DISCLAIMER: HealthSherpa is one of two Enhanced Direct Enrollment (EDE) ACA brokers which run banner ads on my site. EDEs are basically authorized private, 3rd-party versions of ACA exchange sites which have their back ends integrated directly into the federal exchange (HealthCare.Gov) (W3LL is the other EDE which advertises here).
Having said that, I believe Sherpa is the largest ACA EDE out there, and they're pretty transparent about their enrollment metrics, so until CMS posts their official Weekly Snapshot Enrollment Report (which should happen later this week), Sherpa's updates are pretty good indicators of how things are going overall.
Back in early September, I began noticing something very odd going on with my county-level scatter-plot graphs which broke out COVID cases/deaths by what percent of the population had been fully vaccinated:
As you might expect, there's a clear drop-off in new COVID cases per capita as the vaccination rate of the counties goes up. There seems to be a slight drop-off starting around 50% fully vaccinated, followed by a steep drop-off starting around 65% vaxxed. There's a third drop-off at around 75%, but there's literally only a handful of counties which have achieved that high a vaccination rate so far anyway.
HOWEVER, there's one major outlier over the 65% threshold...Miami-Dade County.
According to the Centers for Disease Control, Miami-Dade has fully vaccinated 68% of their entire population (1.84 million out of 2.72 million residents). I use the slightly lower official 2020 U.S. Census popualtion count for Miami-Dade County (2,701,767), which makes the vaccination rate slightly higher still: 68.24%.
I go by FULLY vaccinated residents only (defined as 2 doses of the Pfizer or Moderna vaccine or one dose of the Johnson & Johnson vaccine).
I base my percentages on the total population, as opposed to adults only or those over 11 years old (or even over 4 years old).
For most states + DC I use the daily data from the Centers for Disease Control, but there are some where the CDC is either missing county-level data entirely or where the CDC data is less than 90% complete at the county level. Therefore:
For California, I'm using the CDC data for most counties and the state health dept. dashboard data for the 8 small counties which the CDC isn't allowed to post data for.
Here's the weekly look at the rate of COVID-19 cases & deaths at the county level since the end of June, broken out by partisan lean (i.e, what percent of the vote Donald Trump received in 2020).
The ratio of case rates has started to drop; new cases are now running 2.84x higher per capita in the reddest tenth of the country than the bluest tenth, down from 3.0x higher three weeks ago:
The Centers for Medicare & Medicaid Services (CMS) is reporting that in week one of the 2022 Open Enrollment Period, approximately 774,000 people selected individual market plans in the 33 states that utilize the HealthCare.gov platform. During Open Enrollment, CMS will release weekly enrollment snapshots that provide point-in-time estimates of weekly plan selections, Marketplace Call Center activity, and visits to HealthCare.gov and CuidadoDeSalud.gov for states that utilize the platform.
As longtime readers know, every summer/fall I run analyses of the annual premium rate change filings for both the individual and small group health insurance markets for all 50 states +DC. However, I tend to put most of my focus on the individual market, since that tends to have a lot more interest and activity surrounding it.
The individual market has been rocked by both economic and policy changes from year to year (in both good and bad ways) far more than the small group market, which hasn't been in the news nearly as much. You tend to read a lot of stories about the Individual Market (both ACA-compliant as well as so-called "junk plans" like Short Term, Sharing Ministries, Farm Bureau and the like), and of course the Large Group market is massive (something like 40% of the U.S. population), so even minor changes to that are big news...but the Small Group market (which generally includes companies with 50 or fewer full-time employees, though a few states include companies with 100 or fewer) tends to get short shrift in both the news as well as healthcare wonkery.
Biden-Harris Administration Extends Hundreds of Millions of Dollars to New York’s Essential Plan, its Basic Health Program, Key Connection to Coverage Supported by American Rescue Plan
The Centers for Medicare & Medicaid Services (CMS) is providing approximately $750 million in additional funding in 2022 to support the Essential Plan, New York’s Basic Health Program (BHP), as well as added funds for 2020 and 2021. The additional funds, made available through the American Rescue Plan, increase New York’s ability to provide health care coverage to approximately 1 million individuals.
Biden-Harris Administration Extends Millions in Funding to Minnesota for MinnesotaCare, its Basic Health Program, Key Connection to Coverage Supported by American Rescue Plan
The Centers for Medicare & Medicaid Services (CMS) is providing approximately $100 million in additional funding in 2022 to support MinnesotaCare, Minnesota’s Basic Health Program (BHP), as well as added funds for 2020 and 2021. The additional funds, made available through the American Rescue Plan, increase Minnesota’s ability to provide affordable, quality health care coverage to approximately 100,000 individuals.
Way back in October 2013, I launched the ACA Signups project as a light, nerdy hobby thing which was only supposed to last around six months, through the end of the first ACA Open Enrollment Period (March 31, 2014). Instead...well, let's just say that it's more than eight years later and I'm still doing this.
The reality is that The Graph itself doesn't serve a whole lot of useful function anymore. The enrollment patterns were erratic the first couple of years but have since settled into a pretty predictable...if not downright boring pattern for both the federal and state exchanges. The main reason I keep doing it each year is mostly out of tradition these days; after all, without The Graph, there wouldn't be an ACA Signups and I wouldn't have become a healthcare policy wonk in the first place.
The pattern for both the federal and state-based exchanges typically looks like this:
Over 208,000 Washington Residents Sign Up During First Week of Washington Healthplanfinder Open Enrollment
Most customers can save by comparing plans
The annual open enrollment period for Washingtonians seeking health care coverage in 2022 began Monday, Nov. 1. Washington Health Benefit Exchange (Exchange) reports over 208,000 customers in Washington have already secured health coverage for 2022 through Washington Healthplanfinder, the state’s online insurance marketplace.
