Hey, remember the Inflation Reduction Act?

Remember how one of its healthcare provisions includes putting a copay cap of $35/month on insulin for Medicare enrollees?

Remember how Congressional Democrats & President Biden attempted to make the $35/mo insulin cap apply to ALL Americans as part of the defunct Build Back Better bill but had to settle for it only applying to the ~65 million on Medicare?

Well, guess what just happened? Via Rebecca Robins & Christine Hauser of the New York Times:


Last month I noted that the partisan COVID death rate gap, which had been shrunk down to almost nothing in December for the first time since COVID vaccines became widely available back in May 2021, had started to widen again:

Well, the lines didn't flip after all in January--the reddest quintile jumped up faster than the bluest quintile after all--two months earlier than I expected:

Bluest Quintile: 4.70 per 100K residents

Reddest Quintile: 5.33 per 100K residents (13% higher)

The January gap wasn't that significant by itself...except that it had looked like the rate in the reddest quintile might be lower last month.

Sure enough, the COVID death rate gap between the reddest and bluest fifths of the country widened out more in February, with the rate in the reddest quintile running 63% higher than the bluest quintile (4.22/100K vs. 2.39/100K). The rate actually dropped from January to February in every quintile, but it dropped considerably more in the bluest fifth (to the lowest rate since April 2022) than the reddest.

CMS Logo

via the Centers for Medicare & Medicaid Services (CMS), by email:

Today, the Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). These programs serve as key connectors to care for more millions of Americans.


  • As of November 2022, 65,372,781 people are enrolled in Medicare. This is an increase of 136,217 since the last report.
  • 35,114,923 are enrolled in Original Medicare.
  • 30,257,858 are enrolled in Medicare Advantage or other health plans. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage.

CMS Logo

via the Centers for Medicare & Medicaid Services:

Based on current COVID-19 trends, the Department of Health and Human Services is planning for the federal Public Health Emergency for COVID-19 (PHE), declared under Section 319 of the Public Health Service Act, to expire at the end of the day on May 11, 2023. Thanks to the Administration’s whole-of-government approach to combatting the virus, we are in a better place in our response than we were three years ago, and we can transition away from an emergency phase.


I'd never heard of Illinois state Senator Laura Fine before now. I know absolutely nothing else about her besides her being a Democrat who represents IL Senate District 9.

What I do know (thanks to a heads up from my friend & colleague Louise Norris) is that Sen. Fine recently introduced IL SB1912 into the legislative process:

As I noted a few weeks back, the Patient Protection & Affordable Care Act now directly provides healthcare coverage for a stunning 40 million Americans:

...it's very likely that another 50,000 - 100,000 people will be added to the final QHP tally when the dust settles tomorrow (Tuesday, January 31st) evening. Even assuming the same 94% effectuation rate, that will still bring the effectuated QHP total to roughly 15.4 million.

Add to this the 1,217,517 confirmed Basic Health Plan (BHP) enrollees in New York and Minnesota and the subtotal comes to around 16.62 million QHPs + BHPs combined.

Next, we need to add Medicaid Expansion enrollees.

...the MBES reports only run through March 2022, at which point the national ACA expansion total stood at 22,275,433.

We're up to 38.9 million Americans with ACA coverage already, and we're still missing a lot of Medicaid expansion enrollees.

Update 3/15/23: At the request of Humana's Sales Integrity Dept., I've removed their logo from this blog entry.

Before I start, let me say that I've never been a fan of Medicare Advantage, at least as its currently structured, for a number of reasons. I am not advocating for the Medicare Advantage system--again, as currently structured--to be expanded.

Having said that, the trend has been inevitable: Medicare Advantage has steadily increased its share of total Medicare enrollment for years, from 19% in 2007 to 48% in 2022 according to the Kaiser Family Foundation (the official October 2022 CMS Medicare enrollment report puts it a bit lower, at 46.3%). Either way, the point is that MA is on track to overtake traditional, "fee for service" Medicare within the next few years and become the default choice for new enrollees.

Get Covered NJ Logo

via the New Jersey Dept. of Banking & Insurance:

ICYMI: Governor Murphy and Commissioner Caride Announce Record-Breaking 341K People Signed Up for Health Insurance During Open Enrollment Period 

  • Nearly 40% Increase in Sign-Ups Since the Murphy Administration Assumed Operation of the Health Insurance Exchange 
  • Residents with a Qualifying Life Event or Who Meet Certain Income Levels Still Have Options to Get Covered 

TRENTON – Governor Phil Murphy and Department of Banking and Insurance Commissioner Marlene Caride today announced that more than 341,000 New Jerseyans signed up for health coverage through Get Covered New Jersey during the Affordable Care Act Open Enrollment Period – a record high in New Jersey. 


Over on Twitter, political commentator Krystal Ball made an interesting claim:

A provision in Obamacare allows residents in areas deemed a public health disaster to be covered by Medicare for life. At the very least, East Palestine residents deserve this universal coverage after being exposed to a known carcinogen. https://t.co/ooPYmJ4Y8b

— Krystal Ball (@krystalball) February 21, 2023

What she's referring to is an obscure & fascinating nugget buried in the Patient Protection & Affordable Care Act: Section 10323, which states:


(a) In General.--Title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) is amended by inserting after section 1881 the following new section: