Charles Gaba's blog

Wax On Wax Off

It's been nearly a year since I've checked in on what the off-exchange individual health insurance market looks like. In October 2021, Mark Farrah Associates estimated the total indy market (including both on- and off-exchange enrollees) at around 15.9 million people nationally as of June 2021. Of that, they figured roughly 75.4% of it was on-exchange vs. 24.6% off-exchange.

However, as I noted at the time, there were a couple of important caveats with Mark Farrah's estimates, two of which they mentioned but one of which they didn't:

It is important to note that Mark Farrah Associates (MFA) applied enrollment figures for select carriers not required to report health enrollment on a quarterly basis and made other adjustments based on market analysis. Furthermore, individual enrollment includes short term plan enrollees and may include Medicaid programs, such as CHIP, as some states include subsidized lines in the individual segment. These factors may have resulted in moderate understatement or overstatement of enrollment.


As I just noted in the previous post, Nevada Health Link just issued a press release about the approve 2023 ACA exchange plans and rates:

Since transitioning away from the federal health insurance marketplace,, and becoming a State-Based Exchange (SBE) in 2019, the Exchange has focused on expanding the online marketplace by adding new Qualified Health Plan (QHP) options and insurance carriers. This year, 37 new health insurance plan options have been added, bringing to a total of 163 QHPs across seven private insurance carriers.

The seven private health insurance carriers offering plans through are:

Nevada Health Link Logo

This just in via Nevada Health Link:

Starting today, Nevadans can “window shop” to view and compare plans on

CARSON CITY, Nev. (Oct. 3, 2022) – Nevada Health Link, the online health insurance marketplace operated by the state agency, the Silver State Health Insurance Exchange (Exchange), has announced the expansion of new plan options for the upcoming Open Enrollment Period (OEP). Starting today, Nevadans can visit and start “window shopping” to compare and explore plans prior to OEP beginning Nov. 1, 2022 through Jan. 15, 2023.

New Qualified Health Plan Options

Since transitioning away from the federal health insurance marketplace,, and becoming a State-Based Exchange (SBE) in 2019, the Exchange has focused on expanding the online marketplace by adding new Qualified Health Plan (QHP) options and insurance carriers. This year, 37 new health insurance plan options have been added, bringing to a total of 163 QHPs across seven private insurance carriers.

New York State of Health

via NY State of Health:

  • Consumers Can Preview Affordable and Comprehensive Plan Options Now, Enroll Starting November 16, 2022
  • Enhanced Federal Financial Assistance Will Remain Available for 2023 Health Coverage

ALBANY, N.Y. (October 5, 2022) – NY State of Health, the state’s official health plan Marketplace, today announced the health and dental insurance plans offered through the Marketplace for the upcoming 2023 Open Enrollment Period. New Yorkers shopping for a Qualified Health Plan can compare plan options now and be prepared for the 2023 Open Enrollment Period, which begins on November 16, 2022 and runs through January 31, 2023.

New Jersey

via the New Jersey Dept. of Banking & Insurance:

NJ Department of Banking and Insurance Announces Expanded Health Insurance Options in 2023, Historic Levels of Financial Help Remain Available at Get Covered New Jersey

TRENTON — The New Jersey Department of Banking and Insurance today announced that consumers shopping for 2023 health coverage this fall at Get Covered New Jersey, the state’s official health insurance marketplace, will continue to benefit from historic levels of federal and state financial help. Consumers will also have more choice with Aetna now offering plans on the marketplace, increasing the overall number of carriers for the second consecutive year. 

“Since launching our own health insurance marketplace, the Murphy Administration has been committed to increasing access to quality, affordable health coverage through Get Covered New Jersey,” said Commissioner Marlene Caride. “For the upcoming year, we have expanded the number of carriers offering plans through Get Covered New Jersey to five, up from three in 2020, and will continue to provide record levels of financial help to lower premiums.” 

Maryland Health Connection

via Maryland Health Connection:

BALTIMORE (Oct. 4, 2022) – Marylanders can now explore health plans and prices for 2023 at the Maryland Health Connection, the state’s online health insurance marketplace. Using the Get an Estimate tool, you can compare plans and find out whether you are eligible for financial help in just a few minutes. Open enrollment to sign up for a 2023 health plan runs from Nov. 1, 2022 through Jan. 15, 2023.

“You never know when you might need emergency care or a visit to a doctor or specialist. If you have health insurance, you’re covered for when the unexpected happens,” said Michele Eberle, executive director of the Maryland Health Benefit Exchange. “I want to encourage anyone who is currently going without health care coverage to use the Get an Estimate tool to check out health plans and savings.”

As an example, a 40-year-old individual living in the Baltimore metro region who makes $50,000 a year will pay a monthly premium of $312 for the lowest cost gold plan.

This morning a group of researchers published a working paper at the National Bureau of Economic Research which delves deeply into excess death rates among Republicans vs. Democrats during the COVID-19 pandemic.

In fact, that's literally the title of the paper:

Political affiliation has emerged as a potential risk factor for COVID-19, amid evidence that Republican-leaning counties have had higher COVID-19 death rates than Democrat- leaning counties and evidence of a link between political party affiliation and vaccination views. This study constructs an individual-level dataset with political affiliation and excess death rates during the COVID-19 pandemic via a linkage of 2017 voter registration in Ohio and Florida to mortality data from 2018 to 2021.


via the Minnesota Dept. of Commerce:

Every year, the Minnesota Department of Commerce conducts a thorough review of the rates and plans proposed by health insurance companies in the individual and small group markets. Commerce must approve the rates before the companies can offer them to consumers. Under state law, rates for the following calendar year must be released 30 days prior to the beginning of open enrollment. 

Individual health plans are designed for Minnesotans who buy their own coverage rather than receiving it through employer-based insurance or public programs such as Medicare, Medical Assistance and MinnesotaCare. Small group health plans are designed for employers with two to 50 workers. 

Commerce may deny proposed rates or require insurers to raise or lower them if the department determines that they are excessive or inadequate for the benefits offered.


via MNsure:

Minnesotans Will Save $560/month, On Average, On 2023 Coverage with Tax Credits Through MNsure

ST. PAUL, Minn.—Starting November 1, Minnesotans looking for health coverage for 2023 can shop and compare plans and save money through MNsure, Minnesota’s health insurance marketplace. Now that final rates are available from the Minnesota Department of Commerce, MNsure has new estimates for how much Minnesotans will actually pay for health premiums in 2023—and it’s about 3.5% less than 2022. Eligible Minnesotans are poised to save big on their monthly premiums by taking advantage of tax credits only available through MNsure.

“MNsure projects Minnesota families will save $560 per month, on average, when they enroll in 2023 coverage through MNsure,” said MNsure CEO Nate Clark. “When they buy coverage through MNsure, Minnesotans will have a range of comprehensive health plans to choose from and access to enhanced tax credits that aren’t available anywhere else.”

CMS Logo

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

Today, the Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). These programs serve as key connectors to care for more millions of Americans.


As of June 2022, 64,682,105 people are enrolled in Medicare. This is an increase of 128,817 since the last report. 

  • 34,930,433 are enrolled in Original Medicare.
  • 29,751,672 are enrolled in Medicare Advantage or other health plans. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage.
  • 50,185,416 are enrolled in Medicare Part D. This includes enrollment in stand-alone prescription drug plans as well as Medicare Advantage plans that offer prescription drug coverage. 

Over 12 million individuals are dually eligible for Medicare and Medicaid, so are counted in the enrollment figures for both programs.