One of the biggest non-COVID19 related healthcare policy stories in the news this week was the Monday ruling by the U.S. Supreme Court stating that yes, the federal government does, in fact, have to keep its contractual obligation to make $12 billion in payments legally owed to a bunch of health insurance carriers.

As I've explained many times over the years, the idea behind the ACA's Risk Corridor program was that the launch of the major ACA regulations starting in 2014 involved such a radical reworking of requirements for private health insurance policies (especially on the individual market) that it was unreasonable to expect insurance companies to be able to accurately predict how well or poorly they would fare under the new rules. While the "free market" is supposed to be a "sink or swim" environment, it was agreed that this was so dramatic a change that the carriers should be given "training wheels" of sorts to smooth out the bumpy ride for the first three years.

Since tracking and analyzing data is what I'm best known for...and since I'm mostly stuck sitting in front of the computer all day whether I like it or not these days anyway...I've started my own daily COVID-19 spreadsheet.

Again, I'm not the one who compiled the data itself--many other teams with far better resources than I have are doing that--but I'm pulling their work together and adding some additional context, such as per capita info by state/territory.

Nationally:

Since tracking and analyzing data is what I'm best known for...and since I'm mostly stuck sitting in front of the computer all day whether I like it or not these days anyway...I've started my own daily COVID-19 spreadsheet.

Again, I'm not the one who compiled the data itself--many other teams with far better resources than I have are doing that--but I'm pulling their work together and adding some additional context, such as per capita info by state/territory.

Nationally:

US Chamber of Commerce, which supported ACA repeal bills in 2017, now among those calling for *increasing* ACA subsidies temporarily due to coronavirus crisis https://t.co/QtxCkKqCqX

— Peter Sullivan (@PeterSullivan4) April 28, 2020

Yes, it's true:

Dear Speaker Pelosi, Leader McConnell, Leader McCarthy and Leader Schumer: Thank you for your swift action to help overcome the COVID-19 crisis. Your action is speeding support to hospitals, doctors, nurses, businesses and workers from critical investments in equipment to direct assistance to cover immediate expenses. More must be done, and we stand united in our commitment to work with you and to work together.

Two weeks ago, Covered California reported that 58,000 residents had enrolled in ACA exchange coverage during their COVID-19 Special Enrollment Period, of which roughly 20,000 did so via standard SEPs (losing coverage, moving, getting married/divorced, etc), while an additional 38,000 took advantage of the COVID-specific SEP.

Today they issued a press release with updated numbers and more:

Covered California Continues to See Strong Consumer Interest in Quality Health Care Coverage During the COVID-19 Pandemic

Over the past few days, I've collected and analyzed the daily COVID-19 cases at the county level in Michigan and Wisconsin to see what patterns are emerging as time goes by. I've tried to do this via two criteria: Population density (urban vs. rural) and politically (red vs. blue). The latter, of course, shouldn't even be a thing, but of course it is; pretty much every policy decision being made by the Trump Administration is based on tribal politics, so it'd be naive not to look at the data in that light.

So far, I've found clear and obvious trends in both midwest states, which happen to be two of the three most closely-watched swing states this year: While the urban centers (Detroit/Metro Detroit in Michigan; Milwaukee/Madison in Wisconsin) started out with much higher rates of infection than the rest of the state, over the past few weeks this has shifted dramatically, and appears set to continue to do so.

Since tracking and analyzing data is what I'm best known for...and since I'm mostly stuck sitting in front of the computer all day whether I like it or not these days anyway...I've started my own daily COVID-19 spreadsheet.

Again, I'm not the one who compiled the data itself--many other teams with far better resources than I have are doing that--but I'm pulling their work together and adding some additional context, such as per capita info by state/territory.

Nationally:

  • 5.59 million tests have been completed in the U.S. (1.7% of the population)
  • 23,000 more Americans tested positive today. 1.01 million have tested positive to date.

Yes, that's right: Today the United States of America broke 1 million cases of COVID-19. Hooray for us. Yay team.

Yesterday I had a lengthy post in which I noted that the claims by certain Republicans/"MAGA" types that the COVID-19 pandemic was limited to "blue" areas and "big cities" (wink, wink) is quickly unraveling...at least here in Michigan.

Today, I've run the numbers and put together similar Red/Blue and Urban/Rural breakouts for another extremely closely-watched swing state: Wisconsin.

For Michigan, I was able to separate out the City of Detroit itself from the rest of Wayne County. I also included the wider "Metro Detroit Area", which consists of both Oakland and Macomb County along with the part of Wayne County outside of Detroit.

I'm a lot less familiar with Wisconsin, and they don't break out Milwaukee separately anyway, so I went with Milwaukee County, Dane County (which includes the 2nd largest city in the state, Madison), and the Rest of Wisconsin. Here's what the breakout of COVID-19 cases has looked like over time. Once again, it's really only relevant after the state reached 100 cases:

NOTE: BEFORE reading below, read my explainer from last November on the Risk Corridor Massacre lawsuit and potential Medical Loss Ratio implications.

OK, got all that? Good.

Well, sure enough, this morning the U.S. Supreme Court issued their ruling, and it wasn't even close:

A big Obamacare decision from SCOTUS this morning: The court rules 8–1 that insurers who lost money under the Risk Corridors program have a right to payment from the government AND damages for unpaid amounts. https://t.co/PjODO35oKe

— Mark Joseph Stern (@mjs_DC) April 27, 2020

This was an easy case. Only Justice Alito dissented, complaining that the court mandates "a massive bailout for insurance companies that took a calculated risk and lost." Dude really hates the ACA! https://t.co/PjODO35oKe

Since tracking and analyzing data is what I'm best known for...and since I'm mostly stuck sitting in front of the computer all day whether I like it or not these days anyway...I've started my own daily COVID-19 spreadsheet.

Again, I'm not the one who compiled the data itself--many other teams with far better resources than I have are doing that--but I'm pulling their work together and adding some additional context, such as per capita info by state/territory.

Nationally:

  • 5.44 million tests have been completed in the U.S. (1.6% of the population)
  • 26,500 more Americans tested positive today. 987,000 have tested positive to date (3.0 per thousand)

The U.S. is going to break 1 million positive cases sometime Monday afternoon.

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