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All 50 states + DC have re-opened enrollment on their respective ACA exchanges in response to both the ongoing COVID-19 pandemic and the American Rescue Plan (ARP), which substantially expands and enhances premium subsidies to millions of people!

If you've never enrolled in an ACA healthcare policy before, or if you looked into it years ago but weren't impressed, please give it another shot now. Thanks to the ARP (and some other reasons), it's a whole different ballgame this spring & summer.

Here's 10 important things to understand when you #GetCovered:

via Nevada Health Link:

Nevada Health Link Announces Health Insurance Savings Through the American Rescue Plan Act

  • Nevadans seeking health coverage can access increased or expanded subsidies and premium savings, healthcare tax credits, expanded COBRA protections and increased plan options

CARSON CITY, Nev. (April 16, 2021) – Nevada Health Link, the online health insurance marketplace operated by the state agency, the Silver State Health Insurance Exchange (Exchange), is offering even bigger coverage savings to eligible uninsured and insured off-Exchange Nevadans. These new enhancements are in accordance with the newly-enacted American Rescue Plan Act (ARPA or American Rescue Plan) of 2021 passed by Congress and signed into law by President Biden on March 11, 2021.

A couple of weeks ago, I used the COVID Special Enrollment Period (SEP) data I had for HealthCare.Gov through the end of March, combined with limited SEP data from some state-based ACA exchanges, to extrapolate out a rough estimate of how many new Qualified Health Plan (QHP) selections may have happened since the new "Spring 2021 Special Enrollment Period" was launched on February 15th, 2021.

At the time, I estimated that perhaps 15,800 people per day on average had newly enrolled in ACA exchange policies as of the end of March, or roughly 710,000 nationally. This included the 528,000 confirmed enrollees via HealthCare.Gov, plus another 183,000 or so via the 15 state-based exchanges.

via Get Covered NJ:

Good news! More financial help is now available through Get Covered New Jersey

New Federal and State Savings

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. The State of New Jersey is also providing more financial help to lower health insurance costs for residents enrolling at Get Covered New Jersey.

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 state and 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.

This was apparently decided awhile ago (there was no press release), but I just learned about it today thanks to Louise Norris:

Nevada’s Response to Coronavirus

Nevada Health Link opened a Special Enrollment Period (SEP) for uninsured Nevadans, starting February 15 through August 15, 2021. The SEP is in accordance with the Executive Order issued by President Biden last month, in response to the ongoing national emergency presented by COVID-19.

  • Coming soon! Thanks to the recently passed American Rescue Plan, we’ll soon be offering more money to help pay for your coverage. Learn more here.

Visit here to learn more.

Nice catch by Andrew Sprung. Via the NJ Dept. of Banking & Insurance:

EXTENSION OF COVID-19 SPECIAL ENROLLMENT PERIOD

On January 29, 2021, the Department of Banking and Insurance (“Department”) issued Bulletin No. 21-03 advising carriers and other interested parties that an emergency COVID-19 Special Enrollment Period (“COVID-19 SEP”) would go into effect on February 1, 2021 and extend through May 15, 2021. The COVID-19 SEP ensured that New Jersey residents have access to quality affordable health insurance during a critical time in which the need to protect public health is paramount. Specifically, the COVID-19 SEP made sure that individual market coverage was available to uninsured individuals during the pandemic. It also aligned New Jersey with the Federal Special Enrollment Period which runs through May 15, 2021 and the Federal Public Health Emergency.

A couple of weeks ago, I used the limited COVID Special Enrollment Period (SEP) data I had for HealthCare.Gov from the last two weeks of February, plus some limited SEP data from a handful of state-based ACA exchanges, to extrapolate out a rough estimate of how many new Qualified Health Plan (QHP) selections may have happened nationally.

At the time, I estimated that perhaps 18,500 people were enrolling per day nationally the final two weeks of February, and that IF that pace remained the same throughout the entire month of March, it would amount to upwards of 832,000 new people enrolling by the end of March (666,000 via HealthCare.Gov, plus another 166,000 via the 15 state-based exchanges).

It's important to note that this wasn't a hard estimate--I was pretty sure that the actual enrollment pace would slow down somewhat after the inital surge, at least until expanded subsidies via the American Rescue Plan (ARP) were officially available in most states, which didn't happen until April 1st.

via Nevada Health Link:

The Division of Insurance (“Division”) encourages all Nevadans to take advantage of the new saving opportunities offered by the American Rescue Plan Act of 2021 (“ARPA”). The ARPA, enacted earlier this month, creates more opportunities for Nevadans to save on health insurance coverage.

“I urge consumers, especially those who have off-exchange plans, have no insurance or have found themselves uninsured to start thinking now about how they can benefit from this new law because certain benefits in the ARPA have deadlines,” said Insurance Commissioner Barbara Richardson. “Each month that a consumer does not take advantage of these new low or no cost opportunities, they are leaving money on the table.”

The ARPA will lower monthly premium costs; increase subsidy eligibility for consumers making above the 400% of the Federal Poverty Level; provide options for people who are on unemployment for $0 premium plans; and it will provide 100% COBRA subsidy for six months.

via New York State of Health:

NY State of Health Begins Notifying Over 140,000 Consumers Their Tax Credits are Available and How to Claim Them

ALBANY, N.Y. (March 31, 2021) – NY State of Health, the state’s official health plan Marketplace, today announced, increased financial assistance is now available to current and new consumers enrolling in a health plan through NY State of Health.  NY State of Health began notifying consumers today of their higher tax credit amounts and how to apply them to further lower the cost of coverage. This financial assistance is being implemented as part of  the American Rescue Plan signed into law on March 11, 2021.

Your Health Idaho, which had been scheduled to end their COVID-19 Enrollment Period on March 31st, has understandably extended the deadline out by another month in light of the American Rescue Plan's expanded/enhanced subsidies. Via email:

Enhanced Subsidies Go into Effect at Your Health Idaho April 1

Your Health Idaho Continues to Enroll Idahoans through April 30, 2021

BOISE, Idaho –Your Health Idaho, the state insurance exchange, will remain open throughout the month of April so Idahoans can take advantage of enhanced financial assistance, which lowers consumer’s monthly premiums. 

For the first time ever, tax credits, which act like an instant discount, may be available for those who were not previously eligible and will be increased for Idahoans who already receive them. For some Idahoans, these savings can be significant. For example, a Treasure Valley married couple in their 20s making $50,000 a year could pay less than $10 a month and a family of four making $105,000 could pay as little as $200 a month.

via New York State of Health:

How NY State of Health Enrollees Benefit from the American Rescue Plan

The American Rescue Plan, which was signed into law on March 11, 2021, will lower health care costs by providing new and expanded financial assistance to New Yorkers enrolling in health insurance through NY State of Health. This enhanced assistance is available to current enrollees and new enrollees, including to higher-income individuals for the first time. Starting in early April, individuals with low and moderate incomes can access higher tax credits. Starting in June, NY State of Health will apply these higher tax credits to current enrollees without requiring any action by the enrollee. Also in June, higher-income New Yorkers can access the new tax credits.

The information on this page is organized into six sections. Click the section from the following list to learn how the American Rescue Plan can help you:

UPDATE 3/16/21: Health Source Rhode Island just released their 2021 OEP report as well; they ended up down around 8% y/y. With that, I now have either the final official enrollment numbers or at least close approximations for all 50 states + DC. The table, graph and text below have been updated accordingly.

With New York State of Health releasing their 2021 Open Enrollment Report data (w/some caveats), I now have official (or semi-official) enrollment data for 49 states and the District of Columbia. The odd man out is Rhode Island...which also happens to be one of the smallest states with the smallest number of ACA enrollments; last year they enrolled around 34,600 people.

There's a few caveats:

  • New York's QHP tally included enrollments through 2/28; the official CMS report will likely cut them off as of 1/31.
  • The numbers for DC, Idaho, Rhode Island and Vermont are estimates...it's possible that the official numbers for each will be slightly lower.
  • Minnesota's total could be a few thousand lower than I have it listed below...there's always a difference of a few thousand between MNsure's reports and CMS's; I'm not sure why.

At the very worst, the official CMS 2021 OEP report will come in at something like 11.98 million or so.

UPDATE 3/16/21: With Rhode Island added, the semi-official tally comes in at just over 12.0 million (12,005,270 QHP selections total). Again, it could drop slightly below that if my estimates for a handful of states are off, but it should be damned close to it.

A lot has happened since I last ran some back-of-the-envelope math to get a feel for how many Americans are enrolling in ACA exchange policies durign the 2021 COVID Enrollment Period, which started in most states on February 15th.

At the time, HealthCare.Gov had reported 206,000 Qualified Health Plan (QHP) selections as of February 28th. I also had some partial COVID SEP data from a handful of the state-based ACA exchanges, as of various dates. I had 225,000 QHPs confirmed nationally.

At the time, I concluded that based on the enrollment pace of the first few weeks...

As noted above, Medicaid expansion states have only increased average SEP enrollment by around 2/3 as much as Non-expansion states. Since all 15 state-based exchanges have expanded Medicaid, this suggests that the 206K via HC.gov probably represents more like 80% of the total, meaning perhaps 258,000 nationally (~168,000 more than average).

Thursday, March 18th:

Launching a new special-enrollment period – Covered California will open a new special-enrollment period – which will start on Monday, April 12 and run through the end of the year – to give uninsured and unsubsidized Californians time to sign up for coverage that starts as soon as May 1 and continue the outreach and enrollment effort to have marketing pay-off over time.

4:35pm this afternoon:

Today, President Biden announced that the Centers for Medicare & Medicaid Services (CMS) is extending access to the Special Enrollment Period (SEP) until August 15 – giving consumers additional time to take advantage of new savings through the American Rescue Plan. This action provides new and current enrollees an additional three months to enroll or re-evaluate their coverage needs with increased tax credits available to reduce premiums.

via Nevada Health Link:

Statement re: 11th Anniversary of the Affordable Care Act
Heather Korbulic, executive director, Silver State Health Insurance Exchange

Tomorrow, March 23, 2021, marks 11 years since the passing of the Affordable Care Act (ACA), the landmark reform law that is credited with increasing access to quality healthcare for millions of Americans, forever changing the national healthcare landscape.

Here in Nevada, the ACA is responsible for the creation and ongoing operations of the Silver State Health Insurance Exchange that has provided healthcare coverage to hundreds of thousands of Nevadans who would otherwise be without coverage to receive essential and critical healthcare services. Since the passage of the ACA and the implementation of Nevada Health Link, the Exchange’s online marketplace for ACA-compliant insurance plans, Nevada's number of uninsured has decreased from a staggering 23 percent to 11 percent.

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.

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.

In previous years, New York State of Health has typically been pretty good about providing timely Open Enrollment reports, so I was mildly irritated by their total radio silence on the issue throughout the 2021 Open Enrollment Period (OEP).

My suspicion was that, like many other states which have expanded Medicaid, New York likely saw a significant drop in on-exchange Qualified Health Plan (QHP) enrollment this season due to the massive job & income loss caused by the COVID-19 pandemic last year, as people "downshifted" from QHPs over to Medicaid. In addition, New York is one of only two states which has the ACA's Basic Health Program (BHP) in place; BHP (called the Essential Plan in NY), is sandwiched in between QHPs and Medicaid, for residents earning between 138 - 200% FPL.

Late last night, NYSoH finally got around to releasing their 2021 OEP numbers. Sure enough, my suspicions were correct:

I just received the following COVID Enrollment Period update from Pennie, Pennsylvania's new state-based ACA exchange. This appears to be part of an official report which they're still working on.

The "Existing" numbers refer to current Pennie enrollees who are taking advantage of the COVID SEP to switch to a different plan mid-year; this is something which usually isn't allowed, even during traditional Special Enrollment Periods (SEPs), but Pennie, along with HealthCare.Gov and many of the other state-based exchanges, are allowing them to do so during this period.

There's an obvious reason for this, too: The impending passage of the American Rescue Plan will mean dramatically improved/expanded subsidies for ACA enrollees, including many who haven't been eligible for them until now. This means millions of Americans who enrolled in Bronze plans because they weren't eligible for subsidies will be able to upgrade to Silver or Gold; it also means many people will become eligible for $0-premium plans who currently aren't, and so on.

via KNPR:

In the face of the continuing COVID-19 pandemic, President Joe Biden reopened enrollment in the Affordable Care Act’s health insurance exchanges.

For Nevadans, that means the Silver State Health Insurance Exchange is back in business.

The exchange connects Nevadans to health plans compliant with the Affordable Care Act, and it’s the only place consumers can access any federal subsidies.

“As soon as Nevada learned of the news from the federal government, we took immediate action to plan and collaborate with our insurance carriers and the statewide network of 750-plus brokers and navigators to implement a seamless, streamlined process for Nevadans,” said Heather Korbulic, executive director of Silver State Health Insurance Exchange.

Korbulic told KNPR's State of Nevada that there has already been a lot of interest from people around the state. 

"We're pretty excited about the uptake that we've already started seeing and we think this is a wonderful opportunity for Nevadans to get connected to Nevada HealthLink," she said.

via Access Health CT:

Access Health CT To Host Two Educational “Healthy Chats” During Special Enrollment Period

  • Free Virtual Sessions to Help Uninsured Connecticut Residents Get Covered    

HARTFORD, Conn. (March 4, 2021) — Access Health CT (AHCT) announced today it will host two educational sessions called “Healthy Chats” on Tuesday, March 9 at 6:00 p.m. and Wednesday, March 10 at 6:00 p.m. (Spanish only) to help Connecticut residents learn about plan options, financial help, low-cost and free coverage and tips to stay covered during the Special Enrollment Period that runs until March 15, 2021*. The Special Enrollment Period is for consumers who are not currently enrolled in coverage through AHCT.

About these Healthy Chats

The Healthy Chat events are free and will be held virtually via Zoom (in English & Spanish). To join, attendees can access the event here, or here.

A reminder from Your Health Idaho (via email):

Uninsured Special Enrollment Period in Idaho Begins March 1

  • Idahoans who enroll will have coverage beginning April 1, 2021 

BOISE, Idaho – Your Health Idaho, the state insurance exchange, reopens today for Idahoans still seeking 2021 health insurance. Between March 1, and March 31, 2021, uninsured Idahoans can enroll in comprehensive health insurance coverage through the Uninsured Special Enrollment Period.  

This Special Enrollment Period is available for any uninsured Idahoan who missed the open enrollment window and is still seeking health insurance for 2021. Idahoans who enroll by the March 31, deadline will have coverage beginning April 1, 2021. 

As I did when Access Health CT released their 2021 OEP report, there's so much data here I'm not gonna bother doing any analysis in this entry; I'll just post the most relevant slides for now.

Note: Pennie refers to it as their 2020 annual report, but the enrollment data refers to the 2021 Open Enrollment Period.

OK, Covered California hasn't actually released an official press release or Open Enrollment Report, but I have acquired a single slide which was delivered at a university presentation by Covered CA head Peter Lee the other day. It doesn't provide tons of detail but give the most important toplines (the way the graph breaks out the numbers is a little confusing but I figured it out:

  • Total QHP selections from 11/01/20 - 1/31/21: 1.63 million, a record high for the state

This is a 5.9% increase year over year from the 2020 OEP's 1.54 million (it says 1.57 million on the graph but the official CMS tally is 1,538,819).

Aside from Health Sherpa's announcement the other day that they enrolled over 3x as many people in ACA exchange plans in the first week of the COVID Special Enrollment Period than they normally would via traditional SEPs during the same time period, there's been no hard COVID SEP data released...until now. Via the Washington HealthPlan Finder:

Special Enrollment Period for Health Coverage Now Available

  • Currently uninsured or those seeking new coverage can enroll today on Washington HealthplanfinderOLYMPIA, Wash.

Washington Healthplanfinder is now offering a special enrollment period for Washingtonians who are currently uninsured or seeking new coverage. This special enrollment period, in response to the current public health emergency, opened Feb. 15 and runs for 90 days, ending May 15, 2021.

While all 50 states & DC have now re-launched (or are about to) a new, special 2021 COVID Enrollment Period, the official 2021 Open Enrollment Period ended in every state as of January 31st.

A few of the state-based exchanges have already released their 2021 OEP summary reports, and today Access Health CT posted theirs...and it's chock full of juicy data nuggets. Let's dive in!

Note: I haven't included every single slide, but most of them are shown. Use the link above if you want to view the rest of them. Click the images for a high-res version of each:

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