Add Health Source RI to the list:

HealthSource RI Joins President Biden and Announces New Health Coverage Enrollment Period

EAST PROVIDENCE, Rhode Island (February 1, 2021) — Following President Biden’s announcement on Thursday January 28, HealthSource RI has established a new enrollment period to give Rhode Islanders additional time to sign up for health coverage. Uninsured Rhode Islanders can enroll for coverage effective as early as March 1. HealthSource RI’s enrollment period will continue through May 15, 2021.

This enrollment period is open to all eligible uninsured Rhode Islanders, with no requirement to have a qualifying life event to enroll in health coverage.  Coverage starts the first of the month following a complete enrollment.

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.

I've made some more changes:

  • Every county except those in Alaska lists the 2020 Biden/Trump partisan lean; Alaska still uses the 2016 Clinton/Trump results. I define a "Swing District" as one where the difference between Biden & Trump was less than 6.0%. FWIW, there's just 188 swing districts (out of over 3,100 total), with around 33.8 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 these updates in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Saturday, January 30th, 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

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 utterly dwarfed by North & South Dakota, although things are getting pretty horrible everywhere now.

North Dakota has reached 12.8% of the entire population having tested positive, or over 1 out of every 8 residents.

South Dakota is up to 12.2%, or more than 1 out of every 9 residents.

Rhode Island, Utah, Tennessee, Arizona and Iowa are up to 1 out of every 10 residents having tested positive.

40 states have seen at least 1 out of every 15 residents test positive.

EVERY state except New Hampshire, Washington, Oregon, Maine, Hawaii & Vermont (along with 4 U.S. territories) have now surpassed 1 out of every 20 residents having tested positive.

via the Nevada Health Link...

Today, the Biden‐Harris Administration announced a Special Enrollment Period, allowing Americans to enroll and purchase on‐Exchange health insurance plans from their respective on‐Exchange marketplaces. On behalf of the Silver State Health Insurance Exchange and Nevadans statewide, we are pleased to see positive change taking place at the federal level and to witness the fast‐moving actions to protect the Affordable Care Act (ACA), upon which so many Americans rely for quality, affordable and comprehensive health insurance coverage.

This news comes on the heels of our announcement that nearly 82,000 Nevadans enrolled on Nevada Health Link for coverage in 2021. That’s nearly a six percent increase from last year’s enrollment total.

Today’s news from the White House speaks volumes about how the new Administration will continue to support the ACA and help to bolster the health insurance marketplace, protecting hundreds of millions of Americans.

...Annnnd add Get Covered NJ to the list:

Governor Murphy Announces Extension of Affordable Care Act Enrollment Period for Uninsured In New Jersey In Response to COVID-19 Pandemic

  • New Jersey Joins Biden Administration in Effort to Assist Residents Through Special Enrollment Period

TRENTON – Following the Biden Administration’s health care action today, Governor Phil Murphy announced the State is extending the health insurance enrollment period for uninsured residents to sign up for coverage through Get Covered New Jersey, the state’s official health insurance marketplace, in response to the coronavirus pandemic.

via MNsure:

Statement of Nate Clark, Chief Executive Officer (CEO), MNsure

Re: New executive orders signed by President Biden today that support state-run ACA insurance exchanges like MNsure

ST. PAUL, Minn.—"MNsure welcomes this news and the Biden Administration’s efforts to strengthen the Affordable Care Act to increase access to quality, comprehensive health coverage. As the nation continues to fight the deadliest pandemic in a century, the changes President Biden is making will benefit Minnesotans who need the peace of mind that comes with knowing you have health care coverage.

"President Biden’s executive order directs federal agencies to look at ways to protect and strengthen access to health insurance and increase protections for those who have preexisting conditions, including complications related to COVID-19.

via the Washington Health Benefit Exchange:

Washington Health Benefit Exchange (Exchange) announced today it will open a special enrollment period that parallels the new federal enrollment period which runs from Feb. 15 through May 15, 2021.

“Having health insurance is critically important in these challenging times of COVID,” said Chief Executive Officer Pam MacEwan. “Opening a corresponding special enrollment period in our state gives more uninsured Washingtonians the chance to get needed coverage for 2021.”

The special enrollment period will apply to anyone seeking health insurance coverage. Individuals shopping for coverage during this special enrollment period that select coverage by the 15th of the month will begin receiving coverage the first of the following month.

This was probably inevitable: via Connect for Health Colorado (email):

Colorado to Re-Open Enrollment for Individual Health Insurance 

DENVER – Today, President Joe Biden issued an Executive Order that re-opens enrollment on the Affordable Care Act marketplaces. While the order pertains to states that use the federal exchange, HC.gov, Colorado’s exchange, Connect for Health Colorado will mirror the order by re-opening enrollment.

Coloradans without health insurance will be able to enroll in coverage through C4HCO.com between Feb. 8 - May 15, 2021. Health insurance coverage will begin on the first day of the month following plan selection. This Special Enrollment period is for people who are without health insurance and begins a week earlier than the federal exchange.

The wording of this is important: This SEP is for uninsured residents specifically; presumably it is not open to those who are simply looking to switch from one ACA policy to another. My guess is there will be a checkbox or whatever for enrollees to attest that they do not currently have health insurance coverage.

As I noted earlier today, the Big News® this today is President Biden's pending Executive Order to re-open HealthCare.Gov to a full 3-month COVID-19 Special Enrollment Period starting on February 15th. There's a whole bunch of other important stuff in today's healthcare XO, but some of them will take months to actually finalize and implement.

Frankly, re-opening HC.gov is actually one of the simplest and most obvious healthcare-related executive orders Biden could give at the moment. Now that the starting/ending dates are known, it raises one other important question.

I wrote about this a few days ago, but today it'll be official:

President Biden to Sign Executive Orders Strengthening Americans’ Access to Quality, Affordable Health Care

The Biden-Harris Administration will open a Special Enrollment Period for Americans to sign up for health coverage and roll back attacks on the Affordable Care Act, Medicaid, and access to reproductive health care

Strengthening Medicaid and the Affordable Care Act.

The ACA was originally designed with the intention that all documented Americans living in all 50 states (+DC) earning up to at least 138% of the Federal Poverty Level (FPL) would be eligible for Medicaid. Unfortunately, the 2012 NFIB v. Sebelius ruling by the U.S. Supreme Court stated that Medicaid expansion under the ACA had to be left up to each individual state.

This meant that each state had to decide, whether by legislation, executive order (depending on the state) or ballot initiative, whether or not to expand the low-income public health program or not. Under the ACA, any state which does so will have 90% of the cost paid for by the federal government, while the state has to pony up the other 10% of the cost.

I just realized that while I've broken out state-level 2021 Open Enrollment data between Medicaid expansion & nonexpansion states, I haven't posted the state-level 2021 vs. 2020 data in a single table yet, so I'm rectifying that today. Note that this still only includes partial data for 5 states (CA, DC, MA, NJ & WA) and no data at all for 3 others (NY, RI, VT).

For that matter, Open Enrollment is still ongoing in either 5 or 6 states (Maryland depends on your POV...they ended OEP in December but re-launched it a few weeks ago in response to the COVID-19 pandemic).

While the data below is incomplete, this seems like a good time to see where things stand given that President Biden is widely expected to announce a re-launch of Open Enrollment tomorrow.

Three years ago, I posted what seemed to be a fairly naive question:

All of this brings me to my question:

  • Last summer the Trump administration announced that they were slashing their advertising budget by 90%, from $100 million to just $10 million.
  • They also announced that they were slashing $23 million out of the navigator/outreach program for open enrollment.
  • That means they cut HealthCare.Gov's total budget by $113 million.

So my question is this: Where exactly did that money go?

For that matter, assuming HC.gov is set to bring in $300 million more this year, but doesn't plan on reinstating that $113 million for advertising/outreach, doesn't that mean they should be profiting by over $400 million? Again, if so, where is that money going?

UPDATE: It's official...and it'll be 90 days starting on 2/15, not 60.

In an news which surprises absolutely no one, this Thursday the Biden Administration is expected to officially announce a COVID-19 Special Enrollment Period at HealthCare.Gov, the federal ACA exchange which hosts enrollment for 36 states:

Thursday: ‘Health Care’ day

...The president is also slated to sign an executive order aimed at strengthening Medicaid and initiating an open enrollment period under the Affordable Care Act.

Trump frequently bragged about gutting the Affordable Care Act by rescinding the individual mandate, though Republicans were unable to fully repeal the law as promised.

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