broadway? Shut down. The Capitol? Closed to the public. Entire school districts? Being closed left and right (including our own).
I'm sure you've noticed that I've been posting more frequently about Michigan re. COVID-19 stuff than other states; there's a simple reason--my family and I live here. I'll still be posting major breaking developments for other states as well, of course, but I'm understandably more attuned to what's going on in my own state...
HOUSE DEMOCRATS INTRODUCE FAMILIES FIRST CORONAVIRUS RESPONSE ACT
Legislation provides paid leave, establishes free testing, protects health workers, and provides important benefits to children and families
WASHINGTON, DC — House Democrats today introduced the Families First Coronavirus Response Act to bolster the federal government’s response to the coronavirus outbreak and address the severe impacts of the coronavirus on Americans’ personal safety and financial security.
The Families First Coronavirus Response Act, expected to be considered in the House on Thursday, is sponsored by Appropriations Committee Chairwoman Nita M. Lowey (D-NY) and co-sponsored by Ways and Means Committee Chairman Richard E. Neal (D-MA), Education and Labor Committee Chairman Bobby Scott (D-VA), and Energy and Commerce Committee Chairman Frank Pallone, Jr. (D-NJ).
Maryland would use state tax forms to identify uninsured residents and refer them to options for no-cost or low-cost health care under a bill moving forward in the General Assembly.
The bill, if approved, would add a question on state tax returns asking taxpayers if they have health insurance. Those who answer that they don’t have health insurance would be referred to the state's Medicaid program or the health exchange, where individuals can buy health insurance plans.
...Dorn explained to me that the way it would work is much more than that: The state tax returns would include a new line where uninsured filers would be required to check off one of two boxes:
Two years ago, Democratic Congressmen Frank Pallone, Bobby Scott and Richard Neal introduced the awkwardly-titled "Undo Sabotage and Expand Affordability of Health Insurance Act of 2018", which really amounted to a suite of improvements and strengthening of the Affordable Care Act which I simply labelled "ACA 2.0".
At the time it was purely a messaging bill, of course, since the Democrats were in the minority in the House and Senate, as well as obviously not having control of the White House either.
Almost exactly a year later, the situation had changed: Democrats were still out of power in the White House and Senate, but they had flipped the House of Representatives on a promise of working to protect, repair and strengthen the ACA. Sure enough, the same ACA 2.0 bill was re-introduced with a few tweaks and a new, even clunkier name:The Protecting Pre-Existing Conditions and Making Healthcare More Affordable Act.
As healthcare reporter Kimberly Leonard put it at the time:
BREAKING: The Centers for Medicare & Medicaid Services is allowing Medicare Advantage plans and Medicare drug plans to waive cost-sharing for #COVID2019 testing, treatments delivered by telehealth, prescription refill limits, among other things. https://t.co/LXCyroChSUpic.twitter.com/0xhbeGButN
The Centers for Medicare & Medicaid Services (CMS) is issuing this information to Medicare Advantage Organizations and Part D Sponsors to inform them of the obligations and permissible flexibilities related to disasters and emergencies resulting from COVID-19.
Massachusetts Health Connector offers extended enrollment for uninsured individuals to ease coronavirus fears
BOSTON – March 11, 2020 – To ensure everyone who wants access to covered coronavirus services has it, the Massachusetts Health Connector announced today that uninsured residents can apply and get into coverage through a 45-day window running until April 25.
On March 6, the Division of Insurance announced that Massachusetts health insurers are now required to cover the cost of testing and treatment for members who may be affected by the Coronavirus (COVID-19), including not charging co-pays or deductibles for those services. The Health Connector’s decision to open enrollment to anyone without coverage ensures Massachusetts residents concerned about contracting coronavirus can access necessary services without cost barriers.
A few days ago, in light of HHS Secretary Alex Azar admitting that neither he nor anyone else at the HHS Dept. appears to have the slightest idea about how many Americans have actually been tested for coronavirus, I kiddingly mused:
Maybe I should register CoronaTestCount.net and start up an amateur spreadsheet to track this by state for the HHS Dept...hmmmm...
I was kidding, however, because my own plate is simply too full to take on that task as well.
Michigan announces first presumptive positive cases of COVID-19
Governor Whitmer declares a state of emergency to maximize efforts to slow the spread
LANSING, Mich. – Gov. Gretchen Whitmer, the Michigan Department of Health and Human Services (MDHHS) and the Oakland County Health Division and Wayne County Health Department announced today that two Michigan residents tested presumptive positive for coronavirus disease 2019 (COVID-19), the first confirmed cases in the state. The governor has declared a state of emergency to maximize efforts and assist local governments and officials to slow the spread of the virus.
"We are taking every step we can to mitigate the spread of the virus and keep Michiganders safe," said Governor Whitmer. "I have declared a state of emergency to harness all of our resources across state government to slow the spread of the virus and protect families. It’s crucial that all Michiganders continue to take preventative measures to lower their risk, and to share this information with their friends, family, and co-workers."
ALL OTHER STATES: You may qualify for a 60-day Special Enrollment Period (SEP) if you've recently lost (or will soon lose) your employer-based healthcare coverage, or if you've experienced other Qualifying Life Events (QLE) such as getting marrinew yorked/divorced, moving, giving birth/adopting a child, getting out of prison, turning 26 etc. For these SEPs you may have to provide documentation to verify your QLE. Visit HealthCare.Gov or your state's ACA exchange website for details on the process.
Here's the full transcript (verbatim) of Joe Biden's exchange with Lawrence O'Donnell about whether he'd veto some version of Medicare for All if it were to actually pass the House and Senate:
O'Donnell: "Let's flash forward: You're President, Bernie Sanders is still active in the Senate, he manages to get Medicare for All through the Senate; it's some compromise version, Elizabeth Warren's version or some other version...Nancy Pelosi gets a version of it through the House of Representatives; it comes to your desk. Do you veto it?"
Biden (after pausing to choose his words carefully): "I would veto anything that delays providing the security and the certainty of healthcare being available now. If they got that through and, some miracle, there was an epiphany that occurred, and some miracle occurred that said, 'it's passed', then you gotta look at the cost. I'd want to know how did they find the $35 trillion? What is that doing? Is it gonna significantly raise taxes on the middle class, which it will? What's gonna happen?
Washington becomes 1st state-based marketplace to create a special enrollment opportunity in wake of coronavirus threat.https://t.co/2bYCrboXvl@GtownCHIR
"So, we've told you...we'll tell you what we know and don't know. So there's different types of tests which get sent out. The CDC's test that CDC is sending out, that's that 70...enough to send out 75,000 people, that was sent out last week. Those go to public health labs, about 80 labs in the United States, one in each state at least. Those report results back in to the CDC because they're part of the public health network. The larger quantity of tests that shipped, about 900,000 of the tests that shipped by this weekend, and then so many of the remainder of that 2 point...total, 2.1 million tests...those go to hospitals, private labs, others for testing...they don't currently have to report to us that they've conducted a test or what the result of that test is. The CDC is actively working right now to build that IT connectivity with them so we can gather that information. So right now...I could not give you a number of how many Americans have received a test because many will have received a test through hospitals or non-public health labs, and so...let's work with getting the system, the IT system up through the CDC, you want to get the accurate information as we go.
SEC. 2713. COVERAGE OF PREVENTIVE HEALTH SERVICES.
(a) In General.--A group health plan and a health insurance issuer offering group or individual health insurance coverage shall, at a minimum provide coverage for and shall not impose any cost sharing requirements for--
(1) evidence-based items or services that have in effect a rating of 'A' or 'B' in the current recommendations of the United States Preventive Services Task Force;
(2) immunizations that have in effect a recommendation from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention with respect to the individual involved; and
Governor Lamont Announces First Positive Case of Novel Coronavirus Involving a Connecticut Resident
(HARTFORD, CT) – Governor Ned Lamont today announced that the Connecticut Department of Public Health (DPH) State Laboratory has confirmed the first presumptive positive case of coronavirus disease (COVID-19) involving a Connecticut resident. The patient, a resident of Wilton who is 40 to 50 years of age, is being treated at Danbury Hospital. The person most likely became infected with the virus that causes COVID-19 during a recent trip to California and sought medical care shortly after returning to Connecticut.
This presumptive COVID-19 case is not related to the COVID-19 case involving a Danbury Hospital employee who is a resident of New York State that was announced on Friday, or the COVID-19 case involving a community physician who made rounds at Bridgeport Hospital and is also a New York State resident that was announced on Saturday.
LANSING, Mich. (AP) — Michigan health insurers said Friday they will cover the cost of medically necessary tests for the new coronavirus for people covered under employer and individual health plans, while Gov. Gretchen Whitmer announced the waiving of testing and treatment fees for Medicaid recipients.
...Plans that will waive copays and deductibles for testing costs include Blue Cross Blue Shield of Michigan, Blue Care Network, Priority Health, CVS Health, McLaren and Meridian, according to the governor’s office. The change will not apply — for now — to large employers that self-insure but use insurance companies to administer their benefits.
...Blue Cross Blue Shield will forgo prior authorization rules for diagnostic tests and covered services to treat the disease, set aside refill limits on prescriptions, and expand access to telehealth and a 24-hour nurse hotline.
TO ALL HEALTH INSURERS AND HEALTH MAINTENANCE ORGANIZATIONS AUTHORIZED TO DO BUSINESS IN FLORIDA
~ INSURANCE COVERAGE FOR CORONAVIRUS (COVID-19) ~
In response to the Executive Order #2020-51 issued by Governor Ron DeSantis establishing COVID-19 response protocols and directing a public health emergency in Florida, the Florida Office of Insurance Regulation (OIR) is issuing this Informational Memorandum to all health insurers authorized to do business in Florida to help facilitate the state’s ongoing efforts to protect Floridians.
California orders insurers to waive out-of-pocket costs for coronavirus testing
California on Thursday became the latest state to order insurance companies to waive out-of-pocket costs for coronavirus testing.
The California Department of Insurance and Department of Managed Health Care ordered all full-service commercial and Medi-Cal plans to “immediately reduce cost-sharing — including, but not limited to, co-pays, deductibles or coinsurance — to zero for all medically necessary screening and testing for COVID-19, including hospital, emergency department, urgent care and provider office visits where the purpose of the visit is to be screened and/or tested for COVID-19.”
Larry Levitt of the Kaiser Family Foundation notes:
At a town hall meeting on Fox News Thursday, President Donald Trump acknowledged that his administration intends to cut Social Security and Medicare.
“We — when these trade deals kick in, you know this economy is the best economy we’ve ever had. It’s nothing to what it’s going to be when the trade deals kick in,” said Trump.
“But if you don’t cut something in entitlements, you’ll never really deal with that,” said the questioner.
“We’ll be cutting, but we’re also going to have growth like you’ve never had before,” said Trump.
Ah. Just what you want in the middle of a reelection campaign and a deadly pandemic outbreak.
Vice-President Mike Pence, best known for botching the response to an HIV outbreak while Governor of Indiana (causing up to 200 additional residents to be infected with the disease due to his poor handling of it) has, naturally, now been put in charge of the federal response to the #COVID19 outbreak nationally:
On Wednesday February 26, President Trump placed Vice President Mike Pence in charge of the response to the coronavirus outbreak in the United States. The gesture was partly politics—signaling the disease was important enough to require the vice president’s attention—but also built on a claim about Pence’s expertise as the former governor of Indiana. As he assigned him to this task, the president praised Pence, maintaining that Indiana under his leadership was a model for the country in its approach to health.
Governor Whitmer Creates Task Forces to Combat Spread of Coronavirus
March 3, 2020
Governor creates COVID-19 task forces focused on state operations, health care, education, and the workforce
LANSING, Mich. -- Today, Governor Gretchen Whitmer announced the creation of four task forces to combat the spread of coronavirus and assess the impact it may have on Michiganders’ day-to-day lives. The task forces include:
Kreidler orders Washington health insurers to waive deductibles and copays for coronavirus testing
Contact Public Affairs: 360-725-7055
March 5, 2020
OLYMPIA, Wash. – Insurance Commissioner Mike Kreidler issued an emergency orderto Washington state health insurers requiring them to waive copays and deductibles for any consumer requiring testing for coronavirus (COVID-19).
I'm not sure how else to put this, but it's basically like if the mayor in Jaws not only refused to close the beach, but actually went on the radio and specifically told people with open wounds to go swimming and that the shark just wants to play tug-of-war with their legs.
As Vox journalist Aaron Rupar puts it:
In this clip, Trump:
1. Denies WHO's coronavirus death rate based on “hunch"
2. Calls coronavirus "corona flu" 3. Suggests it's fine for people w/ Covid-19 to go to work
4. Compares coronavirus to "the regular flu," indicating he doesn't get the difference
Osmel Martinez Azcue wanted to do the right thing, for both his own health and the health of the nation. When the Florida resident came down with flu-like symptoms shortly after returning from a trip to China, he immediately went to a local hospital to get tested for coronavirus.
A few weeks later, according to the Miami Herald, Azcue received an invoice for more than $3,000. His insurer claims he’s responsible for $1,400 of the total. He’s expecting even more bills to arrive over the next few weeks.
A 39-year-old Manhattan woman has tested positive for COVID-19, more commonly known as the novel coronavirus, Gov. Andrew Cuomo said late Sunday. She is the first confirmed case in the city and in the tri-state area.
"The patient, a woman in her late thirties, contracted the virus while traveling abroad in Iran, and is currently isolated in her home," Cuomo said in making the announcement late Sunday.
The governor said that the woman is a health care worker, and that her background allowed her to take the appropriate precautions and seek testing. She flew back to New York on Tuesday but did not take mass transit home, Cuomo said Monday. As a precaution, the people on her flight and the ride-share driver are being notified about potential exposure, but Cuomo said the woman was not thought to be contagious at that time. She has respiratory symptoms but Cuomo described them as mild.
Disclosure: I publicly endorsed Joe Biden in the Democratic primary yesterday. It had nothing to do with this post, however. Shout-out to Pradheep Shanker for bringing this to my attention.
Updated w/my exchange with Rep. Khanna at the bottom
Update: I added "(nearly all)" to the headline for extra clarity given the subject of this entry.
Ro Khanna is a Democratic Congressman representing CA-17. He's also a top Bernie Sanders surrogate and a huge Medicare for All advocate.
About an hour ago, he was interviewed on NPR for about five minutes regarding the Caronavirus, tomorrow's California Presidential primary...and Bernie Sanders' Medicare for All plan.
About a month ago I wrote a flow chart, of sorts, explaining the different potential permutations of the absurd Texas vs. Azar (aka Texas vs. U.S., aka #TexasFoldEm) lawsuit which threatens the entire Affordable Care Act. Since then there's been a few more developments (actually, a few more non-developments), the timing of which change the potential landscape a bit.
Sometime this morning the Supreme Court is expected to announce whether they'll intervene in the case:
Hey everyone! The Supreme Court may announce at at 9:30am today its decision about whether to take the big Affordable Care Act case. If it says yes, it'll hear argument in the fall (around the election!). If it says no, it'll take another three years or so to get a final answer.
NOTE: Michigan's Democratic Presidential primary isn't until March 10th, a week after Super Tuesday. With that in mind, I was planning on waiting until after it passed before announcing my own decision. After Joe Biden blew the doors off everyone in the South Carolina primary, however, I've decided to move up my announcement, because it looks pretty clear that there's only three possible ways things can go now: A Bernie victory, a Biden victory or a bonkers contested convention where anything goes.
When I supported Elizabeth Warren for the first half of 2019 (mostly...I never formally endorsed her but was 90% of the way there), I did so with the understanding that, if elected, her actual administration would be more restrained in governing than her official policy positions would indicate (it would have to be due to the nature of Congress)...and I was fine with that.
I knew that Warren knows enough about how the sausage is made to understand that you can only move the Overton Window so far before you end up achieving nothing at all. She gave what I felt was a pitch-perfect response to the question of achieving Universal Healthcare at a CNN Town Hall in March 2019:
