COVID19

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 utterly dwarfed by North & South Dakota, although things are getting pretty horrible everywhere now.

North Dakota has broken 12.5% of the entire population having tested positive, or over 1 out of every 8 residents.

South Dakota is up to 11.9%, or more than 1 out of every 9 residents.

Utah, Tennessee, Rhode Island and Iowa are on the verge of passing 1 out of every 10 residents.

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

Back on December 19th, my colleagues Colin Baillio and Andrew Sprung picked up on something I had posted in response to the semi-final 2021 Open Enrollment snapshot report:

STATE LEVEL:
--25 out of 36 states outperformed last year
--Best % increase y/y: TEXAS (+14.9%)
--Worst $ decrease y/y: KENTUCKY (-6.7%)

I have no idea if there's anything special in either state which caused either to do as well/poorly as they did relative to last year.

Sprung decided to look into it further. He broke out the states between Medicaid expansion and non-expansion states, and voila:

From the state totals one obvious pattern leaps out: enrollment is up 9.7% in states that have not enacted the ACA Medicaid expansion -- and down 0.5% in states that have expanded the expansion (including Nebraska, which opened the Medicaid expansion doors in October of this year).

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 utterly dwarfed by North & South Dakota, although things are getting pretty horrible everywhere now.

North Dakota has broken 12.3% of the entire population having tested positive, or nearly 1 out of every 8 residents.

South Dakota is up to 11.5%, or more than 1 out of every 9 residents.

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

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 utterly dwarfed by North & South Dakota, although their surge seems to be finally dropping (although "dropping" is a relative term...it's still pretty awful everywhere).

North Dakota has broken 12% of the entire population having tested positive. South Dakota is up to 11%. A half-dozen other states are hovering between 8-9% of the population being infected.

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 utterly dwarfed by North & South Dakota, although their surge seems to be finally dropping (although "dropping" is a relative term...it's still pretty awful everywhere).

North and South Dakota are the first two states where more than 10% of the entire population has tested positive (in fact, North Dakota is about to hit 12%). A few other states could all potentially hit the 10% milestone by New Year's Eve as well.

Well, for good or for bad, it's finally here: The stripped-down-but-bipartisan COVID19 relief bill.

You can read the whole thing here...if you have a LOT of spare time on your hands. It's 5,600 pages long, 1.1 million words. For context, the entire Lord of the Rings trilogy is only half that length (576,000 words).

There's 1,000 explainers being written today about the most obvious stuff (the $600 direct relief checks, the extended & enhanced unemployment funding, etc etc), most of which falls far short of what's actually needed. Instead, I'm focusing on the ACA-related provisions. I already wrote about the surprise billing prohibition this morning, of course, but a quick initial scan of the text (which isn't easy...again, 5,600 pages...) reveals several other items directly related to the Affordable Care Act, so let's take a look! (Note: I'm sure I'm missing a few):

Page 4,206:

Surprise!

 

Over six months after House Democrats passed a robust COVID-19 relief bill (only to see it continuously blocked by Republican Senate Majority Leader Mitch McConnell), it looks like Congress is finally set to compromise on a vastly stripped-down bipartisan bill which would provide at least a small amount of relief for hundreds of millions of American families and businesses.

While the bill is underwhelming (to put it mildly) overall, it does include several important provisions, one of which is a long-sought solution to a massive healthcare problem which existed long before COVID came knocking at our door nearly a year ago: Surprise Billing.

Over at the New York Times, Sarah Kliff and Margot Sanger-Katz have written an excellent summary of the problem and the proposed solution:

In my Twitter thread yesterday breaking out the semi-final HC.gov weekly snapshot enrollment report, I noted:

STATE LEVEL:
--25 out of 36 states outperformed last year
--Best % increase y/y: TEXAS (+14.9%)
--Worst $ decrease y/y: KENTUCKY (-6.7%)

I have no idea if there's anything special in either state which caused either to do as well/poorly as they did relative to last year.

My colleagues Colin Baillio and Andrew Sprung took note of this, and Sprung decided to look into it further. He broke out the states between Medicaid expansion and non-expansion states, and voila:

From the state totals one obvious pattern leaps out: enrollment is up 9.7% in states that have not enacted the ACA Medicaid expansion -- and down 0.5% in states that have expanded the expansion (including Nebraska, which opened the Medicaid expansion doors in October of this year).

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

I was doing this earlier in the summer but stopped updating it in August; I've started over with a fresh spreadsheet and have expanded it to include every U.S. territory, including not just DC & Puerto Rico but also American Samoa, Guam, the U.S. Virgin Islands and even the Northern Mariana Islands.

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. The most obvious point is that New York and New Jersey, which towered over every other state last spring, are now utterly dwarfed by North & South Dakota, which are skyrocketing.

North and South Dakota are the first two states where more than 10% of the entire population has tested positive (in fact, North Dakota is about to hit 12%. Iowa, Wisconsin, Nebraska and Utah could all potentially hit the 10% milestone by New Year's Eve as well.

This letter was sent to CMS Administrator Seema Verma over the weekend by Peter Lee, Executive Director of Covered California:

Dear Administrator Verma:

The COVID-19 pandemic continues to surge across the nation, endangering Americans and filling our hospitals from coast to coast. In the middle of this rising crisis, nearly 80 percent of the health insurance marketplaces, including all of those supported by the federally facilitated exchange (FFE) and a small number of state-based exchanges, are set to close their open-enrollment periods on December 15th.

We are writing to recommend that the Centers for Medicare and Medicaid Services (CMS) extend the Healthcare.gov open-enrollment period through January 31st or, at a minimum through December 30th, to allow Americans more time to sign up for health care coverage during this pandemic.

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