Charles Gaba's blog

In my post a few weeks ago about Minnesota's plan to dramatically expand their existing Basic Health Plan (BHP) program, MinnesotaCare, into a full-fledged Public Option open to residents not currently eligible for the program, I made an offhand reference to similar BHP expansion-related news happening in New York State. However, I haven't gotten around to actually writing about NY's BHP program until now.

New York's implementation of the ACA's BHP provision (Section 1331 of the law) is called the Essential Plan, and it already serves over eleven times as many people as Minnesota's does (around 1.1 million vs. 100K). Part of this is obviously due to New York having a larger population, but that's only part of it (NY has 19.84M residents, just 3.5x higher than MN's 5.71M).

Whenever I write about BHPs I always throw in a simple explainer about what it is, with an assist from Louise Norris:

Last fall I noted that Oregon (along with Kentucky, although it looks like the latter got cold feet later on) may end up becoming the third state (after Minnesota and New York) to create a Basic Health Plan program which would provide comprehensive, inexpensive (or potentially free) healthcare coverage for residents who earn between 138% - 200% of the Federal Poverty Level (FPL)...basically, the next income tier above the cut-off for ACA Medicaid expansion. A few days ago, the state legislature passed a bill which would create a task force to put together their findings and recommendations no later than September 1st of this year.

Last year I went pretty off-topic with a lengthy, in-the-weeds post about my experience shopping for, buying and driving an electric vehicle for the first time which received a decent level of attention.

I didn't actually get around to writing up the post until June, but I actually bought the car, a 2022 Kia Niro EV, in early March...March 5, 2022 to be precise, almost exactly one year ago.

With a year of real world driving (including an 1,100 mile (round trip) road trip from Metro Detroit to the District of Columbia) baked in, I figured this would be a good time to post an update on how things are going for those who've never owned an EV and are wondering about the good, the bad & the ugly of the experience.

Before I get started, I should take a moment to note that the EV industry and market have both gone through some tumultuous changes over the past 12 months, including (but not limited to):

NOTE: With the news that the Johns Hopkins University COVID Tracking project & other reliable data sources are shutting down on March 10th, this may be the last update to this project, although I may be able to find alternatives for county-level COVID deaths.

As of this writing, 69.3% of the total U.S. population has completed their primary COVID-19 vaccination series (including 94.3% of those 65+), but a mere 16.2% of the total population has also gotten their updated bivalent booster shot. Even among seniors it's only at 41.4% nationally.

via Pennie, Pennsylvania's state-based ACA exchange:

Harrisburg, PA – At the conclusion of Pennie’s Open Enrollment Period on January 15th, nearly 372,000 Pennsylvanians were enrolled in a comprehensive health plan. Almost 245,000 Pennsylvanians were automatically renewed into a 2023 plan, another 62,000 existing customers returned and shopped for a plan, and nearly 65,000 new enrollees joined the marketplace in 2023.

Pennie provides significant savings on health coverage to improve access to health care and to counter rising costs. Almost 90 percent of total customers are receiving financial savings, which on average, is more than $520 a month for those customers. With these savings, over 32 percent of customers pay less than $50 a month for coverage, and over 50 percent of customers pay less than $150 a month.

Via Health Source Rhode Island:

HealthSource RI Concludes Open Enrollment Period

• 4,318 Rhode Islanders are newly insured, supporting state’s outstanding insured rate of 97%  

PROVIDENCE – HealthSource RI (HSRI) announces that its annual Open Enrollment period has concluded as of January 31, with 4,318 Rhode Island residents newly enrolled in the affordable qualified health plans available through the state marketplace. An additional 24,343 individuals, or 83% of last year’s customers, renewed their coverage during the same period starting November 1.

That's 28,661 QHP selections total, down 11.4% from the 2022 Open Enrollment Period.

“We’re encouraged that each year more Rhode Islanders are taking advantage of the quality, affordable coverage options available to them through HealthSource RI,” said Governor Dan McKee. “Rhode Island continues to be a national leader in health coverage and HSRI is an instrumental piece of the effort to maintain our extraordinarily high rate of insurance coverage.”

UPDATE 3/15/23: The agreed-to Medicaid expansion deal has passed the NC State Senate! It now just needs to pass the state House one final time and then it's on to Gov. Cooper's desk to be signed into law!

UPDATE 3/22/23: The bill has now passed the state House by a stunning 94-22 margin as well! It still has to pass one more time tomorrow (a "concurrence" vote) and then it's on to Gov. Cooper's desk!

UPDATE 3/23/23: On the 13th Anniversary of the Affordable Care Act, the North Carolina House has officially taken the final vote needed for passage, with the bill easily passing 87 - 24. It's now onto Gov. Cooper, who has vowed to sign it into law ASAP.

UPDATE 3/8/23: HB 400 just overwhelmingly passed the New Mexico House!

HUGE NEWS! #HB400 just passed the House Floor by a vote of 58-10! Huge thanks to Rep. @reenaszcz & Speaker @JavierForNM for their work carrying #MedicaidForward through the House of Representatives & to everyone who reached out to their legislator. On to the Senate! #nmleg #nmpol 

— NM Together for Healthcare (@NMT4HC) March 8, 2023

Hey, remember the Inflation Reduction Act?

Remember how one of its healthcare provisions includes putting a copay cap of $35/month on insulin for Medicare enrollees?

Remember how Congressional Democrats & President Biden attempted to make the $35/mo insulin cap apply to ALL Americans as part of the defunct Build Back Better bill but had to settle for it only applying to the ~65 million on Medicare?

Well, guess what just happened? Via Rebecca Robins & Christine Hauser of the New York Times:

Last month I noted that the partisan COVID death rate gap, which had been shrunk down to almost nothing in December for the first time since COVID vaccines became widely available back in May 2021, had started to widen again:

Well, the lines didn't flip after all in January--the reddest quintile jumped up faster than the bluest quintile after all--two months earlier than I expected:

Bluest Quintile: 4.70 per 100K residents

Reddest Quintile: 5.33 per 100K residents (13% higher)

The January gap wasn't that significant by itself...except that it had looked like the rate in the reddest quintile might be lower last month.

Sure enough, the COVID death rate gap between the reddest and bluest fifths of the country widened out more in February, with the rate in the reddest quintile running 63% higher than the bluest quintile (4.22/100K vs. 2.39/100K). The rate actually dropped from January to February in every quintile, but it dropped considerably more in the bluest fifth (to the lowest rate since April 2022) than the reddest.