COVID19

 

All 50 states + DC have re-opened enrollment on their respective ACA exchanges in response to both the ongoing COVID-19 pandemic and the American Rescue Plan (ARP), which substantially expands and enhances premium subsidies to millions of people!

If you've never enrolled in an ACA healthcare policy before, or if you looked into it years ago but weren't impressed, please give it another shot now. Thanks to the ARP (and some other reasons), it's a whole different ballgame this spring & summer.

Here's 10 important things to understand when you #GetCovered:

1. MILLIONS WHO DIDN'T QUALIFY FOR FINANCIAL HELP BEFORE DO NOW...AND IT CAN SAVE YOU THOUSANDS OF DOLLARS!

With the passage and signing of the American Rescue Plan, the ACA's infamous "Subsidy Cliff" has been killed at last (at least for 2021 & 2022, anyway)!

This means two extremely important things:

This was apparently decided awhile ago (there was no press release), but I just learned about it today thanks to Louise Norris:

Nevada’s Response to Coronavirus

Nevada Health Link opened a Special Enrollment Period (SEP) for uninsured Nevadans, starting February 15 through August 15, 2021. The SEP is in accordance with the Executive Order issued by President Biden last month, in response to the ongoing national emergency presented by COVID-19.

  • Coming soon! Thanks to the recently passed American Rescue Plan, we’ll soon be offering more money to help pay for your coverage. Learn more here.

Visit here to learn more.

Nice catch by Andrew Sprung. Via the NJ Dept. of Banking & Insurance:

EXTENSION OF COVID-19 SPECIAL ENROLLMENT PERIOD

On January 29, 2021, the Department of Banking and Insurance (“Department”) issued Bulletin No. 21-03 advising carriers and other interested parties that an emergency COVID-19 Special Enrollment Period (“COVID-19 SEP”) would go into effect on February 1, 2021 and extend through May 15, 2021. The COVID-19 SEP ensured that New Jersey residents have access to quality affordable health insurance during a critical time in which the need to protect public health is paramount. Specifically, the COVID-19 SEP made sure that individual market coverage was available to uninsured individuals during the pandemic. It also aligned New Jersey with the Federal Special Enrollment Period which runs through May 15, 2021 and the Federal Public Health Emergency.

A picture is worth 1,000 words and all that.

I've done my best to label every state/territory, which obviously isn't easy to do for most of them given how tangled it gets in the middle.

More than 1 out of every 8 residents of North Dakota, South Dakota and Rhode Island have tested positive for COVID-19 over the past year.

More than 1 out of every 9 residents of Iowa, Utah, Tennessee and Arizona have tested positive.

More than 1 out of 10 in Nebraska, Arkansas, South Carolina, New Jersey, Alabama, Kansas, Indiana, Mississippi, Idaho, New York, Georgia, Illinois, Wisconsin and Delaware.

More than 1 out of 20 in every state & territory EXCEPT Washington, Guam, Oregon, Maine, Vermont, U.S. Virgin Islands, Hawaii, N. Mariana Islands and American Samoa.

This just in via Connect for Health Colorado:

More Coloradans Than Ever Are Using Colorado’s Exchange to Get Covered

DENVER — In a report released today by Connect for Health Colorado, nearly 180,000 Coloradans signed up for a health insurance plan by the end of the Open Enrollment Period on Jan. 15 for 2021 coverage. The new report includes more detailed information about changes to premium costs and financial help by county, the improved customer experience and our outreach tactics.

The main number here is nothing new; C4HCO had already announced the 180K figure back in January. The report itself contains a ton of key demographic stats & details, however, which I'll get to below.

I last updated my Michigan Medicaid expansion tracking back in January.At the time, I noted that enrollment in this ACA programhas increased dramatically here in Michigan since the COVID-19 pandemic struck, increasing from 673,000 in February 2020 to 853,000 as of January 2021, or nearly 27% in less than one year.

As of April 5th, the Healthy Michigan program (that's the branding of Michigan's ACA Medicaid expansion) notes 897,261 enrollees. That's a net increase of 224,000 Michiganders enrolled in the program since last February, or over 33%.

With this as backdrop, consider the timing of the following events:

The date on this press release is April 1st, but I didn't see it on the MD Connect website until today:

AMERICAN RESCUE PLAN ACT DRAMATICALLY LOWERS HEALTH CARE COSTS FOR MANY MARYLANDERS

Low income individuals and families will pay nearly nothing for private health plans, higher income will be eligible for savings for the first time

(BALTIMORE) — Gov. Larry Hogan and Maryland Health Connection today announced reductions in the health plan costs that reflect additional financial help available through the federal American Rescue Plan Act. The new law means that:

A couple of weeks ago I noted that all 11 California health insurance carriers participating on the state's ACA exchange, CoveredCA.com, have agreed not to reset deductibles for current off-exchange enrollees who shift to an on-exchange plan during the ongoing COVID Enrollment Period.

This is a HUGE deal, especially in California, where an estimated 430,000 residents are enrolled in off-exchange ACA policies which are virtually identical to their on-exchange equivalent, with the sole distinction of those enrolled in them not being eligible for ACA subsidies.

With subsidies being beefed up and the 400% FPL subsidy cliff having been killed (for the next 2 years, at least), this means that hundreds of thousands of Californians have just become eligible for thousands of dollars in savings...as long as they transition to the same plan on-exchange.

via Nevada Health Link:

The Division of Insurance (“Division”) encourages all Nevadans to take advantage of the new saving opportunities offered by the American Rescue Plan Act of 2021 (“ARPA”). The ARPA, enacted earlier this month, creates more opportunities for Nevadans to save on health insurance coverage.

“I urge consumers, especially those who have off-exchange plans, have no insurance or have found themselves uninsured to start thinking now about how they can benefit from this new law because certain benefits in the ARPA have deadlines,” said Insurance Commissioner Barbara Richardson. “Each month that a consumer does not take advantage of these new low or no cost opportunities, they are leaving money on the table.”

The ARPA will lower monthly premium costs; increase subsidy eligibility for consumers making above the 400% of the Federal Poverty Level; provide options for people who are on unemployment for $0 premium plans; and it will provide 100% COBRA subsidy for six months.

Your Health Idaho, which had been scheduled to end their COVID-19 Enrollment Period on March 31st, has understandably extended the deadline out by another month in light of the American Rescue Plan's expanded/enhanced subsidies. Via email:

Enhanced Subsidies Go into Effect at Your Health Idaho April 1

Your Health Idaho Continues to Enroll Idahoans through April 30, 2021

BOISE, Idaho –Your Health Idaho, the state insurance exchange, will remain open throughout the month of April so Idahoans can take advantage of enhanced financial assistance, which lowers consumer’s monthly premiums. 

For the first time ever, tax credits, which act like an instant discount, may be available for those who were not previously eligible and will be increased for Idahoans who already receive them. For some Idahoans, these savings can be significant. For example, a Treasure Valley married couple in their 20s making $50,000 a year could pay less than $10 a month and a family of four making $105,000 could pay as little as $200 a month.

In what's become a pretty expected move, the Maryland Health Benefit Exchange is also extending their COVID SEP out thru mid-August:

GOV. HOGAN ANNOUNCES EXTENSION OF STATE HEALTH INSURANCE SPECIAL ENROLLMENT PERIOD UNTIL AUG. 15

(BALTIMORE) — Gov. Larry Hogan and Maryland Health Benefit Exchange announced today that the state health insurance marketplace, Maryland Health Connection, will extend its current Coronavirus Special Enrollment Period. Uninsured Marylanders have the opportunity to enroll in health coverage now until Aug. 15.

This deadline aligns with the federal special enrollment period extension announced by President Joe Biden for those 35 states that use HealthCare.gov, the federally run health insurance marketplace.

“We are pleased to announce the additional extension of this special enrollment period to Aug. 15, which

is already one of the nation’s longest in response to the COVID-19 pandemic,” said Governor Hogan.

“Our administration remains committed to ensuring Marylanders have access to the resources they need

A picture is worth 1,000 words and all that.

I've done my best to label every state/territory, which obviously isn't easy to do for most of them given how tangled it gets in the middle. For cases per capita, the most obvious point is that New York and New Jersey, which towered over every other state last spring, are now dwarfed by North & South Dakota, although things are pretty horrible nearly everywhere now.

1 out of every 8 residents of North Dakota, South Dakota and Rhode Island have tested positive for COVID-19 over the past year.

1 out of every 9 residents of Utah, Iowa, Tennessee and Arizona have tested positive.

1 out of 10 in Oklahoma Arkansas, Nebraska, South Carolina, Alabama, Kansas, Mississippi, Indiana and Idaho.

1 out of 20 in every state except Washington, Oregon, Maine, Vermont and Hawaii.

Last week the Maryland Health Benefit Exchange issued a press release touting impressive enrollment numbers over the past year via their year-long COVID-19 Special Enrollment Period (SEP). The topline number was that they enrolled over 140,000 Maryland residents in either ACA exchange policies or Medicaid.

Since Medicaid enrollment is open year-round anyway, the number I'm obviously more interested in are the exchange plans, which most people can normally only enroll in during the official Open Enrollment Period each fall/winter. Since COVID has thrown that mostly into disarray, however, I've been keeping a close eye on SEP enrollment in 2020 and now in spring of 2021 as compared to the pre-COVID era, when the SEP rules were far more strictly adhered to.

via Nevada Health Link:

Statement re: 11th Anniversary of the Affordable Care Act
Heather Korbulic, executive director, Silver State Health Insurance Exchange

Tomorrow, March 23, 2021, marks 11 years since the passing of the Affordable Care Act (ACA), the landmark reform law that is credited with increasing access to quality healthcare for millions of Americans, forever changing the national healthcare landscape.

Here in Nevada, the ACA is responsible for the creation and ongoing operations of the Silver State Health Insurance Exchange that has provided healthcare coverage to hundreds of thousands of Nevadans who would otherwise be without coverage to receive essential and critical healthcare services. Since the passage of the ACA and the implementation of Nevada Health Link, the Exchange’s online marketplace for ACA-compliant insurance plans, Nevada's number of uninsured has decreased from a staggering 23 percent to 11 percent.

Thanks to Andrew Sprung for the heads up. Via Get Covered New Jersey:

The American Rescue Plan & Additional Financial Relief

The federal government recently passed a COVID-19 relief bill, the American Rescue Plan Act of 2021, which was signed into law by President Biden on March 11, 2021. The new law will reduce health insurance premiums by providing more financial help to eligible consumers who purchase a plan through Get Covered New Jersey. Get Covered New Jersey is working to implement the changes and update its system to ensure that New Jerseyans receive this relief as soon as possible.

More people than ever will qualify for financial help. If you did not qualify for financial help before because your income was too high, you may qualify under the federal changes. If you already receive financial help, you will likely be eligible for additional premium reductions. These new changes make coverage more affordable at many income levels.

Yesterday's press release from Covered California included a TON of important information about how they're handling the massive subsidy upgrade/expansion under the American Rescue Plan, but it left out one other critically important item which was caught by Inside Health Policy reporter Amy Lotven:

Insurers participating in Covered California have agreed to help move their off-exchange individual plan enrollees into the marketplace so they can benefit from the new Affordable Care Act subsidies available under the American Rescue Plan (ARP) and will not reset the deductibles, Covered California Executive Director Peter Lee said Thursday (March 18) in a webinar with reporters and key stakeholders.

...Off-exchange enrollees could get an average $500 premium drop, which means they could save as much as $12,000 under the two-year provision, Lee says. About 430,000 Californians and 1.5 million people nationally who are enrolled off-exchange plans are newly eligible for help, the exchange estimates.

A picture is worth 1,000 words and all that.

I've done my best to label every state/territory, which obviously isn't easy to do for most of them given how tangled it gets in the middle. For cases per capita, the most obvious point is that New York and New Jersey, which towered over every other state last spring, are now dwarfed by North & South Dakota, although things are pretty horrible nearly everywhere now.

1 out of every 8 residents of North Dakota, South Dakota and Rhode Island have tested positive for COVID-19 over the past year.

1 out of every 9 residents of Utah, Iowa, Tennessee, Arizona and Oklahoma have tested positive.

1 out of 10 in Arkansas, Nebraska, South Carolina, Alabama, Kansas, Mississippi and Indiana.

1 out of 15 in 43 states.

1 out of 20 in 47 states & territories.

The Maryland Health Benefit Exchange has issued a new press release which on the surface doesn't seem terribly unusual--it touts an impressive number of Maryland residents having gained healthcare coverage since they first launched their COVID-19 Special Enrollment Period (SEP).

What's unusual about this PR is that it's listing the cumulative number of people who've gained coverage since they launched their first COVID SEP a year ago:

MORE THAN 140,000 COVERED SINCE MARYLAND HEALTH CONNECTION LAUNCHED COVID-19 SPECIAL ENROLLMENT ONE YEAR AGO

  • 236,000 WHO STILL LACK COVERAGE COULD GET IT FOR FREE OR WITH SIGNIFICANT FINANCIAL HELP

(MARCH 17, 2021) BALTIMORE — Yesterday marked one year since the Maryland Health Benefit Exchange launched a Coronavirus Emergency Special Enrollment Period in response to the public health emergency declared by Gov. Larry Hogan.

Yesterday I wrote a long, wonky post about an unusual case involving a legally-present (green card), unemployed Nigerian immigrant.

The short version is that because his income is so low, he normally wouldn't be eligible for ACA subsidies...except because he lives in Maryland, a Medicaid expansion state, he would normally be eligible for Medicaid...except that because he's an immigrant who's been in the United States for less than five years, he isn't eligible for Medicaid...except that, thanks to an obscure provision baked into the Affordable Care Act, he is eligible for ACA subsidies after all!

‘(B) SPECIAL RULE FOR CERTAIN INDIVIDUALS LAWFULLY PRESENT IN THE UNITED STATES.—If—

‘‘(i) a taxpayer has a household income which is not greater than 100 percent of an amount equal to the poverty line for a family of the size involved, and

I just received the following COVID Enrollment Period update from Pennie, Pennsylvania's new state-based ACA exchange. This appears to be part of an official report which they're still working on.

The "Existing" numbers refer to current Pennie enrollees who are taking advantage of the COVID SEP to switch to a different plan mid-year; this is something which usually isn't allowed, even during traditional Special Enrollment Periods (SEPs), but Pennie, along with HealthCare.Gov and many of the other state-based exchanges, are allowing them to do so during this period.

There's an obvious reason for this, too: The impending passage of the American Rescue Plan will mean dramatically improved/expanded subsidies for ACA enrollees, including many who haven't been eligible for them until now. This means millions of Americans who enrolled in Bronze plans because they weren't eligible for subsidies will be able to upgrade to Silver or Gold; it also means many people will become eligible for $0-premium plans who currently aren't, and so on.

This just in via Connect for Health Colorado:

One Month In, More Than 4,000 Coloradans Sign Up During Exchange's Uninsured Enrollment Period

DENVER – 4,683 previously uninsured Coloradans signed up for a 2021 health insurance plan through Colorado’s Exchange between Monday, February 8 and the end of day Friday, March 5. That’s more than 1,000 new medical enrollments each week during the first month of Colorado’s Uninsured Enrollment Period.

That's an average of 180/day over 26 days for Colorado. I don't know exactly how many Special Enrollment Period (SEP) enrollees they had during the same time period in prior years, but I can estimate based on their monthly dashboards:

via KNPR:

In the face of the continuing COVID-19 pandemic, President Joe Biden reopened enrollment in the Affordable Care Act’s health insurance exchanges.

For Nevadans, that means the Silver State Health Insurance Exchange is back in business.

The exchange connects Nevadans to health plans compliant with the Affordable Care Act, and it’s the only place consumers can access any federal subsidies.

“As soon as Nevada learned of the news from the federal government, we took immediate action to plan and collaborate with our insurance carriers and the statewide network of 750-plus brokers and navigators to implement a seamless, streamlined process for Nevadans,” said Heather Korbulic, executive director of Silver State Health Insurance Exchange.

Korbulic told KNPR's State of Nevada that there has already been a lot of interest from people around the state. 

"We're pretty excited about the uptake that we've already started seeing and we think this is a wonderful opportunity for Nevadans to get connected to Nevada HealthLink," she said.

A picture is worth 1,000 words and all that.

I've done my best to label every state/territory, which obviously isn't easy to do for most of them given how tangled it gets in the middle. For cases per capita, the most obvious point is that New York and New Jersey, which towered over every other state last spring, are now dwarfed by North & South Dakota, although things are pretty horrible nearly everywhere now.

1 out of every 8 residents of North Dakota, South Dakota and Rhode Island have tested positive for COVID-19 over the past year.

1 out of every 9 residents of Utah, Iowa, Tennessee, Arizona and Oklahoma have tested positive.

1 out of 10 in Arkansas, Nebraska, Kansas, Alabama and South Carolina.

1 out of 15 in 42 states.

1 out of 20 in 47 states & territories.

via Access Health CT:

Access Health CT To Host Two Educational “Healthy Chats” During Special Enrollment Period

  • Free Virtual Sessions to Help Uninsured Connecticut Residents Get Covered    

HARTFORD, Conn. (March 4, 2021) — Access Health CT (AHCT) announced today it will host two educational sessions called “Healthy Chats” on Tuesday, March 9 at 6:00 p.m. and Wednesday, March 10 at 6:00 p.m. (Spanish only) to help Connecticut residents learn about plan options, financial help, low-cost and free coverage and tips to stay covered during the Special Enrollment Period that runs until March 15, 2021*. The Special Enrollment Period is for consumers who are not currently enrolled in coverage through AHCT.

About these Healthy Chats

The Healthy Chat events are free and will be held virtually via Zoom (in English & Spanish). To join, attendees can access the event here, or here.

Back in late January, when it became clear that the Biden Administration was planning on announcing some sort of "no excuse needed" COVID Special Enrollment Period for the federal ACA exchange, I did a little back-of-the-envelope math to try and get an idea of how many additional people might enroll via HealthCare.Gov than you'd normally see via "standard" Special Enrollment Periods.

At the time, I concluded that for a 60-day SEP of this nature (that is, one completely open to all comers regardless of whether they had a Qualifying Life Experience (QLE)or not), you might be looking at perhaps an extra 400,000 people. selecting plans during that time period. This would be on top of the 4,200/day who enrolled thru HC.gov between the end of Open Enrollment and the end of May via SEPs over the past couple of years, which would be roughly 254,000 for a 60-day period.

A picture is worth 1,000 words and all that.

I've done my best to label every state/territory, which obviously isn't easy to do for most of them given how tangled it gets in the middle. For cases per capita, the most obvious point is that New York and New Jersey, which towered over every other state last spring, are now dwarfed by North & South Dakota, although things are pretty horrible nearly everywhere now.

1 out of every 8 residents of North & South Dakota's entire populations have tested positive for COVID-19 over the past year.

Rhode Island is up to over 1 out of every 9 residents.

Utah, Iowa, Tennessee, Arizona, Oklahoma, Arkansas, Nebraska, Kansas, Alabama and South Carolina are up to 1 out of every 10 residents.

42 states have seen at least 1 out of every 15 residents test positive.

EVERY state except Washington, Oregon, Maine, Vermont & Hawaii, along with the territories of Guam, U.S. Virgin Islands, the Northern Mariana Islands and American Samoa have now surpassed 1 out of every 20 residents having tested positive.

Pages