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.
As COVID-19 Pandemic Surges Across the State, Covered California Takes the Unprecedented Step of Giving Consumers Until Dec. 30 to Sign up Up for Coverage that That Begins on Jan. 1
The data below comes from the GitHub data repositories of Johns Hopkins University, except for Utah, which comes from the GitHub data of the New York Times due to JHU not breaking the state out by county but by "region" for some reason.
I've made some more changes:
I've now completed updating the partisan lean for every county except Alaska (I'm having trouble getting that broken out by "County-Equivalent Region") to the 2020 Biden/Trump results. Alaska still uses the Clinton/Trump 2016 results, although I can't imagine more than one or two regions changed status there this year.
I've also added columns listing the actual Biden/Trump vote percentage for each county to give a feel for how partisan it is. Again, I'm defining "Swing District" as any county where the difference is less than 6.0%. There's 188 swing districts (out of over 3,100 total), with around 33.8 million Americans out of 332 million total, or roughly 10.2% of the U.S. population.
Finally, new this week: I've added all of the U.S. territories, including a county-equivalent breakout for Puerto Rico, as well as American Samoa, Guam and the U.S. Virgin Islands. None of these vote in the general Presidential election, of course, but I'm still tracking their COVID-19 case & death rates. None show up in the top 100 of either ranking, however.
With these updates in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Friday, December 11th (click image for high-res version).
Blue = Joe Biden won by more than 6 points; Orange = Donald Trumpwon by more than 6 points; Yellow = Swing District
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 past 11% already. Iowa, Wisconsin, Nebraska and Utah could all potentially hit the 10% milestone by New Year's Eve as well.
Access Health CT, Connecticut's ACA exchange, is posting updates to their Open Enrollment Period (OEP) numbers every Friday. Last week they reported 91,965 Qualified Health Plan (QHP) selections during the first 34 days of the 2021 OEP, which sounds more impressive than it is, since most of those were current enrollees having their auto-renewals front-loaded; only 7,500 of them were actually new enrollees. Nothing wrong with that, of course.
I'm pretty sure the reason for the discrepancy is that, like some other state-based exchanges, AccessHealthCT front-loads auto-renewals of all of their current enrollees, then allows them to actively go in and manually cancel their renewals. So, if they have 100K enrolled this year, they'd plug all of them in for 2021, then wait and see how many choose not to stay enrolled for 2021.
Way back on January 17th, 2020, I posted a long, wonky blog entry about how important risk pools are, using my own family making the move from an ACA exchange plan to a university student plan as an example. It included several data-entry system errors which made the switch more complicated than it should have been, though everything was straightened out in the end.
This morning, in response to a tweet by Sarah Kliff referencing an article by Margot Sanger-Katz about the difficulty of choosing the right health insurance policy, I was reminded of my own post from nearly a year ago and decided to re-read it.
Way back in October 2013, I launched the ACA Signups project as a light, nerdy hobby thing which was only supposed to last around six months, through the end of the first ACA Open Enrollment Period (March 31, 2014). Instead...well, let's just say that it's more than seven years later and I'm still doing this.
The reality is that The Graph itself doesn't serve a whole lot of useful function anymore. The enrollment patterns were erratic the first couple of years but have since settled into a pretty predictable...if not downright boring pattern for both the federal and state exchanges. The main reason I keep doing it each year is mostly out of tradition these days; after all, without The Graph, there wouldn't be an ACA Signups and I wouldn't have become a healthcare policy wonk in the first place.
Governor Wolf Declares Dec. 10 Get Covered 2021 Pennsylvania Day in Support of the National Initiative, Get Covered 2021
Pennie stressed the December 15 plan selection deadline and the connection between health coverage and COVID-19 safety
Harrisburg, PA – December 10, 2020 – Today, Pennsylvania leadership announced a statewide partnership with Get Covered 2021 and re-emphasized the vital role that health coverage plays in the overall health and well-being of all Pennsylvanians. Improving access to affordable, quality health coverage is a priority for Pennie, Pennsylvania’s new state-based health insurance marketplace.
Get Covered 2021 is a national initiative promoting COVID-19 safety precautions and the importance of having health coverage. Pennie, in partnership with Pennsylvania leadership, along with 15 other states and Washington D.C., hundreds of health associations, sports figures, and celebrities have joined together to help spread the word to “mask up and get covered.”
Governor Murphy Designates December 10th “Get Covered Day,” Encourages New Jerseyans to Get Covered During Open Enrollment
Proclamation is part of Get Covered 2021, a National Campaign to Prevent the Spread of COVID-19 & Encourage Residents to Enroll in Health Coverage
TRENTON — Joining with state partners from across the country in encouraging residents to enroll in health insurance during the Affordable Care Act Open Enrollment Period, Governor Phil Murphy issued a proclamation designating today, December 10, 2020, as “Get Covered Day” in New Jersey. Department of Banking and Insurance Commissioner Marlene Caride reminded residents that the deadline to enroll for coverage starting in the New Year is December 31st.
Over 200,000 have signed up for health coverage; Get covered by December 15 on Washington Healthplanfinder
Beat the rush by signing up today on Get Covered Day #GetCovered2021
OLYMPIA, Wash. -- As sign ups continue to increase, Washington Healthplanfinder reminds individuals today, Get Covered Day, to visit WA HealthPlan Finder to secure their health and dental coverage by Dec. 15 to ensure a start date of Jan. 1, 2021.
As of Dec. 10, over 200,000 Washingtonians have signed up for 2021 coverage, 5% more than last year at this time, and one person every 17 seconds. Among the 20,000 new customers, over 40% have selected a new Cascade Care plan. These new plans offer deductibles that are on average $1,000 less than other plans, and cover more services prior to meeting a deductible, including primary care visits, mental health services, and generic drugs.
