coronavirus

Me, June 16th, after several months of various state-based ACA exchanges bumping out their COVID-19 Special Enrollment Period deadlines by a month, then another month, then another month:

At a certain point I'm guessing at least one of the state exchanges will just say "screw it" and open 2020 enrollment up for the full year.

The point of a deadline is a) to prevent people from trying to game the system by deliberately waiting until they're sick/injured before enrolling in coverage (thus driving up premiums for everyone else) and b) to goad people into actually taking action (deadlines do have a clear positive impact on enrollment). With the COVID-19 pandemic having thrown the entire healthcare system into disarray, neither of those seem to be much of a factor this year.

Maryland Connect, August 7th:

WATCH: Trump Fans Give CNN's Jim Acosta Jaw-Dropping Reasons Why They're Not Wearing Masks at Packed Rally https://t.co/hNcXv4KYfb pic.twitter.com/vuSEkPFO8s

— Tommy X-TrumpIsARacist-opher (@tommyxtopher) September 11, 2020

Around 5,500 Trump supporters showed up at an aircraft hanger in Freeland, Michigan (Saginaw County) to hear Donald Trump speak. The almost entirely white crowd may have been outside, but they were tightly packed and few were wearing masks. CNN's Jim Acosta (who did wear a mask properly, over both his nose and mouth) interviewed some of the attendees to ask why they weren't doing so, and the responses are...quite telling (click thru for the actual video):

Acosta: "Why are you guys not wearing masks?"

Me, June 16th, after several months of various state-based ACA exchanges bumping out their COVID-19 Special Enrollment Period deadlines by a month, then another month, then another month:

I admit that this is starting to get a bit silly. At a certain point I'm guessing at least one of the state exchanges will just say "screw it" and open 2020 enrollment up for the full year.

The point of a deadline is a) to prevent people from trying to game the system by deliberately waiting until they're sick/injured before enrolling in coverage (thus driving up premiums for everyone else) and b) to goad people into actually taking action (deadlines do have a clear positive impact on enrollment). With the COVID-19 pandemic having thrown the entire healthcare system into disarray, neither of those seem to be much of a factor this year.

Maryland Connect, August 7th:

Back in April, in the midst of the earlier stages of the COVID-19 pandemic sweeping through much of the nation, there was a loud outcry for the various ACA health insurance exchanges, including the federal exchange at HealthCare.Gov which hosts enrollment for over 3 dozen states, to re-open enrollment to anyone who missed the official Open Enrollment Period which had ended several months earlier.

Eventually, twelve of the thirteen state-based exchanges did just that, launching COVID-19-specific Special Enrollment Periods of varying time periods for any resident who would normally be eligible to enroll during Open Enrollment to do so. Many of those SBEs would go on to extend the deadlines of their SEPs by a month...or two months...or even more. As of this writing, in fact, California, Maryland, New York and the District of Columbia are are still offering "open" COVID-19 SEPs.

Just a few days after the previous COVID-19 Special Enrollment Period expired, NY Governor Andrew Cuomo has ordered NY State of Health to reopen their SEP through September 15th:

Governor Andrew M. Cuomo today announced that the Special Enrollment Period for uninsured New Yorkers will be extended for another 30 days, through September 15, 2020, as the State continues to provide supportive services during the COVID-19 public health crisis. New Yorkers can apply for coverage through NY State of Health, New York State's health insurance marketplace, or directly through insurers.

"While we've crushed the curve of the virus, we are still in challenging times for hard-working families throughout the state who need access to quality, affordable health care," Governor Cuomo said. "The state has maintained low infection rates and is moving in the right direction, but we know we're not out of the woods yet. By offering this special enrollment period, we're making sure New Yorkers who need affordable and at times live-saving health care coverage can get it."

Hardly surprising...again.

via the New York State government website:

Special Enrollment for Uninsured New Yorkers Will Extend for Additional 30 days and Remain Open Through August 15, 2020

Governor Andrew M. Cuomo today announced that the Special Enrollment Period for uninsured New Yorkers will be extended for another 30 days, through August 15, 2020, as the State continues to provide supportive services during the COVID-19 public health crisis. New Yorkers can apply for coverage through NY State of Health, New York State's health insurance marketplace, or directly through insurers.

The big story with COVID-19 the past few weeks has been, of course, the out-of-control increase in new cases (if not actual deaths...yet) from the virus in red states like Texas, Florida and especially Arizona which were relatively unscathed throughout the spring while the pandemic was raging across Northeastern blue states like New York, New Jersey and Rhode Island, as well as Michigan and California.

While most of the states being hit with the summer wave are historically Republican strongholds (the states being hit hardest in June/July also include Georgia, Arkansas, South Carolina, etc.), there's one important exception to this: California, which was hit early but which clamped down fairly quickly, has re-emerged as a major hot spot. So what gives?

Hardly surprising at this point, but still important to note:

Health Connector extends enrollment an additional month to July 23rd for uninsured individuals

On June 22, 2020, the Health Connector announced in an Administrative Bulletin an extension to the special enrollment period in response to the coronavirus (COVID-19) emergency through July 23, 2020 to assist uninsured Massachusetts residents seeking health coverage. (The extended enrollment period was previously set to end June 23.)

If you need to apply for coverage, you can start by creating an application.

If you apply coverage under this special enrollment, the deadlines to complete enrollment are as follows:

On April 14th, Covered California reported that 58,000 residents had enrolled in ACA exchange coverage during their COVID-19 Special Enrollment Period, of which roughly 20,000 did so via standard SEPs (losing coverage, moving, getting married/divorced, etc), while an additional 38,000 took advantage of the COVID-specific SEP.

On April 28th, they announced that the number was up to 84,000 new ACA exchange enrollees, averaging around 2.5x as many as enrolled via standard Special Enrollment Periods during the same period a year ago.

On May 20th, they announced the total was up to 123,000 new ACA exchange enrollees via the COVID SEP, "nearly" 2.5x the rate of a year before.

As regular readers know, for the past month or so I've been devoting way too much time to tracking COVID-19 cases & fatalities at the state and county level. For my sources, it's been a combination of state health department websites, the New York Times daily GitHub data archive, the Johns Hopkins University daily GitHub data archive and the WorldoMeter website...which in turn gets their data from other sources. The testing data on my state-level spreadsheet, meanwhile, comes from the COVID Tracking Project website.

For the most part, however, I've settled on WorldoMeter for the state-level data and Johns Hopkins U for the county-level data, as each source formats their data in the most convenient manner for my purposes in porting it to my spreadsheets.

Back in April, I noted that the DC Health Link ACA exchange had announced what appeared to be a special enrollment period specifically intended for employees of small businesses via the ACA's SHOP program, through September 15th, 2020:

DC Health Link Expands Opportunities to Get Covered During Public Health Emergency

Monday, April 6, 2020

Responding to COVID-19 pandemic, DC Health Link permits uninsured employees of DC small businesses that offer health insurance through DC Health Link to get covered now

Note: This is a guest post by Miranda Wilgus, Executive Director and Co-Founder of ACA Consumer Advocacy (disclosure: I'm on the ACACA board of directors).

In the middle of June 2020, with over three months of an international pandemic behind us, over 100,000 Americans and more around the world dead from Covid19 and its complications, what are we waiting for? We know that our administration has done everything possible to impede the facilitation of needs and resources to our country. Special interests are running rampant, price gouging is the norm, government agencies have been scooping up supplies from states that are desperately needed, and the GOP controlled Senate is more focused on packing courts with unqualified idealogues than with passing bills to assist Americans financially affected by the pandemic.

On March 20th, the Vermont Health Connect ACA exchange joined other state-based exchanges in launching a formal COVID-19 Special Enrollment Period.

On April 15th, just ahead of the original SEP deadline, they bumped it out by a month:

Due to the COVID-19 emergency, Vermont Health Connect has opened a Special Enrollment Period until May 15, 2020. During this time, any uninsured Vermonter can sign up for a Qualified Health Plan through Vermont Health Connect. Qualified families can also get financial help paying for coverage.. Please call us at 1-855-899-9600 to learn more.

Then, with the May deadline approaching, I took a look and sure enough, they've bumped it out another month:

On March 16th, New York's ACA exchange, NY State of Health, announced that they'd be launching a COVID-19 Special Enrollment Period with a deadline of April 15th. As that date approached, in the middle of the worst pandemic to hit New York State 100 years, the deadline was extended out by a month, through May 15th.

When that deadline approached, NY Governor Andrew Cuomo ordered the COVID-19 SEP to be bumped out by another month.

And now, with the June 15th deadline having come and gone, lo and behold:

Governor Andrew M. Cuomo today announced low-risk youth sports for regions in phase three of reopening can begin on July 6th with up to two spectators allowed per child. 

On April 14th, Covered California reported that 58,000 residents had enrolled in ACA exchange coverage during their COVID-19 Special Enrollment Period, of which roughly 20,000 did so via standard SEPs (losing coverage, moving, getting married/divorced, etc), while an additional 38,000 took advantage of the COVID-specific SEP.

On April 28th, they announced that the number was up to 84,000 new ACA exchange enrollees, averaging around 2.5x as many as enrolled via standard Special Enrollment Periods during the same period a year ago.

On May 20th, they announced the total was up to 123,000 new ACA exchange enrollees via the COVID SEP, "nearly" 2.5x the rate of a year before.

Since I've been neglecting other ACA/healthcare posts the past couple of weeks, I figured I should at least provide regular updates on why I've been mostly absent.

I've made major progress in updating and revising my breakout of COVID-19 cases and fatalities at not just the state level but the county level. Again, I've separates the states into two separate spreadsheets:

I've made major progress in updating and revising my breakout of COVID-19 cases and fatalities at not just the state level but the county level. Again, I've separates the states into two separate spreadsheets:

Most of the data comes from either the GitHub data repositories of either Johns Hopkins University or the New York Times. Some of the data comes directly from state health department websites.

I hope to fill in the back-data for every state within the next few days, bringing them all up to date. This should allow for plenty of interesting analysis of trends and counties to keep an eye on. It will also allow me to get back to posting more regular ACA policy updates/etc.

Since I've been neglecting other ACA/healthcare posts the past couple of weeks, I figured I should at least provide regular updates on why I've been mostly absent.

I've made major progress in updating and revising my breakout of COVID-19 cases and fatalities at not just the state level but the county level. Again, I've separates the states into two separate spreadsheets:

I've made major progress in updating and revising my breakout of COVID-19 cases and fatalities at not just the state level but the county level. Again, I've separates the states into two separate spreadsheets:

Most of the data comes from either the GitHub data repositories of either Johns Hopkins University or the New York Times. Some of the data comes directly from state health department websites.

I hope to fill in the back-data for every state within the next few days, bringing them all up to date. This should allow for plenty of interesting analysis of trends and counties to keep an eye on. It will also allow me to get back to posting more regular ACA policy updates/etc.

As a follow-up to my prior posts about the urban/rural divide of how COVID-19 has spread throughout Michigan, here's a graph which shows how it's spread in Detroit, the larger Metro Detroit area and the rest of the state on a per capita basis over time.

Obviously the probem is still far worse in Detroit and the Metro Detroit area overall...but the case trendlines are starting to flatten in Detroit and Metro Detroit, while it's still increasing at the same rate or higher in the rest of the state.

Oof! I saw this several weeks ago but somehow forgot to actually post about it until now; it's important to note that the May 25th deadline referred to below was just extended until June 23rd:

Massachusetts Health Connector continues extended enrollment as nearly 45,000 people enroll in new plans, update current coverage

April 28, 2020 – The Massachusetts Health Connector continues to help people who need health insurance after losing coverage or income due to the coronavirus, with a May 23 deadline ahead for June 1 coverage.

Since I've been neglecting other ACA/healthcare posts the past couple of weeks, I figured I should at least provide regular updates on why I've been mostly absent.

I've made major progress in updating and revising my breakout of COVID-19 cases and fatalities at not just the state level but the county level. Again, I've separates the states into two separate spreadsheets:

Not terribly surprising; via the Massachusetts Health Connector:

On May 21, 2020, the Health Connector announced in an Administrative Bulletin an extension to the extended enrollment period in response to the coronavirus (COVID-19) emergency through June 23, 2020 to assist uninsured Massachusetts residents seeking health coverage. (The extended enrollment period was previously set to end May 25.)

If you need to apply for coverage, you can start by creating an application 

If you apply coverage under this special enrollment, the deadlines to complete enrollment are as follows:

Coverage Start DateEnrollment Deadline

  • Coverage Start Date: June 1st: Enrollment Deadline: May 23rd
  • Coverage Start Date: July 1st: Enrollment Deadline: June 23rd

Please note that if you are eligible to enroll due to normal special enrollment period rules, you can select the one that applies when you complete your application.

I've been spending a lot of time working on my county-level COVID-19 tracking project the past few weeks. I'm happy to report that I've managed to plug in the county-level case and fatality data for every thirteen states so far, so I figured this would be a good time to post a visual showing how the virus has spread over time across them in cases per capita (actually cases per thousand residents).

This is a much more useful measure than the raw number of cases since the population of each state (and county) varies so widely.

The states I've completed don't follow any particular pattern...aside from Michigan (which I started with because I live here, of course), the others are simply the states which I was able to get ahold of historic case/death toll data for from March 20th until today. Other states will follow as I complete backdating the data into the spreadsheets.

On April 14th, Covered California reported that 58,000 residents had enrolled in ACA exchange coverage during their COVID-19 Special Enrollment Period, of which roughly 20,000 did so via standard SEPs (losing coverage, moving, getting married/divorced, etc), while an additional 38,000 took advantage of the COVID-specific SEP.

On April 28th, they announced that the number was up to 84,000 new ACA exchange enrollees, averaging around 2.5x as many as enrolled via standard Special Enrollment Periods during the same period a year ago.

Today they issued another update:

Covered California Sees More Than 123,000 Consumers Sign Up for Coverage During the COVID-19 Pandemic

I've made major progress in updating and revising my breakout of COVID-19 cases and fatalities at not just the state level but the county level, and should now be able to post updated summaries of the worst-hit counties on a weekly basis.

Due to the sheer volume of data involved, I've had to separate out the states into two separate spreadsheets:

All data below is up to date as of Saturday, May 16th, although due to variances in when different states report the data, some of the data may be from a day earlier. The counties are color-coded depending on whether they voted for Donald Trump (orange) or Hillary Clinton (blue) in 2016.

Believe it or not, even though Delaware is a fairly solidly blue state in Presidential elections, two of the three counties there (it's pretty small) voted for Donald Trump in 2016. Here's how the state's cases have shifted over time between New Castle County (the largest of the three, which voted for Clinton) and the other two counties which voted for Trump:

This is almost a complete reversal, with New Castle going from 2/3 of all cases at the beginning of April to just 1/3 today:

A few weeks ago, I posted a detailed analysis of how the COVID-19 virus has been spreading throughout Wisconsin. I noted that while the outbreak originally spread quickly in the more urban/blue-leaning areas, that has gradually changed over time, with the virus spreading to the rest of the state--including rural, conservative-leaning areas--at a faster rate while it slowed down in the urban areas.

It's time to check in to see whether that trend has continued...and sure enough, it has. Here's what this trend looks like visually:

A few weeks ago, I posted a detailed analysis of how the COVID-19 virus has been spreading throughout my home state of Michigan. I noted that while the outbreak originally spread quickly in Detroit and the more densely-populated Metropolitan Detroit region (Wayne, Oakland and Macomb counties), that has gradually changed over time, with the virus spreading to the rest of the state--including rural, conservative-leaning areas--at a faster rate while it slowed down in the urban areas.

It's time to check in to see whether that trend has continued...and sure enough, it has:

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