Virginia

Virginia

Virginia has an extremely robust, competitive individual & small group insurance market...and in 2022 it's getting even more competitive, with three new carriers joining the individual market: Aetna, Bright and Innovation Health Plan.

Beyond that, I don't see any shocking or dramatic developments for 2022; average unsubsidized individual market premiums are dropping by 2.9% statewide, while average small group premiums are increasing by 3.6% overall.

Virginia

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 Virginia, I'm using adjusted raw data from the Virginia Dept. of Medical Assistance Services.

Virginia

UPDATE: As I figured, the original data was massivly wrong. Just as one simple example, Virginia's own data set puts Danville's vaccination rate at around 35.5% vs. the 0.1% according to the CDC data.

Someone on Twitter pointed me towards this COVID-19 Community Profile Report which explains the problem:

The following states have ≤80% completeness reporting vaccinations by county, which may result in underestimates of vaccination data for counties and CBSAs: VT (74%), CO (73%), WV (54%), VA (51%), GA (50%), HI (0%), AS (0%), TX (0%), PW (0%), FM (0%), MH (0%), MP (0%)

I'm not doing the U.S. territories anyway, and I gathered the data for Hawaii and Texas straight from the state health departments. Sounds like I'll have to do the same for Virginia if possible. I'll also have to go back and re-do Colorado, Georgia and Vermont, though there was at least some clear pattern in those states (Vermont has few enough counties that it'd be hard to see one anyway). I haven't gotten to West Virginia yet.

I'll leave this post up for the moment but will take it down this evening until I've corrected the data.

UPDATE 6/02/21 9:11pm: OK, I'm using the data from the COVID Act Now project instead, which appears to be pulling their data directly from the Virginia Health Dept's website. Oddly, they don't list any numbers for Manassas City and Manassas Park, so I've pulled it directly from the VA COVID Vaccine Tracker myself.

I've swapped out both the graphs and the county/city table with the corrected versions below.

There still doesn't appear to be much of a partisan lean correlation in Virginia--it's more apparent in the "bubble view" which sizes the dots by population--but at least the numbers are accurate and make sense now, which is the main point.

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 Virginia:

NOTE: The CDC lists ~1.895 million Virginia residents (9.6% of the total fully vaccinated) whose county of residence is unknown. In addition, there are 9 counties which don't list any vaccination data at all. Both of these could skew the trendline significantly.

Even with those factors accounted for, the Virginia graphs below are still massively out of whack with almost every other state. I don't mean because the trendline tilts slightly upwards towards the right side--New Jersey does that as well--I mean because there's massive ranges in vaccination rates across the board regardless of partisan lean, relative county population, etc. Even New Jersey still seems to form some sort of coherent pattern.

I don't know if this is a data error or what. Will update if I find out more.

Gold Bars

NOTE: This is an updated version of a post from a couple of months ago. Since then, there's been a MASSIVELY important development: The passage of the American Rescue Plan, which includes a dramatic upgrade in ACA subsidies for not only the millions of people already receiving them, but for millions more who didn't previously qualify for financial assistance.

Much has been written by myself and others (especially the Kaiser Family Foundation) about the fact that millions of uninsured Americans are eligible for ZERO PREMIUM Bronze ACA healthcare policies.

I say "Zero Premium" instead of "Free" because there's still deductibles and co-pays involved, although all ACA plans also include a long list of free preventative services from physicals and blood screenings to mammograms and immunizations with no deductible or co-pay involved.

Virginia is usually the first state to publicly post their preliminary annual individual/small group market health insurance premium rate filings; historically they've published them as early as mid-April. This year, however, due primarily to the COVID-19 pandemic, I presume, they didn't actually post them until mid-August.

The average premium changes for 2021 on the individual market range from a 13% drop to a 7.7% increase, with the statewide weighted average coming in at around a 7.2% reduction. For the small group market, premiums are increasing by around 3.6% on average, ranging from a 2.4% drop to a 10.9% increase.

Two other noteworthy items: First, Optimum Choice is expanding into VA's individual market (this isn't the same as Optima Health); secondly, VA's indy market has dropped from over 300,000 last year to around 256,000 this year, presumably due to the lingering effects of Medicaid expansion enrollees shifting over from subsidized private plans.

Over a year ago, I wrote an analysis of H.R.1868, the House Democrats bill that comprises the core of the larger H.R.1884 "ACA 2.0" bill. H.R.1884 includes a suite of about a dozen provisions to protect, repair and strengthen the ACA, but the House Dems also broke the larger piece of legislation down into a dozen smaller bills as well.

Some of these "mini-ACA 2.0" bills only make minor improvements to the law, or make improvements in ways which are important but would take a few years to see obvious results. Others, however, make huge improvements and would be immediately obvious, and of those, the single most dramatic and important one is H.R.1868.

The official title is the "Health Care Affordability Act of 2019", but I just call both it and H.R.1884 (the "Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019") by the much simpler and more accurate moniker "ACA 2.0".

Last March I wrote an analysis of H.R.1868, the House Democrats bill that comprises the core of the larger H.R.1884 "ACA 2.0" bill. H.R.1884 includes a suite of about a dozen provisions to protect, repair and strengthen the ACA, but the House Dems also broke the larger piece of legislation down into a dozen smaller bills as well.

Some of these "mini-ACA 2.0" bills only make minor improvements to the law, or make improvements in ways which are important but would take a few years to see obvious results. Others, however, make huge improvements and would be immediately obvious, and of those, the single most dramatic and important one is H.R.1868.

The official title is the "Health Care Affordability Act of 2019", but I just call both it and H.R.1884 (the "Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019") by the much simpler and more accurate moniker "ACA 2.0".

Coming on top of not one, not two, but three other states either scrapping or "delaying" implementation of Medicaid expansion work requirements (Arizona, Indiana and Montana), this one isn't particularly surprising given that Democrats hold the governor's seat and just flipped both the state House and Senate. Still welcome, though!

Gov. Ralph Northam has directed Virginia's Medicaid program to "pause" negotiations with the federal government on approval of a work requirement that was central to a political deal that allowed the state to expand eligibility for the program's health care benefits to hundreds of thousands of uninsured Virginians.

Northam cited the Democratic takeover of both chambers of the General Assembly in legislative elections last month. He also referred to litigation that has faced other states that have tried to link Medicaid health benefits to requirements that program participants seek work, training, education or other forms of civic engagement.

A few weeks ago I noted the following press release from Democratic Virginia Governor Ralph Northam, just ahead of the critical state legislative elections:

It took me a couple of days to post this, but it's an important development, especially on the cusp of the Virginia legislative election next month which could flip both the state House and Senate to the Democrats; thanks to Esther Ferington for the heads up:

Governor Northam Signs Executive Directive to Ensure Access to Affordable, Quality Health Care Coverage for All Virginians

“Health coverage should be both meaningful and affordable, but unfortunately, policies from Washington threaten to increase the number of families who are uninsured or underinsured,” said Governor Northam. “It’s more important than ever that we identify and implement policies at the state level that control costs and ensure that Virginians can afford to buy health insurance that covers their health care needs.”

It took me a couple of days to post this, but it's an important development, especially on the cusp of the Virginia legislative election next month which could flip both the state House and Senate to the Democrats; thanks to Esther Ferington for the heads up:

Governor Northam Signs Executive Directive to Ensure Access to Affordable, Quality Health Care Coverage for All Virginians

RICHMOND—Governor Ralph Northam today issued Executive Directive Five, directing actions to increase the number of Virginians enrolled in quality, affordable health care coverage.

This year, Medicaid expansion is providing access to health coverage for more than 325,000 eligible Virginians who have enrolled, positively impacting their health. But meaningful health coverage remains unaffordable for too many Virginians, due in large part to federal policies that have increased cost and decreased the quality of available coverage.

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