Alabama

As I noted a couple of weeks ago, I've relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.

For total monthly Medicaid enrollment, the official Medicaid.gov monthly enrollment data is only available dating back to late 2013, and it's only current through November 2020. The Kaiser Family Foundation has also compiled the pre-2014 average enrollment for each state based on the 3rd quarter of 2013. In some states I've been able to find more recent enrollment data for December 2020 or later.

MNsure Logo

via MNsure:

ST. PAUL, Minn.—Health insurance companies that partner with MNsure have given Minnesotans another reason to move to a MNsure plan. Most Minnesotans who purchased eligible individual or family coverage directly through BlueCross BlueShield MN, HealthPartners, Medica or Quartz can now purchase a plan from their current insurer through MNsure.org and in many cases without losing the dollars already paid toward their 2021 deductibles and out-of-pocket maximums.

Recent changes to the Affordable Care Act made through the American Rescue Plan mean more Minnesotans will pay less for their insurance. And for the first time ever, Minnesotans who bought their individual or family plan from one of MNsure's partnering health insurance companies can also take advantage of these new savings, but only if they move their coverage and enroll through MNsure. Enrollees should work with their insurance company to determine which plans qualify for a transfer of amounts paid toward their 2021 deductibles and out-of-pocket maximums.

CMS Logo

This just in from the Centers for Medicare & Medicaid:

CMS to Adopt Rules to Lower Health Care Costs in 2022 Federal Health Insurance Marketplace Plans

The Centers for Medicare & Medicaid Services (CMS) today adopted new provisions to lower maximum out-of-pocket costs to consumers by $400, while increasing competition and improving the consumer experience for millions of Americans who will rely on the Federal Health Insurance Marketplaces in plan year 2022. These actions demonstrate a strong commitment by the Biden-Harris Administration to protect and build on the Affordable Care Act (ACA), reduce health care costs, and make our health care system easier to navigate and more equitable.

Rate Change Icon

Every year, I spend months painstakingly tracking every insurance carrier rate filing for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease, and over the years I have a pretty good track record of nailing the average unsubsidized premium changes in each state.

However, it's never going to be dead on target, for a number of reasons: Rounding errors in the rate filings, missing enrollment data, outdated enrollment data, last-minute filing changes and so forth. In some states I'm only able to find on-exchange enrollments and have to estimate the corresponding off-exchange number for each carrier; in some cases the percent changes being approved don't match from the official Uniform Rate Review Template (URRT) form to the Actuarial Filing Memo, and sometimes neither of them match up with what shows up at RateReview.HealthCare.Gov!

COVID Icon

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.

Important:

  • Every county except those in Alaska lists the 2020 Biden/Trump partisan lean; Alaska still uses the 2016 Clinton/Trump results (the 2020 Alaska results are only available by state legislative district, not by county/borough for some reason...if anyone has that info let me know)
  • I define a "Swing District" as one where the difference between Biden & Trump was less than 6.0%. FWIW, there's just 187 swing districts (out of over 3,100 total), with around 33.7 million Americans out of 332 million total, or roughly 10.2% of the U.S. population.
  • For the U.S. territories, Puerto Rico only includes the case breakout, not deaths, which are unavailable by county equivalent for some reason.

With those caveats in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Wednesday, April 28th, 2021 (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 (Biden or Trump won by less than 6 points)
Access Health CT Logo

Access Health CT has officially announced a new Special Enrollment Period for Connecticut residents to take advantage of the newly-expanded ACA subsidies under the American Rescue Plan:

Access Health CT Announces A Special Enrollment Period Allowing New and Existing Customers To Receive Significantly Greater Financial Help At Virtually Every Income Level

Under the American Rescue Plan, new and existing customers who buy health insurance through the Marketplace will become eligible to receive increased financial help to reduce their monthly payments

President Biden, Vice-President Harris, Speaker Pelosi

As expected, the healthcare section of President Biden's first address to a joint session of Congress (technically not a State of the Union, but close enough) included a call for making the subsidies expanded under the American Rescue Plan permanent as part of the American Families Plan.

Also as expected, he did not call for other major healthcare reform priorities to be baked into the #AmFamPlan.

He did, however, spend significant time calling for those other priorities to be passed separately from the AFP...considerably more than he did on the subsidies themselves.

Before I get into the proposed healthcare policies: Early on in the speech, Biden gave a shout-out to his Administration for the success of the current, ongoing COVID Special Enrollment Period:

White House Logo

After weeks of anticipation and jockeying for policy priorities to be included by various advocacy groups, President Biden is set to formally roll out the American Families Plan at a speech to a joint session of Congress this evening...the first such speech of his administration, falling just ahead of his 100th day in office.

The first half of Biden's larger "American Infrastructure Plan" is the "American Jobs Plan" which addresses "hard" infrastructure like road & bridge construction/repairs, green energy investment, broadband access, overhauling our clean water system and so forth.

The #AmFamiliesPlan comprises the second half, and includes the following:

South Dakotans Decide Healthcare

 

Back in January, I. noted that:

...over the past few years, the voters of some of those states have decided to take it upon themselves to force their legislators/governors to expand Medicaid anyway, via statewide ballot initiative campaigns:

Kaiser Family Foundation Logo

With the urgent push by an unusually wide array of Congressional Democrats in both the House and Senate to lower the eligibility age of Medicare from 65 to 60 (or 55), the Kaiser Family Foundation posted an analysis of what that might look like in real-world terms for the newly-eligible enrollees, and the results, while not surprising, are pretty striking when presented the way they are in the KFF study:

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