Get Covered

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.

This is from a couple of weeks ago; I'm reposting it standalone for clarity. Via the Washington Health Benefit Exchange:

Washington Health Benefit Exchange Issues Statement on the Signing of the American Rescue Plan Act of 2021

Pam MacEwan, CEO Washington Health Benefit Exchange (Exchange), issued the following statement today following the signing of the American Rescue Plan Act of 2021:

“The new stimulus plan is great news for both our current Exchange customers as well as the uninsured who have not been able to afford health insurance. Enhanced premium assistance will help people afford and keep health coverage during the current pandemic.

“Our enduring goal is to ensure that every Washingtonian can get affordable health insurance coverage for themselves and their family. Today’s landmark legislation takes the necessary steps to help those who face high insurance costs that have prevented them getting health coverage for 2021 and 2022.

This is from a couple of weeks ago; I'm reposting it standalone for clarity. via HealthSource RI:

New Federal Changes Mean An Increase In Financial Help for Most HealthSource RI Customers; New Customers May Also Enroll Now

EAST PROVIDENCE, Rhode Island (March 11, 2021) — Recent changes at the federal level mean most HealthSource RI (HSRI) customers will soon be paying less for their health coverage. This change will result in the federal government providing an additional $30 million dollars in Advanced Premium Tax Credits (APTCs) that will bring premium costs down for HealthSource RI customers.

This is from a couple of weeks ago; I'm reposting it standalone for clarity. via Pennie: (via a text graphic for some reason):

Joint Statement from The Pennsylvania Insurance Dept. & Pennie regarding the American Rescue Plan Act of 2021:

"The American Rescue Plan Act of 2021 will not only provide financial assistance through the forthcoming stimulus checks, but will also provide an estimated $270 million in additional subsidies to current Pennie customers in 2021 alone. Through this law, marketplace premiums will be capped at 8.5% of a household's income, meaning current Pennie customers will see lower monthly premiums and those without coverae or who were previously ineligible will now have access to financial help if they shop at Pennie.com.

In some cases, lower-income enrollees will have their monthly premiums eliminated entirely. Additionally, anyone who was eligible for unemployment income in 2021 will be eligible for coverage thorugh Pennie with a $0 premium for the remainder of the year.

via MNsure:

MNsure Statement Regarding Federal Changes to the Affordable Care Act

ST. PAUL, Minn.—On Thursday, March 11, President Biden signed the American Rescue Plan, which includes several key health care provisions to the Affordable Care Act that will expand benefits available to Minnesotans through MNsure. This includes an increase in the amount of tax credits MNsure enrollees receive to help them pay for their premiums and an expansion of tax credits to middle-income Minnesotans who previously fell outside income thresholds for financial help. This increase in benefits means Minnesotans who purchase health insurance through MNsure will be able to find a plan with premiums that cost no more than 8.5% of their household income.

This is from a couple of weeks ago, but I'm reposting it standalone for clarity. Via DC Health Link:

Premium Drop for DC Health Link Coverage Thanks to the American Rescue Plan

  • $36 million in yearly insurance premium savings for DC residents with DC Health Link coverage; coverage available for as little as $2/month for laid-off residents; 100% of COBRA premium paid for laid-off workers 

Washington, DC – Today, the DC Health Benefit Exchange Authority announced major savings for residents in the District of Columbia who purchase private health insurance through DC Health Link, the District’s state-based online health insurance marketplace established under the Affordable Care Act (ACA). Now signed into law by President Biden, the American Rescue Plan reduces premiums for health insurance through DC Health Link, provides health insurance for as little as $2/month to people who lost their jobs, and pays for 100% of COBRA for laid-off workers. We estimate that residents will save about $36 million in premiums.

via Access Health CT (via forwarded email):

Dear Brokers,
 
A lot has transpired regarding the American Rescue Plan Act of 2021*. Our team has been meeting with CMS, other state-based marketplaces, our insurance carriers, and other stakeholders, and is in the process of putting together a strategic plan to implement these changes.

We know some of you might be getting questions from customers/stakeholders in the days to come since the federal exchange (Healthcare.gov) will have a robust national campaign supported by President Biden to help spread the word. Here’s what you should know: 

Timelines are/will be different: Healthcare.gov will be implementing the subsidy expansion and a possible Special Enrollment Period at a different time than Access Health CT (AHCT). It may start earlier and may end later than CT (we do not know dates at this time).

Access Health CT:

I actually posted this a couple of weeks ago, but am reposting it as a standalone entry for clarity. Via Connect for Health Colorado:

American Rescue Plan Makes Health Insurance More Affordable for More Coloradans Shopping through the Exchange

DENVER — Yesterday afternoon, President Biden signed the American Rescue Plan Act of 2021(American Rescue Plan) into law. Connect for Heath Colorado® Chief Executive Officer, Kevin Patterson, released the following statement in response to provisions which strengthen the Affordable Care Act and increase affordability:

“We are thrilled and getting ready to implement the health coverage provisions outlined in this law. This expansion of financial help will provide greater access to savings on the health plans we offer. This means more affordable health insurance for many more Coloradans.”

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.

The Maryland Health Benefit Exchange has issued a new press release which on the surface doesn't seem terribly unusual--it touts an impressive number of Maryland residents having gained healthcare coverage since they first launched their COVID-19 Special Enrollment Period (SEP).

What's unusual about this PR is that it's listing the cumulative number of people who've gained coverage since they launched their first COVID SEP a year ago:

MORE THAN 140,000 COVERED SINCE MARYLAND HEALTH CONNECTION LAUNCHED COVID-19 SPECIAL ENROLLMENT ONE YEAR AGO

  • 236,000 WHO STILL LACK COVERAGE COULD GET IT FOR FREE OR WITH SIGNIFICANT FINANCIAL HELP

(MARCH 17, 2021) BALTIMORE — Yesterday marked one year since the Maryland Health Benefit Exchange launched a Coronavirus Emergency Special Enrollment Period in response to the public health emergency declared by Gov. Larry Hogan.

The Centers for Medicare & Medicaid Services (CMS) has just sent out guidance about how the newly-expanded & enhanced subsidies will work for those currently enrolled in (or newly enrolling in) healthcare policies via the federal ACA exchange, HealthCare.Gov.

It's important to note that the following guidelines only apply to residents of the 36 states hosted via HC.gov. The timing, policy and procedures for the new/expanded subsidies for residents of the 15 states which operate their own ACA exchanges may vary.

With that in mind, here's how CMS says things will work via HealthCare.Gov.

The first section is mostly just an overview of the ARP and a refresher on how ACA subsidies are calculated...

American Rescue Plan and the Marketplace

The New Law

Yesterday I wrote a long, wonky post about an unusual case involving a legally-present (green card), unemployed Nigerian immigrant.

The short version is that because his income is so low, he normally wouldn't be eligible for ACA subsidies...except because he lives in Maryland, a Medicaid expansion state, he would normally be eligible for Medicaid...except that because he's an immigrant who's been in the United States for less than five years, he isn't eligible for Medicaid...except that, thanks to an obscure provision baked into the Affordable Care Act, he is eligible for ACA subsidies after all!

‘(B) SPECIAL RULE FOR CERTAIN INDIVIDUALS LAWFULLY PRESENT IN THE UNITED STATES.—If—

‘‘(i) a taxpayer has a household income which is not greater than 100 percent of an amount equal to the poverty line for a family of the size involved, and

via MNsure:

Over 2,200 Minnesotans have signed up for health coverage through MNsure's special enrollment period so far

  • Special enrollment runs through May 17

ST. PAUL, Minn.—2,285 Minnesotans have signed up for private health insurance coverage since the start of MNsure's special enrollment period on February 16. This three-month special enrollment period, which runs through Monday, May 17, is available to any Minnesotan who is uninsured or who is not currently enrolled in a qualified health plan through MNsure. 

Minnesotans who want coverage to start on April 1 must enroll by 11:59 p.m. on Wednesday, March 31. Plans selected during the month of April will have an effective date of May 1, and plans selected by the May 17 deadline will have an effective date of June 1.

In early February, I posted a deep dive into HR 369, the Health Care Affordability Act, and how it would reduce net ACA premiums by permanently eliminating the income "subsidy eligibility cliff" (#KillTheCliff) and making the underlying subsidy formula more generous for all enrollees (#UpTheSubs).

I'm re-posting an updated, modified version of this analysis for two reasons:

  • First, because HR 1319, the American Rescue Plan, is about to actually pass and be signed into law, with a slightly different formula from HR 369 embedded within it (if only for two years).
  • Second, because my earlier analysis also threw in two other subsidy enhancement tables which confused the issue (California's state-based subsidies, and the predecessor to HR 369, both of which are/were less generous)

In this version I'm using the actual Advanced Premium Tax Credit (APTC) table under the American Rescue Plan, and I'm cutting out all references to the other two tables to avoid confusion.

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:

This just in via Connect for Health Colorado:

One Month In, More Than 4,000 Coloradans Sign Up During Exchange's Uninsured Enrollment Period

DENVER – 4,683 previously uninsured Coloradans signed up for a 2021 health insurance plan through Colorado’s Exchange between Monday, February 8 and the end of day Friday, March 5. That’s more than 1,000 new medical enrollments each week during the first month of Colorado’s Uninsured Enrollment Period.

That's an average of 180/day over 26 days for Colorado. I don't know exactly how many Special Enrollment Period (SEP) enrollees they had during the same time period in prior years, but I can estimate based on their monthly dashboards:

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.

Back in late January, when it became clear that the Biden Administration was planning on announcing some sort of "no excuse needed" COVID Special Enrollment Period for the federal ACA exchange, I did a little back-of-the-envelope math to try and get an idea of how many additional people might enroll via HealthCare.Gov than you'd normally see via "standard" Special Enrollment Periods.

At the time, I concluded that for a 60-day SEP of this nature (that is, one completely open to all comers regardless of whether they had a Qualifying Life Experience (QLE)or not), you might be looking at perhaps an extra 400,000 people. selecting plans during that time period. This would be on top of the 4,200/day who enrolled thru HC.gov between the end of Open Enrollment and the end of May via SEPs over the past couple of years, which would be roughly 254,000 for a 60-day period.

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. 

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).

via MNsure:

Last Chance for March 1 Coverage Through MNsure; Special Enrollment Period Continues Through May 17

February 24, 2021

ST. PAUL, Minn.—Minnesotans looking for private health insurance coverage through MNsure that begins on March 1 need to enroll by 11:59 p.m. on Sunday, February 28. Plans selected in March will have an effective date of April 1. MNsure's special enrollment period continues through Monday, May 17, and is available to any Minnesotan who is uninsured or who is not currently enrolled in a qualified health plan through MNsure.

“If you’re looking for health insurance coverage, be sure to check out your options at MNsure.org and get access to comprehensive coverage as soon as possible or prevent a gap in current coverage,” said MNsure CEO Nate Clark. “MNsure's special enrollment period continues through May 17, but Sunday, February 28, is your last chance to get coverage starting in March. Don’t miss out."

Instructions to enroll and frequently asked questions about this special enrollment period can be found here.

Help is available:

Disclosure: Health Sherpa is a paid sponsor of this site.

Back in January, before the ongoing COVID Enrollment Period was officially announced, I ran some back-of-the-envelope math to try and project just how many additional ACA exchange enrollees might sign up nationally due to the addition of a "no questions asked" Special Enrollment Period (SEP) being formally launched across every state, as opposed to the patchwork of COVID SEPs we saw across a dozen states last spring/summer.

I extrapolated those numbers out nationally and estimated that total on-exchange enrollment might increase by perhaps 400,000 more people thanks to a 60-day COVID SEP...that is, 400K more than the "normal" number who typically enroll during that same time period for traditional SEP reasons (losing employer coverage, turning 26, getting married/divorced, moving, giving birth/adopting, etc).

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:

As I've expected, though I'm pretty irritated that they still haven't released any enrollment data to date. Via NY State of Health:

Press Release: Governor Cuomo Announces Open Enrollment for New Yorkers is Extended to May 15 as Federal Marketplace Reopens for Millions of Americans

  • New Yorkers Can Apply Now For Health Coverage Through NY State of Health or Directly Through Insurers
  • Aligns New York with the Federal Marketplace and Numerous State Marketplaces Extending Enrollment

As COVID-19 Response and Vaccine Distribution Continues Statewide, High-Quality Health Insurance More Important Than Ever

via the Nevada Health Link...

Special Enrollment Period through Nevada Health Link begins February 15

  • Uninsured Nevadans will have 90 more days to enroll in a qualified health plan for 2021 coverage

Nevada Health Link, the online health insurance marketplace operated by the state agency, the Silver State Health Insurance Exchange (Exchange), begins its 90-day Special Enrollment Period (SEP) for uninsured Nevadans, starting February 15 through May 15, 2021. The SEP is in accordance with the Executive Order issued by President Biden last month, in response to the ongoing national health emergency presented by COVID-19.

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