via Access Health CT (via forwarded email):

Dear Brokers,
 
A lot has transpired regarding the American Rescue Plan Act of 2021*. Our team has been meeting with CMS, other state-based marketplaces, our insurance carriers, and other stakeholders, and is in the process of putting together a strategic plan to implement these changes.

We know some of you might be getting questions from customers/stakeholders in the days to come since the federal exchange (Healthcare.gov) will have a robust national campaign supported by President Biden to help spread the word. Here’s what you should know: 

Timelines are/will be different: Healthcare.gov will be implementing the subsidy expansion and a possible Special Enrollment Period at a different time than Access Health CT (AHCT). It may start earlier and may end later than CT (we do not know dates at this time).

Access Health CT:

I actually posted this a couple of weeks ago, but am reposting it as a standalone entry for clarity. Via Connect for Health Colorado:

American Rescue Plan Makes Health Insurance More Affordable for More Coloradans Shopping through the Exchange

DENVER — Yesterday afternoon, President Biden signed the American Rescue Plan Act of 2021(American Rescue Plan) into law. Connect for Heath Colorado® Chief Executive Officer, Kevin Patterson, released the following statement in response to provisions which strengthen the Affordable Care Act and increase affordability:

“We are thrilled and getting ready to implement the health coverage provisions outlined in this law. This expansion of financial help will provide greater access to savings on the health plans we offer. This means more affordable health insurance for many more Coloradans.”

Thanks to Andrew Sprung for the heads up. Via Get Covered New Jersey:

The American Rescue Plan & Additional Financial Relief

The federal government recently passed a COVID-19 relief bill, the American Rescue Plan Act of 2021, which was signed into law by President Biden on March 11, 2021. The new law will reduce health insurance premiums by providing more financial help to eligible consumers who purchase a plan through Get Covered New Jersey. Get Covered New Jersey is working to implement the changes and update its system to ensure that New Jerseyans receive this relief as soon as possible.

More people than ever will qualify for financial help. If you did not qualify for financial help before because your income was too high, you may qualify under the federal changes. If you already receive financial help, you will likely be eligible for additional premium reductions. These new changes make coverage more affordable at many income levels.

Alabama & Wyoming Icons

The American Rescue Plan does plenty to make private ACA-compliant health insurance dramatically more affordable for everyone earning more than 100% of the Federal Poverty Level. For those below 100% FPL, however, it takes an indirect approach. As I wrote a few weeks ago:

One possible "solution" would have been to simply remove the lower-bound income cut-off point for ACA exchange subsidy eligibility (that is, to lower the threshold from 100% FPL to 0%)...However, this would create two new problems: First, Medicaid is far more comprehensive than nearly all ACA plans...Secondly, if the lower-end subsidy cut-off were removed, it's almost certain that quite a few states which have already expanded the program would reverse themselves and allow Medicaid expansion to expire, in order to save the 10% portion of the cost that they have to pay.

When the $1.9 trillion American Rescue Plan (ARP) achieved final passage on March 10th, it did so almost exclusively along party lines. I say "almost" because there was a single Democratic House member who voted against it: Representative Jared Golden (ME-02).

I fully understand the tightrope that some swing district Dems have to walk. To his credit, Rep. Golden voted to impeach Donald Trump not once, but twice (though he only voted in favor of one of the 2 articles of impeachment against him the first time around). I certainly don't expect every single Democrat to vote the party line on every single bill.

In the end, the bill passed anyway, if only by a handful of votes; my guess is that he even received Speaker Pelosi's unofficial blessing to vote against it, as long as she knew for sure it would pass regardless.

On Monday I noted that in the wake of the passage and signing of HR 1319 (the American Rescue Plan, or ARP), which includes a dramatic (if time-limited) upgrade & expansion of ACA individual market subsidies, Senate Democrats are hard at work pushing for several other important bills to make President Biden's larger healthcare policy vision a reality on a permanent basis.

The three bills I discussed in Part 1 are:

  • Sen. Mark Warner's Health Care Improvement Act of 2021 (S.352)
  • Sen. Michael Bennet & Sen. Tim Kaine's re-introduced "Medicare X" Act (S.386, I believe)
  • Sen. Jeanne Shaheen's Improving Health Care Affordability Act (S.499)

Of the three, the one which seems most likely to actually have a shot at passing both the House and Senate and being signed into law by President Biden during the 2021 - 2022 legislative session is Sen. Shaheen's S.499, which would:

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 Thursday, March 18th, 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)
Covered California

Yesterday's press release from Covered California included a TON of important information about how they're handling the massive subsidy upgrade/expansion under the American Rescue Plan, but it left out one other critically important item which was caught by Inside Health Policy reporter Amy Lotven:

Insurers participating in Covered California have agreed to help move their off-exchange individual plan enrollees into the marketplace so they can benefit from the new Affordable Care Act subsidies available under the American Rescue Plan (ARP) and will not reset the deductibles, Covered California Executive Director Peter Lee said Thursday (March 18) in a webinar with reporters and key stakeholders.

...Off-exchange enrollees could get an average $500 premium drop, which means they could save as much as $12,000 under the two-year provision, Lee says. About 430,000 Californians and 1.5 million people nationally who are enrolled off-exchange plans are newly eligible for help, the exchange estimates.

A picture is worth 1,000 words and all that.

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. For cases per capita, the most obvious point is that New York and New Jersey, which towered over every other state last spring, are now dwarfed by North & South Dakota, although things are pretty horrible nearly everywhere now.

1 out of every 8 residents of North Dakota, South Dakota and Rhode Island have tested positive for COVID-19 over the past year.

1 out of every 9 residents of Utah, Iowa, Tennessee, Arizona and Oklahoma have tested positive.

1 out of 10 in Arkansas, Nebraska, South Carolina, Alabama, Kansas, Mississippi and Indiana.

1 out of 15 in 43 states.

1 out of 20 in 47 states & territories.

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