Get Covered

No one has been shouting from the rooftops louder than I have for HHS Secretary Alex Azar or CMS Administrator Seema Verma to join nearly all of the state-based ACA exchanges in announcing an official Special Enrollment Period (SEP) in light of the ongoing Coronavirus pandemic, and I'm still urging them to do so as soon as possible. The federal ACA exchange, HealthCare.Gov, hosts ACA enrollment for 38 states representing around 75% of the national population, so this is a pretty big deal.

Having said that, it's important to keep in mind that even without a COVID-19-specific SEP, many people already qualify to enroll in ACA-compliant healthcare coverage anyway, whether they're currently uninsured or because they're about to be...or because their personal circumstances are about to change. And none of these have anything to do with the COVID-19 crisis, although it's certainly going to cause a whole lot more people to qualify for two of those changes:

Special Enrollment Period (SEP)

This Just In via Vermont Health Connect...

The State of Vermont has made temporary changes to assure that Vermonters have access to health insurance. Please visit https://t.co/dXz4Cd2yQm for more information

— VT Health Connect (@VTHealthConnect) March 20, 2020

OK...that's about as vague and understated as you can get. Clicking the link doesn't make it any more obvious:

Stay informed and protect your health.

via the Colorado Dept. of Regulatory Agencies Insurance Division, it looks like Connect for Health Colorado is about to go ahead and establish their own COVID-19 Special Enrollment Period after all (this is from an internal draft document...the dates could still change, and it's not 100% guaranteed that they'll go ahead with it yet):

DEPARTMENT OF REGULATORY AGENCIES Division of Insurance 3 CCR 702-4 LIFE, ACCIDENT AND HEALTH

DRAFT Emergency Regulation 20-E-02

CONCERNING ESTABLISHING A SPECIAL ENROLLMENT PERIOD FOR ENROLLMENT IN AN INDIVIDUAL HEALTH BENEFIT PLAN RELATED TO COVID-19

...This emergency regulation is promulgated and adopted by the Commissioner of Insurance under the authority of §§ 10-1-108(7)(a), (7)(b)(III), 10-1-109(1), 10-16-105(2)(b), 10-16-105.7(3)(a)(II)(G), 10-16-105.7(3)(b)(II)(F),10-16-108.5(8), and 10-16-109, C.R.S.

Section 2 Scope and Purpose

via Access Health CT:

Access Health CT Announces A New Special Enrollment Period For Uninsured Connecticut Residents

AS COVID-19 THREATENS PUBLIC HEALTH, ACCESS HEALTH CT ANNOUNCES A NEW SPECIAL ENROLLMENT PERIOD FOR UNINSURED CONNECTICUT RESIDENTS

New Special Enrollment Period starts Thursday, March 19 and ends Thursday, April 2

As I've noted before, Maryland is already offering a SEP for uninsured residents to #GetCovered when they file their state taxes by checking off a box, but today they went one step further and created an official Coronavirus SEP as well, which is open to any eligible uninsured residents whether they're utilizing the "check the box" tax form option or not:

Coronavirus emergency launches one-month special enrollment period

As part of the state’s overall response to the coronavirus, and in an effort to prioritize health and safety, Maryland Health Connection opened a new special enrollment period for uninsured Marylanders.

When will the special enrollment period begin?

  • The coronavirus emergency special enrollment period will begin Monday, March 16, and end Wednesday, April 15. Coverage will begin April 1, 2020, regardless of when a health plan is selected during that time period.

How do I enroll?

via HealthSource RI:

Special Enrollment Period (SEP) Available to Purchase Coverage through HealthSource RI as a Part of the State’s Response to COVID-19

  •     Special Enrollment Period will be available through April 15, 2020

EAST PROVIDENCE, R.I. (March 14, 2020) — HealthSource RI has adopted a limited-time Special Enrollment Period (SEP), following Governor Raimondo’s State of Emergency declaration in response to the potential growth of Coronavirus (COVID-19). This SEP will allow uninsured Rhode Islanders to purchase coverage through April 15, 2020. Coverage will begin on the first of the month following the application.

Washington becomes 1st state-based marketplace to create a special enrollment opportunity in wake of coronavirus threat. https://t.co/2bYCrboXvl @GtownCHIR

— Sabrina Corlette (@SabrinaCorlette) March 10, 2020

via the Washington Health Benefit Exchange:

Washington Healthplanfinder Announces Special Enrollment Period in Response to Growing Coronavirus Outbreak

UPDATE 2/24/20: California and New York have come out with their final, official enrollment numbers, as have Vermont,Rhode Island and the District of Columbia, although the latter three are estimates on my part due to the way they're reporting their enrollment data:

This just in from DC Health Link:

DC Health Link to Offer Even More Opportunities for Residents to Get Covered 

  • DCHBX Executive Board Votes to Allow Pre-Natal Special Enrollment Period and Four Other New Opportunities

Washington, DC – With Open Enrollment recently concluded, District residents and small businesses have new opportunities to sign up for health insurance coverage through DC Health Link. The DC Health Benefit Exchange Authority (DCHBX) Executive Board recently adopted recommendations from its Standing Advisory Board to create four Special Enrollment Periods (SEP) and an extended open enrollment period for DC small businesses.

via MNsure:

Though open enrollment through MNsure has ended, there are still opportunities to enroll through a special enrollment period (SEP). Minnesotans who experience a qualifying life event, like aging off a parent's health insurance (turning 26), getting married, or losing other health coverage, may be eligible to apply. See a complete list of qualifying life events, including coverage start dates.

This is very interesting. ACA Open Enrollment deadline extensions have become kind of a running joke over the years, but for the most part they've been restricted to the December deadlines. the states with deadlines already extending into January have stuck with them for the most part...until this year.

A few days ago, New York State of Health announced that they're extending their final enrollment deadline (for March 1st coverage) by a week, until midnight on Friday, February 7th.

Late last night, the DC Health Link announced that they, too, are extending their final deadline (for March 1st coverage) by five days, until midnight on Wednesday, February 5th.

California and New York have both released updated 2020 Open Enrollment numbers, so I figured I'd update my spreadsheet one more time before the final data is released. This time I've included a smaller secondary table at the bottom which adjusts the Federal and State-based exchange numbers for Nevada.

OFFICIALLY, HealthCare.Gov enrollment is down nearly 128,000 people this year, but that's not fair because Nevada broke off of HC.gov onto their own full state-based exchange platform this year. When you adjust for that, HC.gov is only down 119,000 people for the remaining 38 states. Meanwhile, the state-based exchanges are officially down 2,900 at the moment, but again, with Nevada joining them, they're actually down around 8,900.people.

That leaves the missing enrollment data from five states. Rhode Island and Vermont haven't released any data...I'm assuming they'll both be very close to last year (call it at least 33,000 and 24,000 respectively). I'm assuming New York + DC will be good for perhaps 3,000 more enrollees combined in their final days. And California will likely tack on another 30,000 or so in their final 2 days of Open Enrollment.

This just in from the New York State of Health ACA exchange:

Press Release: New Yorkers Have More Time to Get Covered in 2020: NY State of Health Open Enrollment Deadline Extended to February 7

  • Enroll Now for Affordable, High-Quality Health Coverage in 2020
  • Free, In-Person Enrollment Help is Available: Click Here to Find a NY State of Health Certified Assistor

ALBANY, N.Y. (January 28, 2020) – NY State of Health, the state’s official health plan Marketplace, announced that consumers will have an additional week to enroll in a Qualified Health Plan (QHP) for 2020. The Open Enrollment deadline has been extended until February 7 to give consumers more time to enroll. NY State of Health’s Customer Service Center representatives and in-person assistors are available to help individuals find the best plan for themselves and their families.

Huh. That's unexpected.

via New York State of Health:

Certified In-Person Assistors Provide Enrollment Opportunities at MLK Day Events Across the State Leading up to January 31 Enrollment Deadline

ALBANY, N.Y. (January 16, 2020) – NY State of Health, the State’s official health plan Marketplace, today announced participation in several Dr. Martin Luther King, Jr. Day events being held throughout the State. Certified In-Person Assistors will be at events celebrating the legacy of Dr. Martin Luther King, Jr. to ensure New Yorkers have access to high-quality, affordable health care and to answer questions regarding enrolling or re-enrolling through the Marketplace. All events are open to the public.

“We are excited to meet New Yorkers at events celebrating Dr. Martin Luther King, Jr. to help them find a quality, low-cost health plan during Open Enrollment,” said NY State of Health Executive Director Donna Frescatore. “Enrollment in a 2020 Qualified Health Plan runs through January 31, and our participation in these events offers New Yorkers another opportunity to complete the enrollment process.”

The FINAL 2020 Open Enrollment Period data for the 38 states hosted by HealthCare.Gov was released yesterday, shaving around 17,000 enrollees off of the semi-final report issued before Christmas. In addition, final 2020 OEP numbers have now been released by Idaho, Maryland, Minnesota, Nevada and Washington State.

Incomplete numbers have been released for California, Colorado, Connecticut, the District of Columbia, Massachusetts and New York, all of which still have ongoing Open Enrollment, and I'm still waiting on any enrollment data for Rhode Island or Vermont.

With all that in mind, here's a state-by-state breakout showing where things stand as of today, Jaunary 9th. The states have been sorted from worst-performing to best, although obviously the 8 states with partial or no data are misleading (vice-versa for the bar graph).

Just another quick update from AccessHealthCT:

As of today, their press release page states the following:

Stats as of December 20, 2019:

Qualified Health Plans (QHP):

  • Net Total QHP Enrollment: 104,799
  • 2020 OE Acquisition Summary: 22,026

...Medicaid: Completed applications/redeterminations processed through the integrated eligibility system: 44,950

That's as of today (?). They'll have to have added another 6,267 people to beat last year's total of 111,066.

This Just In from Nevada Health Link:

Nevada’s State Based Exchange Announces Enrollment Figures for Plan Year 2020

Carson City, Nev. – The Silver State Health Insurance Exchange (Exchange), Nevada’s state agency that helps individuals get connected to budget‐appropriate health coverage through the online marketplace, Nevada Health Link, enrolled 77,410 Nevadans during Open Enrollment for Plan Year 2020. The Exchange's seventh Open Enrollment Period ended Dec. 15, 2019 and included an extension for consumers who started the enrollment process on or before Sunday, Dec. 15 to complete their application by Friday, Dec. 20.

A couple of weeks ago, Covered California reported that as of December 7th, over 486,000 residents were taking advantage of their newly-expanded & enhanced state ACA subsidies:

...More than 486,000 individuals have been determined eligible for the new state subsidy, including about 23,000 in the 400 to 600 percent range of the federal poverty level, which could extend to an individual making up to $74,940 and family of four with a household income of up to $154,500. Of those in this income range who have signed up through Covered California, 44 percent have been found eligible for the state financial assistance.

...If I'm following correctly, the total breakout is:

  • 777,000 = either 138 - 200% FPL or not eligible for any subsidies
  • 463,000 = 200 - 400% FPL; receiving both federal & state subsidies
  • 23,000 = 400-600% FPL; receiving state subsidies only

The press release also broke out the household average for the new/expanded subsidies:

The lastest 2020 Open Enrollment Period data was released last week by most of the exchanges, including HealthCare.Gov, Covered California, Connect for Health Colorado, Access Health CT, Maryland Health Connection and the Washington HealthPlan Finder. When combined with the existing data from the MA Health Connector, MNsure, New York State of Health and the brand-new Nevada Health Link, we should now have over 95% of the total 2020 Open Enrollment QHP selections locked in.

Update 12/23: I've updated the text and graph to include the final numbers from Minnesota & Nevada.

This is by no means the final version of The Graph for 2020, of course; there's still no data at all from the District of Columbia, Idaho, Rhode Island or Vermont, and the deadline is still days, weeks or even a month away for nine states.

Having said that, with the Week 7 HC.gov Snapshot Report being released earlier this afternoon, this is a good time to pause and take a look at how the 2020 Open Enrollment Period is shaping up. Remember, even HC.gov's total will change slightly when the dust settles...they're still missing the final 3 hours of the extended Open Enrollment Period (I'm guessing perhaps 30,000 more?), plus an unknown number of "callbacks" to people who were unable to get through on 12/15 but left their contact information (perhaps another few thousand?).

This just in via the Washington HealthPlanFinder:

Washington Healthplanfinder Reminds Customers to Make First Premium Payment

  • Payment options available online and by phone or mail through insurance companies.

Washington Health Benefit Exchange (Exchange) is reminding customers who selected a plan during 2020 open enrollment to make the first month’s premium payment to their health insurance company.

“It is critical that customers make their first premium payment associated with their 2020 health insurance coverage,” said Pam MacEwan, chief executive officer at the Exchange. “This simple action will prevent unintended loss of health coverage or delays in accessing care in the new year.”

Just another quick update from AccessHealthCT:

As of today, their press release page states the following:

Stats as of December 20, 2019:

Qualified Health Plans (QHP):

  • Net Total QHP Enrollment: 104,439
  • 2020 OE Acquisition Summary: 21,001

Overall Volume

  • Unique Website Visitors: 185,869
  • Calls Handled: 183,637

Medicaid: Completed applications/redeterminations processed through the integrated eligibility system: 40,496

This was as of 12/20. They'll have to have added another 6,627 people to beat last year's total of 111,066.

As a reminder, Access Health CT has extended their Open Enrollment deadline by a full month, to January 15th:

Access Health CT Extends 2020 Health Insurance Open Enrollment Period

This just in from Covered California:

Covered California Releases New Enrollment Data and Issues Reports on Five Years of Improving Affordability, Access and Accountability

  • Covered California announced that there are more than 230,000 new plan selections during the current open enrollment period – up approximately 16 percent over this time last year. More than 1.15 million people have also renewed their coverage.
  • In addition, more than 540,000 people will receive new state subsidies that will make quality health care coverage more affordable in 2020.
  • The agency also released two extensive reports that detail Covered California’s impacts on lowering costs and assuring quality care in its implementation of the Affordable Care Act.
  • Since 2013, California has reduced its uninsured rate by more than any other state in the nation has by expanding Medi-Cal, investing in marketing and outreach and keeping costs low for consumers.
  • California’s individual market consistently ranks among the healthiest in the nation, helping unsubsidized consumers save about $1,550 annually in 2018 on their premiums compared to consumers in the federal marketplace.
  • Covered California’s open-enrollment period runs through Jan. 31. Consumers must sign up before the end of Dec. 20 for their coverage to start on Jan. 1. California is one of 10 state marketplaces that are still open for business, representing 28 percent of Americans.

I actually already reported this yesterday, but it's good to have the formal press release as well, which includes additional details:

Nevadans Who Started Their Enrollment Applications on or Before the Dec. 15 Deadline Have Until Dec. 20 to Complete Applications for Coverage that Begins on Jan. 1 2020

Carson City, Nev. – The Silver State Health Insurance Exchange (Exchange), Nevada’s state agency that helps individuals obtain budget-appropriate health coverage through the online marketplace, Nevada Health Link, has extended its Open Enrollment deadline to 11:59 p.m. PST Friday, Dec. 20 for consumers who started the application process on or before the Dec. 15 midnight Open Enrollment deadline.

"We recognize the enrollment process for health insurance can be time-consuming. That’s why we are giving consumers five extra days to complete their application to purchase plans for coverage that begins Jan. 1, 2020," said Heather Korbulic, executive director, Silver State Health Insurance Exchange.

In response to tremendous pressure after yesterday's major technical issues at HealthCare.Gov, CMS Administrator Seema Verma just announced that the deadline for people to #GetCovered in the 38 states which host their ACA enrollment platform with HealthCare.Gov will indeed be extended by 2 days:

We at @CMSGov want to ensure a seamless shopping experience for everyone seeking coverage, so starting at 3 pm ET today, we are extending the marketplace #OpenEnrollment deadline until 3 am ET December 18! https://t.co/HmVdpJlX2C

— Administrator Seema Verma (@SeemaCMS) December 16, 2019

(I originally misread this as being a 3-day extension, but it's only 2 days, since it runs through midnight Pacific Time on Tuesday.)

OK, this is about as obscure of an "announcement" as I can imagine: Per a heads up from Louise Norris, if you visit the Washington HealthPlan Finder website this morning, there's a simple message at the top reading:

 

There's still time to get covered. Sign up by Dec. 30 to get coverage that starts Feb 1st.

That's it. There's no link to a press release, there's nothing in their "news announcements" archive, and as of this writing there's no tweet from their Twitter account announcing it...just that simple text message.

I'll update if/when there's a formal announcement, but until then...it appears that Washington State residents do indeed have another 16 days to #GetCovered after all, even if they'll face a one-month gap in coverage.

UPDATE: Confirmed:

Still need to sign up in a health plan? You're in luck!

Enroll in a plan from now through Dec. 30 at 8pm to receive coverage starting Feb. 1, 2020. #GetCoveredWA

The 2020 Open Enrollment Period may have ended for most states, but it continues for residents of New York:

If you still missed the deadline, you won't be eligible to enroll for ACA-compliant major medical coverage for the rest of the year unless you qualify for a Special Enrollment Period (SEP) due to a qualify life event lke getting married/divorced, moving, giving birth/adopting a child, turning 26, becoming ineligible for Medicaid or losing your employer-sponsored health insurance coverage.

Dammit, I took a couple of hours off to rewatch The Force Awakens with my kid (in anticipation of The Rise of Skywalker coming out this week), and look what happens...

HealthCare.Gov is not letting people login to enroll. This is the second outage, the first lasted 15 minutes. We're 8 minutes into the second. Last time this happened, 100k people could not enroll. @CMSGov must extend the deadline.

— Joshua Peck (@JoshuaFAPeck) December 15, 2019

When I loaded the site, I got the same error screen...but when I refreshed, the login screen came back up again.

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