A few weeks ago I raised an alarm about the federal budget introduced by former Trump Administration OMB Director Russell Vought's think tank, which is being embraced by many House Republicans as their blueprint for a formal budget proposal.

As I noted at the time, Vought's proposed budget would include, among many other horrific things, completely eliminating funding for the ACA's Medicaid expansion program as well as complete elimination of all Advance Premium Tax Credit (APTC) funding for ACA exchange-based individual market enrollees.

I went on to note that if this proposal were to somehow pass the Senate and be signed into law by President Biden (neither of which is likely to happen, to put it mildly), nearly 40 million Americans would lose healthcare coverage as a result nationally.

Below, I've broken that number out by state to give better context about just how draconian such an eventuality would be.

via Covered California:

La versión en español de este Comunicado puede ser descargada en este enlace.

SACRAMENTO, Calif. — Covered California announced that 263,320 people had newly selected a health plan for 2023, continuing a trend of steady growth in recent years. The total is more than 14,000 higher than 2021’s total, and 8,000 higher than last year’s figure. In addition, more than 1.4 million Californians renewed their health insurance for 2023, bringing Covered California’s overall enrollment to 1.74 million.

“Covered California is woven into the fabric of our health care system, providing quality coverage in every corner of the state and protecting more than 1.7 million Californians,” said Jessica Altman, executive director of Covered California. “The strength in these numbers is driven by the Inflation Reduction Act, which provides increased and expanded financial help, bringing the cost of coverage within reach for millions of Californians who need health insurance.”

Obviously much of this is unlikely to actually go anywhere given House Republicans plans to almost completely defund the ACA and completely gut Medicaid overall, but as President Biden always says, "Don’t tell me what you value. Show me your budget—and I’ll tell you what you value.”

So, you know...there's that. Via the HHS Dept:

HHS Releases President’s Fiscal Year 2024 Proposed Budget 

Investments address urgent needs to extend Medicare solvency, lower drug costs, bolster public health preparedness, improve the well-being of children and seniors, expand access to health care, increase the health care workforce, and advance research underlying medicine, public health, and social services

New York

In my post a few weeks ago about Minnesota's plan to dramatically expand their existing Basic Health Plan (BHP) program, MinnesotaCare, into a full-fledged Public Option open to residents not currently eligible for the program, I made an offhand reference to similar BHP expansion-related news happening in New York State. However, I haven't gotten around to actually writing about NY's BHP program until now.

New York's implementation of the ACA's BHP provision (Section 1331 of the law) is called the Essential Plan, and it already serves over eleven times as many people as Minnesota's does (around 1.1 million vs. 100K). Part of this is obviously due to New York having a larger population, but that's only part of it (NY has 19.84M residents, just 3.5x higher than MN's 5.71M).

Whenever I write about BHPs I always throw in a simple explainer about what it is, with an assist from Louise Norris:

West Virginia

Last fall I noted that Oregon (along with Kentucky, although it looks like the latter got cold feet later on) may end up becoming the third state (after Minnesota and New York) to create a Basic Health Plan program which would provide comprehensive, inexpensive (or potentially free) healthcare coverage for residents who earn between 138% - 200% of the Federal Poverty Level (FPL)...basically, the next income tier above the cut-off for ACA Medicaid expansion. A few days ago, the state legislature passed a bill which would create a task force to put together their findings and recommendations no later than September 1st of this year.

Last year I went pretty off-topic with a lengthy, in-the-weeds post about my experience shopping for, buying and driving an electric vehicle for the first time which received a decent level of attention.

I didn't actually get around to writing up the post until June, but I actually bought the car, a 2022 Kia Niro EV, in early March...March 5, 2022 to be precise, almost exactly one year ago.

With a year of real world driving (including an 1,100 mile (round trip) road trip from Metro Detroit to the District of Columbia) baked in, I figured this would be a good time to post an update on how things are going for those who've never owned an EV and are wondering about the good, the bad & the ugly of the experience.

Before I get started, I should take a moment to note that the EV industry and market have both gone through some tumultuous changes over the past 12 months, including (but not limited to):

NOTE: With the news that the Johns Hopkins University COVID Tracking project & other reliable data sources are shutting down on March 10th, this may be the last update to this project, although I may be able to find alternatives for county-level COVID deaths.

As of this writing, 69.3% of the total U.S. population has completed their primary COVID-19 vaccination series (including 94.3% of those 65+), but a mere 16.2% of the total population has also gotten their updated bivalent booster shot. Even among seniors it's only at 41.4% nationally.

Pennie Logo

via Pennie, Pennsylvania's state-based ACA exchange:

Harrisburg, PA – At the conclusion of Pennie’s Open Enrollment Period on January 15th, nearly 372,000 Pennsylvanians were enrolled in a comprehensive health plan. Almost 245,000 Pennsylvanians were automatically renewed into a 2023 plan, another 62,000 existing customers returned and shopped for a plan, and nearly 65,000 new enrollees joined the marketplace in 2023.

Pennie provides significant savings on health coverage to improve access to health care and to counter rising costs. Almost 90 percent of total customers are receiving financial savings, which on average, is more than $520 a month for those customers. With these savings, over 32 percent of customers pay less than $50 a month for coverage, and over 50 percent of customers pay less than $150 a month.

HealthSourceRI Logo

Via Health Source Rhode Island:

HealthSource RI Concludes Open Enrollment Period

  • 4,318 Rhode Islanders are newly insured, supporting state’s outstanding insured rate of 97%  

PROVIDENCE – HealthSource RI (HSRI) announces that its annual Open Enrollment period has concluded as of January 31, with 4,318 Rhode Island residents newly enrolled in the affordable qualified health plans available through the state marketplace. An additional 24,343 individuals, or 83% of last year’s customers, renewed their coverage during the same period starting November 1.

That's 28,661 QHP selections total, down 11.4% from the 2022 Open Enrollment Period.

“We’re encouraged that each year more Rhode Islanders are taking advantage of the quality, affordable coverage options available to them through HealthSource RI,” said Governor Dan McKee. “Rhode Island continues to be a national leader in health coverage and HSRI is an instrumental piece of the effort to maintain our extraordinarily high rate of insurance coverage.”

UPDATE 3/15/23: The agreed-to Medicaid expansion deal has passed the NC State Senate! It now just needs to pass the state House one final time and then it's on to Gov. Cooper's desk to be signed into law!

UPDATE 3/22/23: The bill has now passed the state House by a stunning 94-22 margin as well! It still has to pass one more time tomorrow (a "concurrence" vote) and then it's on to Gov. Cooper's desk!

UPDATE 3/23/23: On the 13th Anniversary of the Affordable Care Act, the North Carolina House has officially taken the final vote needed for passage, with the bill easily passing 87 - 24. It's now onto Gov. Cooper, who has vowed to sign it into law ASAP.