Charles Gaba's blog

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Yeah, they're a bit late to the party on this, but it's still nice to see HealthSource RI issue their official 2022 Open Enrollment Period report:

EAST PROVIDENCE, R.I. (April 14, 2022) HealthSource RI’s Open Enrollment period was held from November 1, 2021 and ended on January 31, 2022. This was a very successful Open Enrollment period for HealthSource RI (HSRI), with enrollments increasing to 31,445 in 2022 compared to 30,071 in 2021. These mark HealthSource RI’s highest enrollment numbers since 2020.

The American Rescue Plan Act (ARPA), enacted by the federal government in February 2021, provided historically high savings in the form of subsidies/tax credits for eligible individuals and families in Rhode Island. ARPA also created a new opportunity for individuals and families whose income is over 400% of the federal poverty level (FPL) to receive financial assistance.

I've been posting weekly looks at the rate of COVID-19 cases & deaths at the county level since the point at which every U.S. adult could theoretically have received 2 COVID vaccination doses nearly a year ago, broken out by partisan lean (i.e, what percent of the vote Donald Trump received in 2020), as well as by the vaccination rate of each county in the U.S. (nonpartisan).

For a long time I used July 1st, 2021 as my start point, but in recent months I decided to back this up to May 1st, 2021 instead. Pinning down an exact date for this is a bit tricky since a) different populations were made eligible at different points in 2021, and b) it takes 3-4 weeks after getting your first vaccination dose before you can get the second one, but May 1st is what I've finally settled on.

As always, here's my methodology:

New York State of Health

via NY State of Health:

Enrollment Assistors Visit Public Libraries in Upstate New York Throughout April and May to Educate Patrons on Their Health Plan Options and Help Them Enroll

ALBANY, N.Y. (April 13, 2022) - NY State of Health, the state’s official health plan Marketplace, today announced that certified enrollment assistors will be available at public libraries across upstate New York this spring.  The enrollment assistors will visit libraries throughout April and May to educate New Yorkers about enrolling in quality, affordable health insurance. Assistors will provide in-person support to library patrons by educating them on their plan options, answering questions, scheduling appointments, and helping with enrollment. 

It's been several years since I've written anything substantive about "grandfathered" or "grandmothered" (aka "transitional") individual market healthcare policies. As a quick refresher:

  • Grandfathered Policies: These are non-ACA compliant policies which people were already enrolled in prior to March 2010, when the ACA was signed into law. Anyone enrolled in one of these can keep renewing them until the day they die if they wish (as long as they keep paying the premiums), or until the carrier chooses to (voluntarily) discontinue the policy.
  • Transitional (or "Grandmothered") Policies: These are non-ACA compliant policies which people enrolled in between March 2010 and October 2013. This category was created by President Obama and the HHS Dept. in November 2013 during the ugly "If You Like Your Plan You Can Keep It!" backlash. Basically, the ACA originally would have required that these policies be terminated as of 12/31/13. However, after a bunch of people received cancellation notices from their carrier, there was a massive backlash, leading Obama to announce an extension program.
Medicaid

As I (and many others) have been noting for many months now, the official end of the federal Public Health Emergency (PHE), whenever it happens, will presumably bring with it reason to celebrate...but will also likely create a new disaster at the same time:

What goes up usually goes back down eventually, and that's likely to be the case with Medicaid enrollment as soon as the public health crisis formally ends...whenever that may be.

Well, yesterday Ryan Levi and Dan Gorenstein of of the Tradeoffs healthcare policy podcast posted a new episode which attempts to dig into just when that might be, how many people could be kicked off of the program once that time comes and how to mitigate the fallout (I should note that they actually reference my own estimate in the program notes):

Connect for Health Colorado Logo

via Connect for Health Colorado:

New Program Connecting Tax Filers to Health Coverage Ends April 15

DENVER— Colorado’s new Tax Time Enrollment Program that connects uninsured tax filers to health coverage is coming to a close this Friday, April 15. Due to a state law passed in 2020, this tax season was the first in which residents could mark on their Colorado tax form that they were uninsured and interested in getting connected to coverage with Health First Colorado (Colorado’s Medicaid program) or Connect for Health Colorado, the state’s official health insurance marketplace.

Way back in the Before Times® of 2015, fellow healthcare policy wonk Andrew Sprung (aka Xpostfactoid) posed an interesting question:

Do any ACA marketplace enrollees (or off-exchange enrollees for that matter) actually confess to being smokers? Why would you?

— xpostfactoid (@xpostfactoid1) November 13, 2015

I've been posting weekly looks at the rate of COVID-19 cases & deaths at the county level since the point at which every U.S. adult could theoretically have received 2 COVID vaccination doses nearly a year ago, broken out by partisan lean (i.e, what percent of the vote Donald Trump received in 2020), as well as by the vaccination rate of each county in the U.S. (nonpartisan).

For a long time I used July 1st, 2021 as my start point, but in recent months I decided to back this up to May 1st, 2021 instead. Pinning down an exact date for this is a bit tricky since a) different populations were made eligible at different points in 2021, and b) it takes 3-4 weeks after getting your first vaccination dose before you can get the second one, but May 1st is what I've finally settled on.

As always, here's my methodology:

A few weeks ago I sounded the alarm about the massive health insurance premium rate hikes which millions of ACA enrollees will face starting in January 2023 if the American Rescue Plan's (ARP) enhanced premium tax credits aren't extended beyond their current expiration date at the end of 2022.

Today, the Urban Institute, supported by the Robert Wood Johnson Foundation, released a detailed analysis which projects just how many people would likely find themselves priced out of the health insurance market, thus losing healthcare coverage, if the ARP subsidies aren't extended. They delve into the impact at different income brackets and even break out their estimates by state:

Key Findings

With the Build Back Better Act having passed the U.S. House of Representatives last fall only to come screeching to a halt when it reached the U.S. Senate due to all 50 Republicans + Dem. Senator Joe Manchin refusing to support it, Congressional Democrats have started introducing standalone bills in an attempt to push through at least some of the more popular provisions.

One of these, which would limit co-pays for insulin to no more than $35/month or less, passed the House last week.

Today, U.S. Senator Raphael Warnock, who also sponsored the Senate version of the insulin co-pay cap bill, introduced a second stand-alone bill plucked from the ashes of Build Back Better:

Senator Reverend Warnock Introduces New Legislation to Cap Prescription Drug Costs for Georgia Seniors

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