Charles Gaba's blog

Every month for years now, the Centers for Medicare & Medicare Services (CMS) has published a monthly press release with a breakout of total Medicare, Medicaid & CHIP enrollment; the most recent one was posted in late February, and ran through November 2022.

Since December 2022, however, they haven't sent out the normal press release; instead, they included a brief note leading to a Medicaid/CHIP data slideshow , along with another note leading to their new Medicare Monthly Enrollment database.

In any event, according to the spreadsheet I exported, as of September 2023:

Via MNsure:

Take the first step towards your health goals and start the new year off right by signing up for health insurance through MNsure, Minnesota’s official health insurance marketplace. January 15, 2024, is the last day of MNsure’s open enrollment period and the final deadline to enroll in medical and dental coverage that begins on February 1.

Comprehensive health insurance helps you get the health care you need throughout the year and provides financial protection from unexpected injury or illness. When you buy a plan through MNsure, you can be sure you’re getting quality, comprehensive insurance and not a “junk plan” that provides little or no coverage when you need it most. That’s because every plan sold through MNsure is guaranteed to cover essential health benefits including prescription drugs, emergency services, and hospitalization.

BeWell NM

BeWell NM, New Mexico's state-based ACA exchange, has launched a very handy new Enrollment Data portal which includes plenty of info for a data hound like myself to pore over:

First, the top line numbers (as of 1/04/23):

  • Number of enrolled consumers: 52,780
  • Consumers enrolled in Medical coverage: 52,018
  • Consumers enrolled in Dental coverage: 13,237

While dental coverage is also important, standalone dental plans aren't considered Qualified Health Plans (QHPs); it's the "Medical Coverage" which is the key number here.

Also, the total number above may look confusing, but most of the Medical & Dental coverage enrollees overlap:

  • Medical Only: 39,543
  • Dental Only: 762
  • Medical + Dental: 12,475

For comparison, last year BeWell NM reported enrolling just 38,384 people through January 7th, so it breaks out as:

Via Access Health CT's News/Press Releases page:

Stats as of January 5, 2023

Qualified Health Plans (QHP):

  • QHP Enrollment In 2023 Coverage: 124,465
  • 2024 OE Acquisition Summary: 24,419


  • Completed applications/redeterminations processed through the integrated eligibility system: 45,355

It's my understanding that "Acquisition Summary" refers to CT residents who are brand-new enrollees (never enrolled via the exchange before).

By comparison, last year Access Health CT reported enrolling 104,658 people through January 6th (one extra day since Nov. 1st fell on a Tuesday last year):

  • 2023: 104,658 in 66 days (1,586/day)
  • 2024: 124,465 in 65 days (1,915/day)

In other words, Connect's ACA exchange has enrolled 20.7% more people per day so far.

In mid-December, I posted an update to my 2024 ACA Open Enrollment Period projections in which I upgraded my prior estimate of 18.5 million QHPs + BHPs combined to more than 19 million total.

A few days later, based on a press release from the Centers for Medicare & Medicaid Services (CMS) announcing over 15.3 million QHPs via the federal exchange alone, I updated my projection significantly more, to around 20.7 million QHPs (Qualified Health Plans) and 1.3 million BHPs (Basic Health Plans), or roughly 22 million total.

CMS's press release states that they won't be posting the next detailed/state-by-state enrollment breakout until January 10th, so aside from a handful of minor SBM updates here and there, there hasn't been much to report on the enrollment front since then...until this:

Normally, states will review (or "redetermine") whether people enrolled in Medicaid or the CHIP program are still eligible to be covered by it on a monthly (or in some cases, quarterly, I believe) basis.

However, the federal Families First Coronavirus Response Act (FFCRA), passed by Congress at the start of the COVID-19 pandemic in March 2020, included a provision requiring state Medicaid programs to keep people enrolled through the end of the Public Health Emergency (PHE). In return, states received higher federal funding to the tune of billions of dollars.

As a result, there are tens of millions of Medicaid/CHIP enrollees who didn't have their eligibility status redetermined for as long as three years.

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

  • In September 2023, 88,414,773 individuals were enrolled in Medicaid and CHIP.
    • 81,408,432 individuals were enrolled in Medicaid in September 2023, a decrease of 1,621,776 individuals (2.0%) from August 2023.
    • 7,006,341 individuals were enrolled in CHIP in September 2023, an increase of 28,391 individuals (0.4%) from August 2023.
  • As of September 2023, enrollment in Medicaid and CHIP has decreased by 5,435,967 individuals since March 2023, the final month of the Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA) and amended by the Consolidated Appropriations Act, 2023.
    • Medicaid enrollment has decreased by 5,309,005 individuals (6.1%).
    • CHIP enrollment has decreased by 126,962 individuals (1.8%).
  • Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 22,975,671 individuals (32.4%) to 93,850,740.
    • Medicaid enrollment increased by 22,637,644 individuals (35.3%).
    • CHIP enrollment increased by 338,027 individuals (5.0%).

via U.S. News:

Managing diabetes will be a less expensive proposition for more Americans in 2024.

Sanofi has officially joined Novo Nordisk and Eli Lilly in lowering the cost of insulin to $35 a month for many patients. The three drug makers are also drastically lowering the list prices for their insulin products.

The price-cutting moves were first announced last spring, but some of them didn’t take effect until Jan. 1.

...Over 8 million Americans need insulin to survive, but up to a quarter of those patients haven't been able to afford the medication and have dangerously rationed doses, according to the ADA.

Now, thanks to the Inflation Reduction Act, Medicare enrollees pay no more than $35 a month for their insulin prescriptions.

I tried to come up with a less inflammatory headline. I really did. But in the end this is what it comes down to. Via Eleanor Klibanoff of the Texas Tribune:

Emergency rooms not required to perform life-saving abortions, federal appeals court rules

  • The Biden administration reminded hospitals of their obligation to perform life-saving abortions under the Emergency Medical Treatment and Labor Act after the overturn of Roe v. Wade. Texas sued, arguing it was an overstep that mandated abortions.

Federal regulations do not require emergency rooms to perform life-saving abortions if it would run afoul of state law, a federal appeals court ruled Tuesday.

After the overturn of Roe v. Wade in June 2022, the U.S. Department of Health and Human Services sent hospitals guidance, reminding them of their obligation to offer stabilizing care, including medically necessary abortions, under the Emergency Medical Treatment and Labor Act (EMTALA).

via, Maine's state-based ACA exchange:

Plan Selection Snapshot

The Maine Department of Health and Human Services (DHHS) Office of the Health Insurance Marketplace (OHIM) will release biweekly updates on plan selections through, Maine’s Health Insurance Marketplace.  

Plan selections provide a snapshot of activity by new and returning consumers who have selected a plan for 2024. “Plan selections” become “enrollments” once consumers have paid their first monthly premium to begin insurance. These numbers are subject to change as consumers may modify or cancel plans after their initial selection.   

The deadline to select a plan for coverage beginning January 1, 2024 is December 15, 2023. Consumers who select a plan between December 16, 2023 and January 16, 2024 will have coverage beginning February 1, 2024. Activity Through December 26, 2023