The GOP has spent a solid decade trying to tear down the Patient Protection & Affordable Care Act. They started even before the bill was passed or signed into law, of course, which is why it ended up passing without a single Republican vote in either the House or Senate. After that, they filed lawsuit after lawsuit (a handful with merit, others utterly baseless, such as the current one, which may have the thinnest case in history to ever make it so far in federal court), while simultaneously voting to repeal the ACA either partly or fully dozens of times.
The recent elections in Virginia, Kentucky and Louisiana had two things in common: The first is that all three were huge victories for Democrats (they took control of both the state House and Senate in Virginia, flipped the Governor's seat in Kentucky and held onto it in deep red Louisiana).
The second is that all three elections were won in large part based on...Medicaid expansion.
Yet Edwards won, in large part, by also stressing his implementation of the Affordable Care Act’s Medicaid expansion in the state during his first term. Indeed, Edwards’s lead pollster, Zac McCrary, told me during an interview that no single issue was more important in driving the governor’s victory.
OK, this is a bit confusing. Over the past few years, more and more of the state-based exchanges have shifted from waiting until the end of Open Enrollment to officially report auto-renewals of existing enrollees...to going ahead and auto-renewing everyone up front, and then subtracting those current enrollees who actively cancel their renewals.
This has caused a bit of confusion, since the exchanges don't always make it clear who's being counted and when.
Case in point: Access Health CT, Connecticut's ACA exchange. Last year they reported 12,777 enrollees during the first two weeks of Open Enrollment...and also noted that there were another 85,000 existing enrollees who hadn't yet actively renewed their policies as of 11/18.
CARSON CITY, Nev. (KLAS) — Nearly 60,500 Nevadans have enrolled in a Qualified Health Plan for plan year 2020 since open enrollment began on Nov. 1.
The Silver State Health Insurance Exchange, which runs online insurance marketplace Nevada Health Link, announced these numbers just 15 days into the enrollment period.
Nevada Health Link migrated 65,563 Nevadans from HealthCare.gov onto the State Based Exchange platform at NevadaHealthLink.com.
“At exactly one-third of the way into open enrollment, we are enthusiastic about the level of engagement we’ve seen from consumers and brokers,” said Heather Korbulic, executive director of Silver State Health Insurance Exchange, in a press release. “While we still have work to do to reach the uninsured populations throughout our state, we remain optimistic that we will see enrollment numbers continue to rise throughout the duration of this enrollment period.”
The agency says this is the first year Nevada Health Link will no longer rely on HealthCare.gov after the transition began in 2018.
I've written a lot over the past nearly three years about the damage caused to ACA policy enrollment caused by the Trump Administration's slashing of 90% of HealthCare.Gov's marketing, awareness and outreach budgets.
A significant portion of the reduction in ACA exchange enrollment in 2017, 2018 and 2019 can be blamed squarely on this.
That's not just my opinion; it's been supported by detailed analysis as well as the corresponding increase in enrollment on state-based exchanges, which operate their own marketing/outreach budgets.
The following graph compares the two over the first six Open Enrollment Periods. I've had to adjust for the fact that since 2014, several states have switched from state exchanges to the federal one or vice-versa, but even so, the contrast is dramatic and clear:
Press Release: NY State of Health Announces Annual Renewal Begins Saturday
500,000 New York State Households Expected to Renew Their Health Plan for the 2020 Plan Year
Consumers Must Enroll or Renew by December 15 for Coverage Effective January 1
ALBANY, N.Y. (November 14, 2019) - NY State of Health, the state’s official health plan Marketplace, today announced that beginning November 16, the Marketplace will be open for individuals looking to renew or change their health plan for 2020. Open Enrollment for new customers seeking to enroll in a Qualified Health Plan began November 1 and runs through January 31, 2020. New Yorkers must enroll by December 15 for coverage beginning January 1, 2020.
Mayor Bowser Encourages DC Residents to Get Covered During 2020 Open Enrollment Period
Wednesday, November 13, 2019
Residents Must Enroll at DCHealthLink.com by December 15 for Coverage to Start January 1
(Washington, DC) – Mayor Muriel Bowser is encouraging DC residents to sign-up for high-quality, affordable health insurance at DCHealthLink.com, the District’s online state-based health insurance marketplace established under the Affordable Care Act. Open enrollment for District residents runs through January 31, 2020. For coverage to be effective January 1, 2020, residents must enroll by December 15.
“If you are a District resident in need of health insurance, there is no better time to find an affordable, high-quality plan,” said Mayor Bowser. “We are proud that the District has been able to build on the Affordable Care Act and ensure every family has access to health insurance and the peace of mind that coverage provides.”
As my regular readers know, I've been a strong proponent of encouraging states to pass laws locking in as many ACA "blue leg" protections as possible in the event that the ACA itself is actually struck down by the idiotic #TexasFoldEm lawsuit (again: the ruling by the 5th Circuit Court of Appeals is due to drop at any time).
However, I've also tried to make it clear that there would be a trade-off involved: If you're going to lock in all of those "Blue Leg" protections (Guaranteed Issue, Community Rating, Essential Health Benefits, No Annual/Lifetime Caps, etc), that will mean that the premiums/deductibles will be higher than they are without those protections.
This is precisely why so-called "short-term, limited duration" policies (aka #ShortAssPlans) and other non-ACA compliant policies cost so much less at the front end...they cherry pick their enrollees and don't cover the more expensive treatments many people require.
Personally, I still think states should lock in those protections anyway, since there's only two ways this can play out:
Last year, Minnesota's ACA exchange, MNsure, reported the following QHP selections numbers for the first two weeks of Open Enrollment (technically the first 13 days):
BY THE NUMBERS—
Private health plan sign ups—97,944
Call volume—14,335
Average speed of answer—7 seconds
Plan comparison sessions—49,064
The sign-ups reported include new consumers, renewing consumers who have come back and shopped for a new plan for 2019, and renewing consumers who are continuing their previous plan for 2019.
Of those, around 2,400 were new enrollees; the other 95.5K were renewals of existing enrollees (either active or auto-renewals).