As I noted a couple of weeks ago, I've relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.
ST. PAUL, Minn.—Health insurance companies that partner with MNsure have given Minnesotans another reason to move to a MNsure plan. Most Minnesotans who purchased eligible individual or family coverage directly through BlueCross BlueShield MN, HealthPartners, Medica or Quartz can now purchase a plan from their current insurer through MNsure.org and in many cases without losing the dollars already paid toward their 2021 deductibles and out-of-pocket maximums.
Recent changes to the Affordable Care Act made through the American Rescue Plan mean more Minnesotans will pay less for their insurance. And for the first time ever, Minnesotans who bought their individual or family plan from one of MNsure's partnering health insurance companies can also take advantage of these new savings, but only if they move their coverage and enroll through MNsure. Enrollees should work with their insurance company to determine which plans qualify for a transfer of amounts paid toward their 2021 deductibles and out-of-pocket maximums.
CMS to Adopt Rules to Lower Health Care Costs in 2022 Federal Health Insurance Marketplace Plans
The Centers for Medicare & Medicaid Services (CMS) today adopted new provisions to lower maximum out-of-pocket costs to consumers by $400, while increasing competition and improving the consumer experience for millions of Americans who will rely on the Federal Health Insurance Marketplaces in plan year 2022. These actions demonstrate a strong commitment by the Biden-Harris Administration to protect and build on the Affordable Care Act (ACA), reduce health care costs, and make our health care system easier to navigate and more equitable.
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, and over the years I have a pretty good track record of nailing the average unsubsidized premium changes in each state.
However, it's never going to be dead on target, for a number of reasons: Rounding errors in the rate filings, missing enrollment data, outdated enrollment data, last-minute filing changes and so forth. In some states I'm only able to find on-exchange enrollments and have to estimate the corresponding off-exchange number for each carrier; in some cases the percent changes being approved don't match from the official Uniform Rate Review Template (URRT) form to the Actuarial Filing Memo, and sometimes neither of them match up with what shows up at RateReview.HealthCare.Gov!
The data below comes from the GitHub data repositories of Johns Hopkins University, except for Utah, which comes from the GitHub data of the New York Times due to JHU not breaking the state out by county but by "region" for some reason.
Important:
Every county except those in Alaska lists the 2020 Biden/Trump partisan lean; Alaska still uses the 2016 Clinton/Trump results (the 2020 Alaska results are only available by state legislative district, not by county/borough for some reason...if anyone has that info let me know)
I define a "Swing District" as one where the difference between Biden & Trump was less than 6.0%. FWIW, there's just 187 swing districts (out of over 3,100 total), with around 33.7 million Americans out of 332 million total, or roughly 10.2% of the U.S. population.
For the U.S. territories, Puerto Rico only includes the case breakout, not deaths, which are unavailable by county equivalent for some reason.
With those caveats in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Wednesday, April 28th, 2021 (click image for high-res version).
Blue = Joe Biden won by more than 6 points
Orange = Donald Trumpwon by more than 6 points
Yellow = Swing District (Biden or Trump won by less than 6 points)
Access Health CT Announces A Special Enrollment Period Allowing New and Existing Customers To Receive Significantly Greater Financial Help At Virtually Every Income Level
Under the American Rescue Plan, new and existing customers who buy health insurance through the Marketplace will become eligible to receive increased financial help to reduce their monthly payments
As expected, the healthcare section of President Biden's first address to a joint session of Congress (technically not a State of the Union, but close enough) included a call for making the subsidies expanded under the American Rescue Plan permanent as part of the American Families Plan.
Also as expected, he did not call for other major healthcare reform priorities to be baked into the #AmFamPlan.
He did, however, spend significant time calling for those other priorities to be passed separately from the AFP...considerably more than he did on the subsidies themselves.
Before I get into the proposed healthcare policies: Early on in the speech, Biden gave a shout-out to his Administration for the success of the current, ongoing COVID Special Enrollment Period:
After weeks of anticipation and jockeying for policy priorities to be included by various advocacy groups, President Biden is set to formally roll out the American Families Plan at a speech to a joint session of Congress this evening...the first such speech of his administration, falling just ahead of his 100th day in office.
The first half of Biden's larger "American Infrastructure Plan" is the "American Jobs Plan" which addresses "hard" infrastructure like road & bridge construction/repairs, green energy investment, broadband access, overhauling our clean water system and so forth.
...over the past few years, the voters of some of those states have decided to take it upon themselves to force their legislators/governors to expand Medicaid anyway, via statewide ballot initiative campaigns:
With the urgent push by an unusually wide array of Congressional Democrats in both the Houseand Senate to lower the eligibility age of Medicare from 65 to 60 (or 55), the Kaiser Family Foundation posted an analysis of what that might look like in real-world terms for the newly-eligible enrollees, and the results, while not surprising, are pretty striking when presented the way they are in the KFF study:
This morning, healthcare reform advocacy organization Protect Our Care held a webinar in which they went over the results of a new national survey of 1,200 Americans conducted a couple of weeks ago called, simply enough, "Next Steps on Healthcare: What Voters Want".
For the most part, none of the results are terribly surprising:
Lowering the cost of healthcare and expanding affordable health insurance coverage is a top priority for a large majority of voters.
There's strong support across the board for three major healthcare proposals:
Lowering the cost of health insurance for people who purchase coverage on their own
Giving Medicare the power to negotiate with drug companies for lower prices
Giving low-income Americans who are uninsured the opportunity to obtain health insurance at little or no cost
Several of the questions were more about the framing of the issues--that is, which specific types of messaging work best.
The American Rescue Plan provides new and expanded financial help that will dramatically lower health care premiums for people who purchase health insurance through Covered California.
Nearly 200,000 San Diegans, including the uninsured and people enrolled directly through a health insurance carrier, stand to benefit from the new financial help that is now available.
In order to maximize their savings, San Diegans need to enroll before the end of this month so they can begin benefitting from the new law on May 1.
Many people will be able to get a high-quality plan for as little as $1 per month, while currently insured consumers could save up to $700 per month on their coverage if they sign up through Covered California.
SACRAMENTO, Calif. — Covered California announced that San Diegans have until April 30 to sign up for health insurance coverage, and start benefitting from new financial help available through the American Rescue Plan as early as May 1st. The landmark law provides new and increased federal tax credits that will lower health care premiums for an estimated 200,000 people in the region.
Rebecca recently testified in front of Congress on behalf of Medicare for All. Instead of trying to tell her and Charlie's story second-hand, I'm presenting her written testimony verbatim (with her permission). It's a testament to both of their strength and preserverence, but also to how unbelievably screwed up our healthcare system can be.
We may disagree about the the best route forward to achieve it, but our ultimate goal is pretty much the same: Universal, quality, comprehensive healthcare coverage for everyone in the country, without the bureaucratic paperwork nightmare which so many people face in dealing with the system today.
The trailer above is a documentary in progress being made about Rebecca, Charlie and the ongoing fight for universal healthcare coverage:
The American Rescue Plan provides new and expanded financial help that will dramatically lower health insurance premiums for people who purchase coverage through Covered California
More than 400,000 Asian Americans in California, including the uninsured and people enrolled directly through a health insurance carrier, stand to benefit from the new financial help that is now available.
In order to maximize their savings, consumers need to enroll before the end of this month so they can begin benefitting from the new law on May 1.
Many Asian Americans will be able to get a high-quality plan for as little as $1 per month, while currently insured consumers could save up to $700 per month on their coverage if they sign up through Covered California.
SACRAMENTO, Calif. — Covered California announced the state’s Asian American community has until April 30 to sign up for health insurance coverage, and start benefitting from new financial help available through the American Rescue Plan as early as May 1. The landmark law provides new and increased federal tax credits that will lower health care premiums for more than 400,000 Asian Americans in California.
Department of Health and Human Services (HHS) Secretary Xavier Becerra announced commitments from national organizations to support Black American outreach and enrollment efforts during the Special Enrollment Period (SEP) made available on HealthCare.gov by President Biden due to the COVID-19 Public Health Emergency. Black Americans represent roughly 13% of the U.S. population but 16% of the uninsured.
As part of the Black American Week of Action, April 25 – May 1, HHS and its partnership organizations will combine social media efforts to inform Black American consumers and spur enrollment in affordable, quality health plans through HealthCare.gov. An estimated 66% of Black uninsured adults now may have access to a zero-premium plan and 76% may be able to find a low-premium plan as a result of expanded coverage.
Today, the U.S. Department of Health and Human Services (HHS) announced that to continue its efforts to increase access to enrollment assistance for consumers, the Centers for Medicare & Medicaid Services (CMS) will make $80 million available in grants to Navigators in Federal Marketplaces for the 2022 plan year. The funding, which will be used for outreach and education efforts, is the largest allocation CMS has made available for Navigator grants to date and represents an eight fold increase in funding from the previous year. CMS invested $10 million annually in the Navigator program beginning with funding awarded in 2018 for the 2019 plan year. CMS awarded $36.2 million in 2017 for the 2018 plan year, down from a high of $63 million awarded in 2016 for the 2017 plan year.
I've done my best to label every state/territory, which obviously isn't easy to do for most of them given how tangled it gets in the middle.
Nearly 1 out of every 7 residents of North Dakota and Rhode Island have tested positive for COVID-19 to date.
More than 1 out of every 8 residents of South Dakota has tested positive to date.
More than 1 out of every 9 residents of Iowa, Utah, Tennessee, Arizona, Nebraska, Oklahoma, New Jersey and South Carolina.
More than 1 out of 10 in Arkansas, Alabama, New York, Kansas, Indiana, Delaware, Mississippi, Idaho, Illinois, Georgia, Florida, Wisconsin, Nevada, Montana and Minnesota.
More than 1 out of 20 in every state & territory EXCEPT Guam, Maine, Oregon, Vermont, zU.S. Virgin Islands, Hawaii, N. Mariana Islands & American Samoa.
As I noted last night, the healthcare provisions of the upcoming American Families Plan could be in jeopardy, due primarily to (wait for it) the liberal and progressive wings of the Democratic party squabbling over whether to pass ACA 2.0 or to beef up Medicare instead. Aside from the fact that this is likely a false choice (there seem to be several options available to pay for both, or at the very least to pay for large portions of each), this has also led to various factions of Democrats to move more assertively to ensure their priorities are included.
The New Democrat Coalition (NDC) consists of 94 mainstream House Democrats, including many of those who first took office after the 2018 midterms to help flip control of the House.
Another quick Connecticut update...I've received the following Special Enrollment Period (SEP) QHP selection numbers for the past three years, and they're pretty telling:
SEP Enrollment for the 2/15 – 4/15 Timeframe:
2019 - 1,817
2020 - 4,250
2021 - 5,890
That averages out to:
2019: 30/day
2020: 70/day (2020 was a leap year)
2021: 98/day
2020 isn't really a good comparison year, since COVID had already started ravaging the U.S. by mid-March and Connecticut also launched a COVID SEP from March 18th - April 17th last year as well. The spring of 2019, however, didn't have anything special going on, so that's a perfect pre-COVID comparison year: The 2021 COVID SEP racked up 3.26x as many new enrollees as you'd typically expect to during the off-season for the same time period.
A week or so ago, Access Health CT's COVID Special Enrollment Period ended...but they also announced that they're re-launching a new SEP starting on May 1st anyway. This amounts to them taking a 2-week pause to reprogram/retool their website to take advantage of the expanded ACA subsidies under the American Rescue Plan.
At the time, they were only allowing current exchange enrollees to switch plans mid-year via a cumbersome process of calling into the exchange directly. Today it sounds like that's been changed:
The Biden Administration's first major bill was, of course, the American Rescue Plan, which actually consisted of perhaps a dozen smaller bills which were debated and passed out of a bunch of different House/Senate committees individually before being merged together into the larger package bill.
The next major legislative effort in the works is supposed to be an even larger omnibus infrastructure bill, broken into two major sections: "The American Jobs Plan" and "The American Families Plan". The "Jobs Plan" is supposed to include so-called "hard infrastructure". Here's the summary of the major bullets according to the White House website:
It's been nearly a month since I posted my final estimate of the official national and state-level tally for the 2021 Open Enrollment Period (OEP). At the time, I pegged the final total at just barely over 12.0 million QHP selections nationally...the first time an ACA OEP had hit that threshold since the end of the Obama Administration (this seems fitting for obvious reasons).
Earlier today, the Centers for Medicare & Medicaid (CMS) issued the official 2021 OEP report, as well as the accompanying Public Use Files (PUFs) which break the data out in all sorts of ways. Let's dig in!
The data below comes from the GitHub data repositories of Johns Hopkins University, except for Utah, which comes from the GitHub data of the New York Times due to JHU not breaking the state out by county but by "region" for some reason.
Important:
Every county except those in Alaska lists the 2020 Biden/Trump partisan lean; Alaska still uses the 2016 Clinton/Trump results (the 2020 Alaska results are only available by state legislative district, not by county/borough for some reason...if anyone has that info let me know)
I define a "Swing District" as one where the difference between Biden & Trump was less than 6.0%. FWIW, there's just 187 swing districts (out of over 3,100 total), with around 33.7 million Americans out of 332 million total, or roughly 10.2% of the U.S. population.
For the U.S. territories, Puerto Rico only includes the case breakout, not deaths, which are unavailable by county equivalent for some reason.
With those caveats in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Thursday, April 20th, 2021 (click image for high-res version).
Blue = Joe Biden won by more than 6 points
Orange = Donald Trumpwon by more than 6 points
Yellow = Swing District (Biden or Trump won by less than 6 points)
Quick: Run a Google search for "Obamacare" or "Health Insurance" and see what the first listings which come up are. The odds are pretty high that the first listing won't be HealthCare.Gov, Pennie.com, CoveredCA.com or any of the other state-based ACA exchanges. In fact, the first link which comes up probably won't even be for Blue Cross Blue Shield, Molina or Centene (the actual health insurance carriers themselves).
It's far more likely that the most prominent sites to come up in Google's paid search listings will be third-party health insurance brokers. If you click on the link, you may be taken to a legitimate health insurance broker authorized to sell on-exchange ACA policies...or you may be taken to a fly-by-night quasi-legal outfit which either pushes junk plans or simply resells your contact info to fourth-party scammers. In many cases, they may even include the terms "Obamacare" or "ACA" baked into their names:
I've noted before that enrollment in Michigan's ACA Medicaid expansion program, "Healthy Michigan", has risen sharply over the past year since the COVID-19 pandemic hit; it's up by over 1/3 since last February.
However, it's also worth noting that non-ACA Medicaid enrollment has also jumped significantly since the pandemic arrived. I've dug into data from the Centers for Medicare & Medicaid, the Kaiser Family Foundation and Michigan's Health Dept. archives and put together the graph below, showing that non-ACA Medicaid enrollment has risen from around 1.66 million Michiganders in February 2020 to over 1.92 million today, a 16% increase.
Combined, total Medicaid enrollment is up by around 21% to over 2.82 million as of April 2021.
Around half the 50 states (+DC) expanded Medicaid under the Affordable Care Act starting in 2014. Since then, roughly half of the remaining states have also done so, either via executive order by the Governor, a new state legislature coming around or, most frequently, via statewide ballot initiative.
Final Deadline for 2021 Health Insurance is April 30
Last Chance for Idahoans to Receive Enhanced Subsidies
BOISE, Idaho – Your Health Idaho, the state health insurance exchange, announced the final day to enroll in 2021 health insurance, without a Qualifying Life Event, is April 30.
“This is the last chance for Idahoans to take advantage of the increased tax credits and enroll in 2021 coverage,” said Pat Kelly, Your Health Idaho Executive Director. “These savings can be significant for Idaho families who may have thought health insurance was out of reach prior to the American Rescue Plan Act.”
I've confirmed that unlike other state exchanges which have bumped out their deadlines repeatedly, Your Health Idaho explicitly does not intend on extending this deadline out again: April 30th is the final deadline.
After extending the special enrollment period deadline from March 31, exchange officials are urging Idahoans to apply for savings from a health insurance tax credit and make their final plan selection by 11:59 p.m. (MT) on Friday, April 30.
Nevada Health Link Announces Health Insurance Savings Through the American Rescue Plan Act
Nevadans seeking health coverage can access increased or expanded subsidies and premium savings, healthcare tax credits, expanded COBRA protections and increased plan options
CARSON CITY, Nev. (April 16, 2021) – Nevada Health Link, the online health insurance marketplace operated by the state agency, the Silver State Health Insurance Exchange (Exchange), is offering even bigger coverage savings to eligible uninsured and insured off-Exchange Nevadans. These new enhancements are in accordance with the newly-enacted American Rescue Plan Act (ARPA or American Rescue Plan) of 2021 passed by Congress and signed into law by President Biden on March 11, 2021.
The Urban Institute has come out with a brand-new analysis which projects the impact of making the ACA subsidies which have been expanded & enhanced temporarily under the American Rescue Plan permanent. In other words, this is what they expect the real-world impact would be if Congress were to finally #KillTheCliff and #UpTheSubs permanently (as opposed to for just 2021 - 2022), as I and other healthcare activists been pushing for for years now.
A couple of weeks ago, I used the COVID Special Enrollment Period (SEP) data I had for HealthCare.Gov through the end of March, combined with limited SEP data from some state-based ACA exchanges, to extrapolate out a rough estimate of how many new Qualified Health Plan (QHP) selections may have happened since the new "Spring 2021 Special Enrollment Period" was launched on February 15th, 2021.
At the time, I estimated that perhaps 15,800 people per day on average had newly enrolled in ACA exchange policies as of the end of March, or roughly 710,000 nationally. This included the 528,000 confirmed enrollees via HealthCare.Gov, plus another 183,000 or so via the 15 state-based exchanges.
Savings to the Rescue – Pennie is Now Open with Increased Savings
Pennie Customers Can Now See Savings When Shopping for Health Coverage
Uninsured Pennsylvanians will be able to receive significant savings in health coverage as a result of the American Rescue Plan
Harrisburg, PA – April 16 – As a result of the recent American Rescue Plan, also known as the COVID-19 relief package, provisions specific to the Affordable Care Act have impacted the way health insurance is available in Pennsylvania. These provisions include significant impacts, including an increase in savings, for Pennsylvanians seeking individual market coverage and those already enrolled through Pennie, as well as those who may lose their employment and rely on COBRA to maintain their employer coverage. Pennie is excited to announce that these savings are now available at pennie.com for those looking to enroll in quality, affordable coverage.
Good news! More financial help is now available through Get Covered New Jersey
New Federal and State Savings
The federal government recently passed a COVID-19 relief bill, the American Rescue Plan Act of 2021, which was signed into law by President Biden on March 11, 2021. The new law will reduce health insurance premiums by providing more financial help to eligible consumers who purchase a plan through Get Covered New Jersey. The State of New Jersey is also providing more financial help to lower health insurance costs for residents enrolling at Get Covered New Jersey.
More people than ever will qualify for financial help. If you did not qualify for financial help before because your income was too high, you may qualify under the state and federal changes. If you already receive financial help, you will likely be eligible for additional premium reductions. These new changes make coverage more affordable at many income levels.
I've done my best to label every state/territory, which obviously isn't easy to do for most of them given how tangled it gets in the middle.
More than 1 out of every 8 residents of North Dakota, South Dakota and Rhode Island have tested positive for COVID-19 over the past year.
More than 1 out of every 9 residents of Iowa, Utah, Tennessee, Arizona and Nebraska have tested positive.
More than 1 out of 10 in Arkansas, South Carolina, New Jersey, Alabama, Kansas, Indiana, New York, Mississippi, Idaho, Delaware, Illinois, Georgia, Wisconsin, Nevada and Florida.
More than 1 out of 20 in every state & territory EXCEPT Guam, Oregon, Maine, Vermont, U.S. Virgin Islands, Hawaii, N. Mariana Islands and American Samoa.
OK, this is a first...while most other states have been simply extending their existing COVID Special Enrollment Periods out through August to allow for the newly-expanded ACA subsidies, Connecticut is shutting theirs down at midnight tonight (April 15th)...but relaunching it again on May 1st:
American Rescue Plan Act of 2021: Savings Coming for Connecticut Residents
You Can Start to Take Action & See Savings After May 1, 2021
A new federal law was passed in March 2021, the American Rescue Plan Act, and it changed the way we calculate financial help for customers for this year and 2022. Many more customers will now qualify for financial help to make plans more affordable. Whether you’re a first-time shopper, or an existing customer, there could be big changes ahead for your household, and we want to make sure you know how to take advantage of the new financial help available.
Connect for Health Colorado Offers More Savings to More Coloradans on Health Insurance Costs
Many Residents Can Find Coverage for Just A Few Dollars a Month
DENVER – Starting today, Thursday, April 15, Coloradans seeking health insurance can access more savings as a result of the American Rescue Plan (also known as the “COVID relief package”) when they shop through Connect for Health Colorado®. The American Rescue Plan expanded financial help for health insurance plans that people buy via the federal and state health insurance exchanges through 2022. And, for the first time, ever, Colorado individuals and families of all income ranges can qualify for reduced premiums.
“We’re ready and eager to provide these savings to more Coloradans who need relief right away,” said Chief Executive Officer Kevin Patterson. “I encourage those who need coverage to sign up. If you were unable to obtain financial help in the past, now is the time to re-apply. You might be surprised how much you can save.”
So, the American Rescue Plan includes two important provisions whch I've been fighting for for years: #KillTheCliff and #UpTheSubs. The only downside is that, for now at least, these ACA enhancements are only included for two years (including 2021...the beefed-up & expanded subsidies are retroactive to January 1st of this year).
As a reminder (this is like the 20th time I've posted a table like this), here's the official ACA subsidy formula compared to the improved formula under the American Rescue Plan (ARP):
Note: The Federal Poverty Level (FPL) is 15% higher per household in Hawaii and 25% higher in Alaska.
The data below comes from the GitHub data repositories of Johns Hopkins University, except for Utah, which comes from the GitHub data of the New York Times due to JHU not breaking the state out by county but by "region" for some reason.
Important:
Every county except those in Alaska lists the 2020 Biden/Trump partisan lean; Alaska still uses the 2016 Clinton/Trump results (the 2020 Alaska results are only available by state legislative district, not by county/borough for some reason...if anyone has that info let me know)
I define a "Swing District" as one where the difference between Biden & Trump was less than 6.0%. FWIW, there's just 187 swing districts (out of over 3,100 total), with around 33.7 million Americans out of 332 million total, or roughly 10.2% of the U.S. population.
For the U.S. territories, Puerto Rico only includes the case breakout, not deaths, which are unavailable by county equivalent for some reason.
With those caveats in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Thursday, April 14th, 2021 (click image for high-res version).
Blue = Joe Biden won by more than 6 points
Orange = Donald Trumpwon by more than 6 points
Yellow = Swing District (Biden or Trump won by less than 6 points)
A few weeks ago, I noted that one of the numerous ACA-related provisions of the American Rescue Plan was this one:
Put simply, subsidized enrollees last year received around $6.3 billion in "excess subsidies"...they underestimated their income for the year 2020 and would normally be required to pay them back, but the ARP is waiving that "clawback" of overpayments for one year only in response to the pandemic.
Again, these are subsidies which were already paid out in 2020. The money is already in the hands of the enrollees (well, technically it's in the hands of the insurance carriers, but that in turn freed up an equal amount in the bank accounts of the enrollees, anyway). This provision simply says that the enrollees don't have to pay it back.
...there's also another small but critical detail included in the table above which escaped my attention last summer in H.R. 1425.
Take a look at the first line of Rep. Underwood's 2019 version (H.R 1868):
Over 100.0 percent up to 133.0 percent
Now take a look at the first line under both H.R. 1425 and H.R. 369:
Up to 150.0 percent
Notice the difference? I'm not talking about the "up to 150%" part. I'm talking about the removal of the "Over 100.0 percent" part.
If this were to pass the House & Senate and be signed into law by President Biden using this exact language, it would apparently eliminate the Medicaid Gap...albeit with a couple of major caveats.
UPDATE 4/13/21:An earlier version of this post had misinterpreted Linda Blumberg's estimate how much S.499 would cost--I thought that the $350 billion estimate was the gross projected 10-year cost without taking into account the impact of eliminating Silver Loading, but it turns out that it's the net cost after taking that into account as well. My apologies for such a bone-headed error.
Having said that, there's still the possibility of up to $196 billion in additional savings elsewhere, so it's still worth discussing the relative costs of both proposals and seeing whether both, or at least parts of both, could still be worked into the American Families Plan. I've significantly reworked the the wording of the post accordingly.
Nevada Health Link opened a Special Enrollment Period (SEP) for uninsured Nevadans, starting February 15 through August 15, 2021. The SEP is in accordance with the Executive Order issued by President Biden last month, in response to the ongoing national emergency presented by COVID-19.
Coming soon! Thanks to the recently passed American Rescue Plan, we’ll soon be offering more money to help pay for your coverage. Learn more here.
On January 29, 2021, the Department of Banking and Insurance (“Department”) issued Bulletin No. 21-03 advising carriers and other interested parties that an emergency COVID-19 Special Enrollment Period (“COVID-19 SEP”) would go into effect on February 1, 2021 and extend through May 15, 2021. The COVID-19 SEP ensured that New Jersey residents have access to quality affordable health insurance during a critical time in which the need to protect public health is paramount. Specifically, the COVID-19 SEP made sure that individual market coverage was available to uninsured individuals during the pandemic. It also aligned New Jersey with the Federal Special Enrollment Period which runs through May 15, 2021 and the Federal Public Health Emergency.
Covered California Opens the Doors for Millions of Californians to Benefit From Lower Health Care Premiums, Save Money and Stimulate the Economy Through the American Rescue Plan
The data below comes from the GitHub data repositories of Johns Hopkins University, except for Utah, which comes from the GitHub data of the New York Times due to JHU not breaking the state out by county but by "region" for some reason.
Important:
Every county except those in Alaska lists the 2020 Biden/Trump partisan lean; Alaska still uses the 2016 Clinton/Trump results (the 2020 Alaska results are only available by state legislative district, not by county/borough for some reason...if anyone has that info let me know)
I define a "Swing District" as one where the difference between Biden & Trump was less than 6.0%. FWIW, there's just 187 swing districts (out of over 3,100 total), with around 33.7 million Americans out of 332 million total, or roughly 10.2% of the U.S. population.
For the U.S. territories, Puerto Rico only includes the case breakout, not deaths, which are unavailable by county equivalent for some reason.
With those caveats in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Thursday, April 8th, 2021 (click image for high-res version).
Blue = Joe Biden won by more than 6 points
Orange = Donald Trumpwon by more than 6 points
Yellow = Swing District (Biden or Trump won by less than 6 points)
Two months ago, I noted that the Washington state legislature had decided to beef up their quasi-Public Option law to make the PO plans (called "Cascade Select") more robust and less expensive:
Let's step back a moment: There's actually up to three types of policies being offered depending on the carrier:
Qualified Health Plans (QHPs)...these are the normal policies which comply with ACA regulations offered by most carriers.
Cascade (Standard)...these are QHPs which also follow another state law passed last year (see below), and
Cascade (Select)...these are Standardized QHPs which are also public option plans.
Here's the distinction between Cascade "standard" and Cascade "select":
I've done my best to label every state/territory, which obviously isn't easy to do for most of them given how tangled it gets in the middle.
More than 1 out of every 8 residents of North Dakota, South Dakota and Rhode Island have tested positive for COVID-19 over the past year.
More than 1 out of every 9 residents of Iowa, Utah, Tennessee and Arizona have tested positive.
More than 1 out of 10 in Nebraska, Arkansas, South Carolina, New Jersey, Alabama, Kansas, Indiana, Mississippi, Idaho, New York, Georgia, Illinois, Wisconsin and Delaware.
More than 1 out of 20 in every state & territory EXCEPT Washington, Guam, Oregon, Maine, Vermont, U.S. Virgin Islands, Hawaii, N. Mariana Islands and American Samoa.
A couple of weeks ago, I used the limited COVID Special Enrollment Period (SEP) data I had for HealthCare.Gov from the last two weeks of February, plus some limited SEP data from a handful of state-based ACA exchanges, to extrapolate out a rough estimate of how many new Qualified Health Plan (QHP) selections may have happened nationally.
At the time, I estimated that perhaps 18,500 people were enrolling per day nationally the final two weeks of February, and that IF that pace remained the same throughout the entire month of March, it would amount to upwards of 832,000 new people enrolling by the end of March (666,000 via HealthCare.Gov, plus another 166,000 via the 15 state-based exchanges).
It's important to note that this wasn't a hard estimate--I was pretty sure that the actual enrollment pace would slow down somewhat after the inital surge, at least until expanded subsidies via the American Rescue Plan (ARP) were officially available in most states, which didn't happen until April 1st.
More Coloradans Than Ever Are Using Colorado’s Exchange to Get Covered
DENVER — In a report released today by Connect for Health Colorado, nearly 180,000 Coloradans signed up for a health insurance plan by the end of the Open Enrollment Period on Jan. 15 for 2021 coverage. The new report includes more detailed information about changes to premium costs and financial help by county, the improved customer experience and our outreach tactics.
I last updated my Michigan Medicaid expansion tracking back in January.At the time, I noted that enrollment in this ACA programhas increased dramatically here in Michigan since the COVID-19 pandemic struck, increasing from 673,000 in February 2020 to 853,000 as of January 2021, or nearly 27% in less than one year.
As of April 5th, the Healthy Michigan program (that's the branding of Michigan's ACA Medicaid expansion) notes 897,261 enrollees. That's a net increase of 224,000 Michiganders enrolled in the program since last February, or over 33%.
With this as backdrop, consider the timing of the following events:
Obviously a lot has changed since then, primarily due to the COVID-19 pandemic, but I presume this is the most recent comprehensive, reliable data they've been able to compile:
The ACA's language didn't account for the possibility that some states might not expand Medicaid, which is why the lower-end range of exchange plan subsidy eligibility starts off at 100% FPL...
Unfortunately, those earning less than 100% FPL are still stuck without any viable options besides either "going bare" and praying they don't get sick or injured or possibly buying a junk plan of some sort. According to the Kaiser Family Foundation, there's around 2.2 million Americans still caught in the "Medicaid Gap", where they don't qualify for Medicaid but don't earn enough to be eligible for subsidized ACA exchange policies (Kaiser estimates another 1.8 million uninsured adults in these states in the 100 - 138% "overlap" cateogory, plus around 356,000 who are eligible for Medicaid but still haven't enrolled for one reason or another).
Note:A few weeks ago, I ran a rough back-of-the-envelope extrapolation of partial data from the first 2 weeks of the ongoing COVID Special Enrollment Period and concluded that IF enrollment via the 36 HealthCare.Gov states was representative nationally, and IF the pace of the last 2 weeks of February held perfectly steady, it would mean around 666,000 new enrollees via HC.gov and 832,000 nationally by the end of March. Those were two pretty big caveats, of course, and as you'll see below, the reality wasn't quite as eyebrow-raising, though it's still pretty impressive.
AMERICAN RESCUE PLAN ACT DRAMATICALLY LOWERS HEALTH CARE COSTS FOR MANY MARYLANDERS
Low income individuals and families will pay nearly nothing for private health plans, higher income will be eligible for savings for the first time
(BALTIMORE) — Gov. Larry Hogan and Maryland Health Connection today announced reductions in the health plan costs that reflect additional financial help available through the federal American Rescue Plan Act. The new law means that:
The White House is expected to roll out the health care priorities for its two-part infrastructure package sometime this Spring, and the health piece potentially could move separately now that the Senate parliamentarian has agreed Democrats have another shot passing their priorities through a simple majority. While there appears to be consensus that the bill will expand, or make permanent, the Affordable Care Act tax credits from the American Rescue Plan, other policies are less clear and will likely depend on the amount of offsets lawmakers can glean from drug-pricing measures.
Minnesotans will see expanded tax credits through MNsure beginning today
Savings will be applied this spring and summer; MNsure extends special enrollment period through July 16
ST. PAUL, Minn.—Recent changes to the Affordable Care Act made through the American Rescue Plan mean more Minnesotans will be able to access tax credits through MNsure. The changes lower premiums for most people who are currently enrolled through MNsure and expand access to tax credits to many Minnesotans who previously made too much money to qualify for financial help. Minnesotans who are not currently enrolled in a plan through MNsure, including those who are uninsured, have until July 16 to enroll in coverage.
Of all the problems the ACA has encountered over the 11 years since it was first signed into law by President Obama, one of the stupidest and most irritating ones had nothing to do with Republican sabotage. The call on this one was made by the IRS (then under the Obama Administration), based on their interpretation of a few bits of language within the legislative text itself back in 2013: The Family Glitch.
We still get calls on a regular basis from people who are shopping for individual insurance because adding dependents to their employer plan is prohibitively expensive. We estimate that roughly 20 percent of the people who contact us are in this situation.
Unfortunately, due to a “glitch” in the ACA, they are not eligible for premium subsidies in the exchange if the amount the employee has to pay for employee-only coverage on the group plan is deemed “affordable” – defined as less than 9.78 percent of household income in 2020.
Out of the dozen or so rule changes included in the 2022 NBPP, several of them were perfectly reasonable; several were fairly nominal or neutral...and several of them should have set off red flags everywhere for the incoming Biden Administration, including:
Allowing states to flat-out privatize their ACA marketplaces
Pushing navigators and assisters to use private, 3rd-party direct enrollment brokers
Codifying the Trump Administration's warped interpretation of ACA Section 1332 waivers
There's also a couple of rules in the 2022 NBPP which I opposed, but which won't cause too much damage (at least relative to the three above):
NOTE: This is an updated version of a post from a couple of months ago. Since then, there's been a MASSIVELY important development: The passage of the American Rescue Plan, which includes a dramatic upgrade in ACA subsidies for not only the millions of people already receiving them, but for millions more who didn't previously qualify for financial assistance.
Much has been written by myself and others (especially the Kaiser Family Foundation) about the fact that millions of uninsured Americans are eligible for ZERO PREMIUM Bronze ACA healthcare policies.
I say "Zero Premium" instead of "Free" because there's still deductibles and co-pays involved, although all ACA plans also include a long list of free preventative services from physicals and blood screenings to mammograms and immunizations with no deductible or co-pay involved.
The data below comes from the GitHub data repositories of Johns Hopkins University, except for Utah, which comes from the GitHub data of the New York Times due to JHU not breaking the state out by county but by "region" for some reason.
Important:
Every county except those in Alaska lists the 2020 Biden/Trump partisan lean; Alaska still uses the 2016 Clinton/Trump results (the 2020 Alaska results are only available by state legislative district, not by county/borough for some reason...if anyone has that info let me know)
I define a "Swing District" as one where the difference between Biden & Trump was less than 6.0%. FWIW, there's just 187 swing districts (out of over 3,100 total), with around 33.7 million Americans out of 332 million total, or roughly 10.2% of the U.S. population.
For the U.S. territories, Puerto Rico only includes the case breakout, not deaths, which are unavailable by county equivalent for some reason.
With those caveats in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Thursday, April 1st, 2021 (click image for high-res version).
Blue = Joe Biden won by more than 6 points
Orange = Donald Trumpwon by more than 6 points
Yellow = Swing District (Biden or Trump won by less than 6 points)
Single Parent; Nuclear Family; Empty Nesters w/College-age kid; 60-yr old couple
Here's how much the "Nuclear Family of four" example (40-yr old ocuple with 2 children) would theoretically save, assuming they choose the avg. national benchmark Silver plan:
Washington Healthplanfinder is extending special enrollment period for Washingtonians seeking health coverage through August 15, 2021
More Savings Coming to Washington Healthplanfinder Customers
Due to recent federal action bringing new savings opportunities to current and new individual health insurance market customers, Washington Healthplanfinder is extending the current special enrollment period from May 15 through August 15. This aligns with the recent federal announcement extending the special enrollment period for those using the federal marketplace. This special enrollment period allows currently uninsured individuals, and people both on and off the Exchange, the opportunity to benefit from these new savings.
Roughly 29 million people currently living in the US lack health insurance. According to the new HHS estimates, about 6.8 million of them could now purchase an ACA plan with no monthly premium, and another 1.3 million could sign up for a health plan that costs less than $50 a month. Many of those people already qualified for free or low-cost coverage prior to the ARP, but based on the federal projections, the new law’s expansion of the ACA made an additional 2 million Americans eligible for free or cheap coverage.
An average of three out of five eligible uninsured Americans can access $0 plans after advance payments of tax credits and an average of four out of five current HealthCare.gov consumers will be able to find a plan for $10 or less per month after advance payments of tax credits
Department also announces $50 Million Boost to Special Enrollment Period Outreach Campaign
Today, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra announced that additional savings and lower health care costs are available for consumers on HealthCare.gov. The American Rescue Plan (ARP) has increased tax credits available to consumers, helping to reduce premiums and giving consumers access to affordable health care coverage.
The Department also announced an additional $50 million in advertising to bolster the Special Enrollment Period outreach campaign. The campaign will run through August 15, 2021.
