As I noted this morning, while the 2023 ACA Open Enrollment Period has now officially ended in all states, there's still a lot of Special Enrollment Period (SEP) exceptions for people who have Qualified Life Experiences (QLEs) such as losing their current coverage, turning 26, moving, getting married/divorced, giving birth and so forth.

There's also year-round enrollment available for members of Native American tribes, as well as those eligible for Medicaid and the Children's Health Insurance Program (CHIP).

Finally, in most states, residents are eligible to enroll year-round as long as their income is below a certain threshold--usually 150% of the Federal Poverty Level (FPL), somewhat higher in some states, including New York, where residents earning. up to 200% FPL can enroll in the Essential Plan year-round.

Last month I noted that the partisan COVID death rate gap, which had been significantly higher in the reddest U.S. counties than the bluest counties every month since July 2020, appeared to be on the verge of finally disappearing entirely:

The initial COVID wave in March - May 2020, of course, devastated Blue America, primarily densely populated (and heavily Democratic) New York and New Jersey, while leaving Red America (mostly sparsely populated, rural Republican counties) relatively unscathed.

This situation quickly began to reverse itself only a few months later. Starting in July 2020--the same month the Vanity Fair expose was published, as it happens--the situation had already reversed itself: The reddest fifth of the U.S. was already experiencing a higher COVID death rate than the bluest fifth...and it has stayed that way ever since.

The 2023 ACA Open Enrollment Period has now officially ended in every state.

However, as I keep noting, there's still plenty of people who are eligible to enroll in ACA healthcare coverage during the off-season (thanks to Louise Norris for providing some of the links below):

MOST STATES: If your household income is less than 150% of the Federal Poverty Level (or higher in some states), you can enroll year-round:

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.

Medicare

Yesterday evening, the Health & Human Services Office of Intergovernmental & External Affairs sent out this notice from the Biden Administration:

STATEMENT OF ADMINISTRATION POLICY

• H.R. 382 – A bill to terminate the public health emergency declared with respect to COVID-19 (Rep. Guthrie, R-KY, and 19 cosponsors)
• H.J. Res. 7 – A joint resolution relating to a national emergency declared by the President on March 13, 2020 (Rep. Gosar, R-AZ, and 51 cosponsors)

The COVID-19 national emergency and public health emergency (PHE) were declared by the Trump Administration in 2020. They are currently set to expire on March 1 and April 11, respectively. At present, the Administration’s plan is to extend the emergency declarations to May 11, and then end both emergencies on that date. This wind-down would align with the Administration’s previous commitments to give at least 60 days’ notice prior to termination of the PHE.

via Covered California:

With time running out, Covered California announced new enrollment data and encouraged consumers to sign up for coverage before this year’s open-enrollment period ends.

As of Jan. 29, more than 240,000 consumers had newly signed up for health insurance through Covered California during the current open-enrollment period. In addition, more than 1.5 million Californians have renewed their coverage for another year.

That's a grand total of at least 1,740,000 people...or around 21,000 higher than CMS had reported California being at as of January 15th. Note the "more than" clarifier re. the 1.5M figure; this suggests that the actual total could be as much as ~40K or so higher.

Last spring, I noted that total enrollment in healthcare policies either specifically created by or expanded to more people by the Affordable Care Act had broken 36 million Americans:

The press release talks about "more than 35 million" being enrolled, but when you look at the actual data, it's almost certainly over 36 million as of today. Here's how they break it out:

• Effectuated ACA exchange enrollment as of March 2022: 13,640,412
• Medicaid Expansion (newly eligible) as of October 2021: 16,781,800
• Medicaid Expansion (previously eligible) as of October 2021: 4,261,277
• Basic Health Plan enrollment as of March 2022: 1,135,190
• TOTAL: 35,818,679

Notice that even without delving further, the total is already over 35.8 million.

However, there's two important dates to look at here: First, the Medicaid Expansion totals are only up to date as of last October, a good 6 months ago.

via the Centers for Medicare & Medicaid Services:

Temporary Special Enrollment Period (SEP) for Consumers Losing Medicaid or the Children’s Health Insurance Program (CHIP) Coverage Due to Unwinding of the Medicaid Continuous Enrollment Condition– Frequently Asked Questions (FAQ)

...Since the onset of the novel coronavirus disease of 2019 (COVID-19) Public Health Emergency (PHE), state Medicaid agencies have made policy, programmatic, and systems changes to respond effectively to the pandemic. State Medicaid agencies also have made changes to qualify for the temporary Federal Medical Assistance Percentage (FMAP) increase under section 6008 of the Families First Coronavirus Response Act (FFCRA), including satisfying a continuous enrollment condition for most Medicaid beneficiaries who were enrolled in the program as of or after March 18, 2020.1 Similarly, during the COVID-19 PHE, some states have been granted 1115 demonstration authority to provide continuous enrollment for Children’s Health Insurance Program (CHIP) beneficiaries in addition to other flexibilities that have had this effect.

via DC Health Link:

City leaders to join DC Health Link for whirlwind final weekend of Open Enrollment featuring barbershop outreach, pizza delivery outreach, door-to-door canvassing, and enrollment marathon with unique events at barbershops, Ben's Chili Bowl and all over DC

WHAT/WHO:

Because District residents have only four days left to sign up for health insurance coverage before the Open Enrollment deadline, DC Health Link is crisscrossing the city this weekend to make sure every resident in high uninsured areas of the District has the opportunity to enroll in quality, affordable health insurance. DC Health Link is holding its signature Enrollment Marathon and partnering with local businesses, city leaders, and civic groups to offer District residents FREE one-on-one, and virtual, enrollment help over the weekend at different locations throughout the District. These additional enrollment opportunities will help residents get covered before the Open Enrollment Period ends at midnight January 31, 2023.

There's still likely between 40,000 - 80,000 Qualified Health Plan (QHP) enrollments to be added to the 2023 Open Enrollment Period (OEP) tally from the states which have extended deadlines (through Tuesday, January 31st), but I decided to throw this together today for the hell of it.

The table below charts the first ten years of ACA Open Enrollment Periods, broken out by state. I've also included Basic Health Plan (BHP) enrollment in Minnesota & New York, the only states where BHP programs have been implemented to date.

The states which jump out at me the most in terms of enrollment growth, at least visually, are Florida, Georgia, New York (BHPs) and Texas.

No further analysis or comment here; I just think this is a pretty cool graphic.