via Connect for Health Colorado:

Connect for Health Colorado Offers Coloradans Through Dec. 18 to Enroll in Health Insurance Starting Jan. 1

DENVER — To help as many people as possible sign up for health insurance that begins on the first day of 2021, Connect for Health Colorado has decided to extend the deadline for January 1 coverage to this Friday, Dec. 18.

“Too many Coloradans have been left unemployed, uninsured and are struggling to get by as the pandemic grows,” said Chief Executive Officer Kevin Patterson. “By giving people a few extra days this week to get the coverage they need right on January 1st, we can ease some of the strain people are feeling. Financial help is available to reduce costs and local experts can also provide free enrollment assistance.”

Access Lower Premiums and Health Care Costs

Last week, Get Covered New Jersey, NJ's brand-new state-based ACA exchange, reminded New Jersey residents to enroll via Open Enrollment via the #GetCovered2021 campaign. The press release also mentioned, in passing, that nearly 227,000 NJ residents have already signed up for 2021, over 20,000 of whom are new enrollees.

Today, they posted a much more detailed breakout of their enrollment data so far, as well as reminding residents that unlike most states, New Jersey's Open Enrollment Period isn't over until the end of January, although they have to enroll by December 31st for coverage starting January 1st:

There's no formal press release, but Pennie, Pennsylvania's brand-new state-based ACA exchange just noted via their official Twitter account that they're extending the enrollment deadline for coverage starting January 1st by one week:

IMPORTANT ANNOUNCEMENT! We have extended the deadline! You now have until Tuesday, December 22 to select health coverage that begins New Year’s Day.

— Pennie (@PennieOfficial) December 15, 2020

A reminder from MNsure, Minnesota's ACA exchange:

The Final Countdown; MNsure's Open Enrollment Period Ends December 22 at Midnight

ST. PAUL, Minn.—Minnesotans looking for health insurance coverage starting January 1, 2021, have until 11:59 p.m. on Tuesday, December 22 to enroll in coverage through MNsure.org. The federal health insurance exchange, HealthCare.gov, ends its enrollment period today, but Minnesotans have an extra week to enroll through MNsure.

"There is still time to get 2021 health care coverage through MNsure," said MNsure CEO Nate Clark. "Minnesotans have through December 22 to sign up for comprehensive health insurance and access the financial help that makes it more affordable. But, don’t wait! Visit MNsure.org today so you can be sure you’re covered in the new year."

Need help? MNsure's Contact Center will provide extended hours leading up to the deadline:

via the Washington Health Benefit Exchange:

Washington Healthplanfinder Urges Customers to Act Now for Jan. 1 Health Coverage

• People need to enroll in their desired 2021 health plan by midnight, Tuesday Dec. 15

Washington Healthplanfinder is urging individuals needing 2021 health and dental coverage beginning Jan. 1 that they have less than 36 hours to take action and sign up. Customers wanting coverage that starts Jan.1 must select a plan through Washington Healthplanfinder by 11:59 p.m. this Tuesday, Dec. 15.

“For those who have left this decision to the last minute, now is the time to sign up for 2021 health and dental coverage,” said the Exchange Chief Executive Officer Pam MacEwan. “There are plenty of resources available to help people understand their options and secure health insurance coverage.”

via the Nevada Health Link:

While most of the country’s Exchanges prepare to conclude their Open Enrollment Periods, Nevada Health Link remains open through January 15, 2021 to purchase 2021 coverage

• Nevadans have 30 more days to get covered Nearly 72,000 Nevadans have enrolled to date

Carson City, Nev. – While most of the country prepares to conclude their open enrollment periods s this week on Dec. 15, Nevadans have an additional 30 days to enroll in health insurance coverage for 2021. Now through Jan. 15, 2021, Nevada Health Link, the online health insurance marketplace operated by the Silver State Health Insurance Exchange (Exchange), remains open and available for Nevadans to purchase comprehensive, Affordable Care Act (ACA) compliant health plans for 2021. As a State Based Exchange (SBE), Nevada Health Link makes its own decisions and is autonomous from the federal marketplace – HealthCare.gov – therefore allowing for an extended Open Enrollment Period (OEP), which is one of the many advantages to operating as a SBE.

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.

via Covered California:

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 Trump won by more than 6 points; Yellow = Swing District

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 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.

This week, they report that they have 95,230 total QHP selections, of which 9,959 are new.

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.

In doing so, I did a double-take when I read one passage in particular:

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.

via Pennie, PA's new ACA exchange:

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.”

via Get Covered New Jersey, NJ's brand-new state-based ACA exchange:

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.