Florida

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Yesterday there was a bit of a brouhaha caused when NPR reporters Geoff Brumfiel and Daniel Wood published an in-depth report on the partisan divide when it comes to county-level COVID-19 vaccination and death rates, which was heavily influenced by my own work over the past seven months, including two hour-long interviews in which we went into in-depth discussions of data sources, methodology and conclusions.

The controversial aspect was due to the fact that their published piece originally failed to mention my involvement or assistance in any way whatsoever.

After being called out on this by myself and others, Brumfiel called me to personally apologize and rectify the situation. To his credit, he took full responsibility and specifically noted that his colleague, Daniel Wood, had nothing to do with the oversight. Also to his credit, he arranged for the NPR story to be quickly updated to mention my assistance by name as well as to link to one of my own related COVID data analysis posts:

Miami-Dade County

Back in early September, I began noticing something very odd going on with my county-level scatter-plot graphs which broke out COVID cases/deaths by what percent of the population had been fully vaccinated:

As you might expect, there's a clear drop-off in new COVID cases per capita as the vaccination rate of the counties goes up. There seems to be a slight drop-off starting around 50% fully vaccinated, followed by a steep drop-off starting around 65% vaxxed. There's a third drop-off at around 75%, but there's literally only a handful of counties which have achieved that high a vaccination rate so far anyway.

HOWEVER, there's one major outlier over the 65% threshold...Miami-Dade County.

According to the Centers for Disease Control, Miami-Dade has fully vaccinated 68% of their entire population (1.84 million out of 2.72 million residents). I use the slightly lower official 2020 U.S. Census popualtion count for Miami-Dade County (2,701,767), which makes the vaccination rate slightly higher still: 68.24%.

Florida

Florida state law apparently gives private corporations wide berth as to what sort of information, which is easily available in some other states, they get to hide from the public under the guise of it being a "trade secret."

In the case of health insurance premium rate filing data, that even extends to basic information like "how many customers they have."

If you think I'm being sarcastic, this is literally a screenshot of what you get if you attempt to use the Florida Office of Insurance Regulation's filing search:

Florida

For the past couple of months now, most of my COVID scatter-plot charts...whether measuring vaccination rates, new case rates or new death rates...have been based primarily on partisan lean. That is, at both the state and county levels, I've been using the percent of the 2020 Presidential vote won by Donald Trump as the basis for comparison.

I've also looked at vaccination rates by other criteria, of course: Population density, urban vs. rural status, education level and median household income levels...but none of these have had nearly as high a correlation as sheer partisan lean has (although I haven't checked any of those in over a month; perhaps the situation has changed by now).

Florida

I've once again relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.

For the various enrollment data, I'm using data from Medicaid.gov's Medicaid Enrollment Data Collected Through MBES reports. Unfortunately, they've only published enrollment data through December 2020. In most states I've been able to get more recent enrollment data from state websites and other sources.

For Florida's 2021 data, I'm using estimates based on raw data from the FL Agency for Health Care Administration.

Florida is one of 12 states which still hasn't expanded Medicaid eligibility under the ACA (13 if you include Missouri, whose voters expanded the program last year...but which the state legislature refuses to fund).

Florida

Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.

Here's Florida:

Florida

OK, I know this may seem a bit petty, but take a look at this story from yesterday's Miami Herald:

Florida accounts for nearly one-third of the country’s new Obamacare sign-ups

Florida leads the country in new Obamacare sign-ups during an ongoing six-month special enrollment period announced by President Joe Biden shortly after he took office.

The state saw 264,088 new people enroll in the healthcare.gov marketplace between Feb. 15 and April 30, higher than the number of new enrollees during the shorter enrollment periods of 2020 and 2019 combined, the White House told McClatchy on Tuesday. Florida accounts for nearly a third of all new enrollees so far this year in the entire country.

Most of the article is just a general overview of how the ongoing COVID-19 Special Enrollment Period is doing, but there's two major problems with it.

Florida

As I noted recently, I've relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.

For total monthly Medicaid enrollment, the official Medicaid.gov monthly enrollment data is only available dating back to late 2013, and it's only current through November 2020. The Kaiser Family Foundation has also compiled the pre-2014 average enrollment for each state based on the 3rd quarter of 2013. In some states I've been able to find more recent enrollment data for December 2020 or later.

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.

Back in late August, the Florida Office of Insurance Regulation posted preliminary 2021 individual & small group market rate filings. At the time, the weighted average increases were around 1.8% on the individual market and 3.3% for small group plans. Unfortunately, the actual enrollment data for each carrier is protected as a trade secret in Florida, but the FLOIR did post those weighted statewide averages.

Last month (I'm a bit behind) they posted the approved, final rate filings. The average individual market increases actually went up a bit, which is unusual (usually they're whittled down a few points), while the small group market average is exactly the same (oddly, they had it as 3.3% in August but say that the preliminary average was 3.4% now):

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