Charles Gaba's blog

Michigan

It's no secret that as a) a lifetime Michigan resident and b) an openly activist Democrat, I'm a huge fan of Michigan Governor Gretchen Whitmer (I was even on a healthcare town hall panel with her back in 2017 during the Repeal/Replace debacle). Having said that, I'm still impressed with the announcement just put out by the MI Dept. of Insurance & Financial Services:

Michigan Insurers on HealthCare.Gov Provide Consumer Flexibility

(LANSING, MICH) Through an agreement announced today between Governor Gretchen Whitmer, the Michigan Department of Insurance and Financial Services (DIFS), and all nine of Michigan’s Marketplace insurers, Michiganders enrolled in a health plan through the Health Insurance Marketplace can now take advantage of expanded tax subsidies offered by the American Rescue Plan without having to restart their deductibles when they switch to another plan offered by their current insurer, and in some cases even if they choose a plan through another insurer.

Arizona Icon

As I noted recently, 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.

For total monthly Medicaid enrollment, the official Medicaid.gov monthly enrollment data is only available dating back to late 2013, and it's only current through November 2020. The Kaiser Family Foundation has also compiled the pre-2014 average enrollment for each state based on the 3rd quarter of 2013. In some states I've been able to find more recent enrollment data for December 2020 or later.

Get Covered Stay Covered 2021

via the Centers for Medicare & Medicaid Services (CMS):

Today, Department of Health and Human Services (HHS) Secretary Xavier Becerra kicked off Asian Pacific Heritage Month by announcing that HHS will be partnering with select, national organizations the first week in May to support and enhance outreach and enrollment efforts for this population during the HealthCare.gov Special Enrollment Period (SEP). During the Asian American and Pacific Islander (AAPI) Week of Action, which runs May 3-7, 2021, HHS and partnering organizations will provide education and enrollment assistance to AAPI consumers and use social media to encourage them to enroll in affordable, quality health coverage available through HealthCare.gov. 

Alaska Icon

As I noted recently, 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.

For total monthly Medicaid enrollment, the official Medicaid.gov monthly enrollment data is only available dating back to late 2013, and it's only current through November 2020. The Kaiser Family Foundation has also compiled the pre-2014 average enrollment for each state based on the 3rd quarter of 2013. In some states I've been able to find more recent enrollment data for December 2020 or later.

COVID-19 Icon

A picture is worth 1,000 words and all that.

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.

NOTE: Starting this week, I've updated the spreadsheet to account for the official 2020 Census Bureau populations of every state. In most cases this has nudged their case & mortality rates down slightly.

Nearly 1 out of every 7 residents of South Dakota, North Dakota and Rhode Island have tested positive for COVID-19 to date.

More than 1 out of every 9 residents of Iowa, Tennessee, Utah, Arizona, South Carolina, Oklahoma, Nebraska and Arkansas.

More than 1 out of 10 in New Jersey, Indiana, Delaware, Mississippi, Kansas, Alabama, Illinois, Florida, New York, Georgia, Idaho, Wisconsin, Nevada, Minnesota, Wyoming and Montana.

More than 1 out of 20 in every state & territory EXCEPT Guam, Maine, Oregon, Vermont, U.S. Virgin Islands, Hawaii, N. Mariana Islands & American Samoa.

Alabama

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.

For total monthly Medicaid enrollment, the official Medicaid.gov monthly enrollment data is only available dating back to late 2013, and it's only current through November 2020. The Kaiser Family Foundation has also compiled the pre-2014 average enrollment for each state based on the 3rd quarter of 2013. In some states I've been able to find more recent enrollment data for December 2020 or later.

MNsure Logo

via MNsure:

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 Logo

This just in from the Centers for Medicare & Medicaid:

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.

Rate Change Icon

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!

COVID Icon

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 Trump won by more than 6 points
  • Yellow = Swing District (Biden or Trump won by less than 6 points)

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