Since I've been neglecting other ACA/healthcare posts the past couple of weeks, I figured I should at least provide regular updates on why I've been mostly absent.
I've made major progress in updating and revising my breakout of COVID-19 cases and fatalities at not just the state level but the county level. Again, I've separates the states into two separate spreadsheets:
This page contains proposed health plan rate information for the District of Columbia’s health insurance marketplace, DC Health Link, for plan year 2021.
The District of Columbia Department of Insurance, Securities and Banking (DISB) received 188 proposed health insurance plan rates for review from Aetna, CareFirst BlueCross BlueShield, Kaiser Permanente and United Healthcare in advance of open enrollment for plan year 2021 on DC Health Link, the District of Columbia’s health insurance marketplace.
The four insurance companies filed proposed rates for individuals, families and small businesses for the 2021 plan year. Overall, 188 plans were filed, compared to 181 last year. The number of small group plans increased from 156 to 163, and the number of individual plans remained at 25.
In the middle of a deadly global pandemic which has already killed more than 100,000 Americans and completely disrupted the entire U.S. healthcare system, private insurance carriers still have to go about preparing their annual premium rate change filings for 2021. This is a long, complicated process which begins a good nine months before the new plans and prices are actually enrolled in.
The task of setting 2020 premiums was the first time since the ACA went into effect which was relatively calm for insurance carrier actuaries:
My county-level tracking project continues. I've now plugged in confirmed/official COVID-19 cases and fatalities across 26 states and hope to bring the remaining 24 states (plus the U.S. territories) up to date within the next few days.
Meanwhile, here's how cases have spread on a per capita basis across those 26 states from March 20th until May 23rd. At the high end, I haven't gotten to the worst-hit states yet (New York, New Jersey, Massachusetts & Rhode Island), which wouldn't fit on this chart anyway; at the lower end, once you get below Alabama, there's a cluster of states which are difficult to separate out at this level as they're running so close together.
Just as important as the infection rate itself, of course, is the curve of the line. Louisiana and Michigan were hit hard early on, but seem to be flattening their curves, while states like Minnesota, Iowa and Alabama, which were hit later, are starting to curve upwards now, definitely the wrong direction.
I've made major progress in updating and revising my breakout of COVID-19 cases and fatalities at not just the state level but the county level. Again, I've separates the states into two separate spreadsheets:
Most of the data comes from either the GitHub data repositories of either Johns Hopkins University or the New York Times. Some of the data comes directly from state health department websites.
I hope to fill in the back-data for every state within the next few days, bringing them all up to date. This should allow for plenty of interesting analysis of trends and counties to keep an eye on. It will also allow me to get back to posting more regular ACA policy updates/etc.
As a follow-up to my prior posts about the urban/rural divide of how COVID-19 has spread throughout Michigan, here's a graph which shows how it's spread in Detroit, the larger Metro Detroit area and the rest of the state on a per capita basis over time.
Obviously the probem is still far worse in Detroit and the Metro Detroit area overall...but the case trendlines are starting to flatten in Detroit and Metro Detroit, while it's still increasing at the same rate or higher in the rest of the state.
Massachusetts Health Connector continues extended enrollment as nearly 45,000 people enroll in new plans, update current coverage
April 28, 2020 – The Massachusetts Health Connector continues to help people who need health insurance after losing coverage or income due to the coronavirus, with a May 23 deadline ahead for June 1 coverage.
Silver State Health Insurance Exchange enrolls 5,479 during Exceptional Circumstance Special Enrollment Period in Response to COVID-19
Carson City, Nev. – The Silver State Health Insurance Exchange (Exchange), Nevada’s state agency that helps individuals secure budget-appropriate health coverage through the online marketplace and State Based Exchange (SBE) platform, Nevada Health Link, enrolled 6,017 Nevadans during its limited-time Exceptional Circumstance Special Enrollment Period (SEP), March 17 – May 15, including 5,479 new consumer enrollments related to the Exceptional Circumstance Special Enrollment Period, and 538 enrollments due to loss of Minimum Essential Coverage (MEC).
In response to Governor Sisolak’s March 12 Emergency Declaration, the SEP was opened to allow qualified Nevadans who missed OEP to secure health care coverage. Consumers who enrolled on or before April 30 received coverage effective May 1, and consumers who enrolled between May 1 and 15 will have coverage effective June 1, 2020.
OLYMPIA, Wash. – Fifteen health insurers filed 183 plans for Washington’s 2021 individual health insurance market — with two new insurers entering: UnitedHealthcare of Oregon and Community Health Network of Washington.
The filings indicate a strong response from health insurers to provide more choice for consumers during the current coronavirus pandemic. They also show that individuals in all counties in Washington will have at least two options for coverage in 2021, a distinct change from recent years.
Since I've been neglecting other ACA/healthcare posts the past couple of weeks, I figured I should at least provide regular updates on why I've been mostly absent.
I've made major progress in updating and revising my breakout of COVID-19 cases and fatalities at not just the state level but the county level. Again, I've separates the states into two separate spreadsheets:
On May 21, 2020, the Health Connector announced in an Administrative Bulletin an extension to the extended enrollment period in response to the coronavirus (COVID-19) emergency through June 23, 2020 to assist uninsured Massachusetts residents seeking health coverage. (The extended enrollment period was previously set to end May 25.)
If you apply coverage under this special enrollment, the deadlines to complete enrollment are as follows:
Coverage Start DateEnrollment Deadline
Coverage Start Date: June 1st: Enrollment Deadline: May 23rd
Coverage Start Date: July 1st: Enrollment Deadline: June 23rd
Please note that if you are eligible to enroll due to normal special enrollment period rules, you can select the one that applies when you complete your application.
I've been spending a lot of time working on my county-level COVID-19 tracking project the past few weeks. I'm happy to report that I've managed to plug in the county-level case and fatality data for every thirteen states so far, so I figured this would be a good time to post a visual showing how the virus has spread over time across them in cases per capita (actually cases per thousand residents).
This is a much more useful measure than the raw number of cases since the population of each state (and county) varies so widely.
The states I've completed don't follow any particular pattern...aside from Michigan (which I started with because I live here, of course), the others are simply the states which I was able to get ahold of historic case/death toll data for from March 20th until today. Other states will follow as I complete backdating the data into the spreadsheets.
On April 14th, Covered California reported that 58,000 residents had enrolled in ACA exchange coverage during their COVID-19 Special Enrollment Period, of which roughly 20,000 did so via standard SEPs (losing coverage, moving, getting married/divorced, etc), while an additional 38,000 took advantage of the COVID-specific SEP.
Note: I've been distracted by my county-level COVID19 tracking project for the past couple of weeks, so I'm posting a series of entries on various ACA/healthcare policy developments which I've missed along the way.
Back in 2016, many health insurers which had been losing money hand over fist on the ACA individual market (in spite of many making record profits in other divisions) decided to bail on the ACA market entirely. Of these, the biggest shocks to the system were Aetna, Humana and UnitedHealthcare, each of which pulled out of multiple states, and UHC bailing was the biggest blow of all:
Note: I've been distracted by my county-level COVID19 tracking project for the past couple of weeks, so I'm posting a series of entries on various ACA/healthcare policy developments which I've missed along the way.
Sen. John Cornyn (R-Texas) sat down for an interview yesterday with PBS Austin's Judy Maggio, who raised concerns about "holes in the safety nets" affecting many Texans. Specifically, the host noted that as more people lose their jobs during the pandemic, they're also losing their health security. Maggio asked the Senate Republican about possible federal efforts for those who are now "wondering what they're going to do for health insurance."
I've made major progress in updating and revising my breakout of COVID-19 cases and fatalities at not just the state level but the county level, and should now be able to post updated summaries of the worst-hit counties on a weekly basis.
Due to the sheer volume of data involved, I've had to separate out the states into two separate spreadsheets:
All data below is up to date as of Saturday, May 16th, although due to variances in when different states report the data, some of the data may be from a day earlier. The counties are color-coded depending on whether they voted for Donald Trump (orange) or Hillary Clinton (blue) in 2016.
Annnnnd we're off! In the middle of a deadly global pandemic which has already killed more than 85,000 Americans and completely disrupted the entire U.S. healthcare system, private insurance carriers still have to go about preparing their annual premium rate change filings for 2021. This is a long, complicated process which begins a good nine months before the new plans and prices are actually enrolled in.
The task of setting 2020 premiums was the first time since the ACA went into effect which was relatively calm for insurance carrier actuaries. Unlike setting rates for 2014 or 2015, they weren't dealing with a complete overhaul of the entire insurance industry. Unlike 2016-2017, they weren't dealing with the prospect of ACA premiums being crippled for 3/4 of the country (via King v. Burwell) or the fallout of the Risk Corridor Massacre. Unlike 2018, they weren't dealing with how to deal with CSR rembursements being cut off or the entire ACA being repealed by Congress. Unlike 2019, they didn't have the unknown impact of the individual mandate being repealed to consider.
Every year, I spend months painstakingly tracking every insurance carrier rate filing for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease.
Carriers jump in and out of the market, their tendency repeatedly revise their requests, and the confusing blizzard of actual filing forms which sometimes make it next to impossible to find the specific data I need. The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier:
Believe it or not, even though Delaware is a fairly solidly blue state in Presidential elections, two of the three counties there (it's pretty small) voted for Donald Trump in 2016. Here's how the state's cases have shifted over time between New Castle County (the largest of the three, which voted for Clinton) and the other two counties which voted for Trump:
This is almost a complete reversal, with New Castle going from 2/3 of all cases at the beginning of April to just 1/3 today:
A few weeks ago, I posted a detailed analysis of how the COVID-19 virus has been spreading throughout Wisconsin. I noted that while the outbreak originally spread quickly in the more urban/blue-leaning areas, that has gradually changed over time, with the virus spreading to the rest of the state--including rural, conservative-leaning areas--at a faster rate while it slowed down in the urban areas.
It's time to check in to see whether that trend has continued...and sure enough, it has. Here's what this trend looks like visually:
A few weeks ago, I posted a detailed analysis of how the COVID-19 virus has been spreading throughout my home state of Michigan. I noted that while the outbreak originally spread quickly in Detroit and the more densely-populated Metropolitan Detroit region (Wayne, Oakland and Macomb counties), that has gradually changed over time, with the virus spreading to the rest of the state--including rural, conservative-leaning areas--at a faster rate while it slowed down in the urban areas.
It's time to check in to see whether that trend has continued...and sure enough, it has:
Due to the COVID-19 emergency, Vermont Health Connect has opened a Special Enrollment Period until May 15, 2020. During this time, any uninsured Vermonter can sign up for a Qualified Health Plan through Vermont Health Connect. Qualified families can also get financial help paying for coverage.. Please call us at 1-855-899-9600 to learn more.
More than 14,000 Coloradans gain health coverage during emergency Special Enrollment Period; Marketplace reports higher enrollments and lower costs in 2020
DENVER — A total of 14,263 Coloradans gained health insurance coverage during Connect for Health Colorado’s emergency Special Enrollment Period, which ran from March 20 to April 30. The Marketplace opened the Special Enrollment Period in response to the outbreak of the coronavirus (COVID-19), to ensure as many Coloradans as possible have access to health care.
“We’ve seen a tremendous response to the emergency Special Enrollment Period and need for affordable health coverage,” said Chief Executive Officer Kevin Patterson. “As always, we are here to help Coloradans get covered and stay covered as they navigate life changes this year.”
MNsure offers enrollment opportunity for Minnesotans newly eligible for financial help due to decrease in income
MNsure is the only place to get financial help to lower the cost of health insurance
Starting May 11, 2020, MNsure is offering an ongoing special enrollment period for Minnesotans who experience a decrease in household income and become newly eligible for advanced premium tax credits (APTC). Those looking to enroll will need to have had health insurance that meets the standards in the Affordable Care Act, also known as minimum essential coverage (MEC), for one or more days in the 60 days immediately preceding their decrease in household income.
Minnesotans must act within 60 days after they experience a decrease in household income to be eligible.
Regular readers have no doubt noticed that I've let the blog sit mostly idle for the past week or so, even though there's been a ton of noteworthy developments. As I noted on Friday, part of this was due to an emergency laptop replacement/transfer. Part of it was due to it being Mother's Day weekend. Part of it was due to some other personal issues.
This has been far more difficult than you might imagine. While there are a half a dozen great sites out there already doing up-to-date tracking of COVID-19 data at the state level, such as the COVID Tracking Project, WorldoMeters and so forth, when it comes to the county-level data, it's a very different story. Some state health department websites make this data easily available and in an easy-to-read format; others make it next to impossible.
Since tracking and analyzing data is what I'm best known for...and since I'm mostly stuck sitting in front of the computer all day whether I like it or not these days anyway...I've started my own daily COVID-19 spreadsheet.
Again, I'm not the one who compiled the data itself--many other teams with far better resources than I have are doing that--but I'm pulling their work together and adding some additional context, such as per capita info by state/territory.
You may have noticed that I haven't posted many entries the past week or so aside from nightly COVID summaries and a few reposts of SBM press releases. Two reasons for this:
First, I've been spending a lot of time expanding/updating my county-level COVID-19 spreadsheets, which I've split off onto their own link (the state-level version was starting to get bogged down...it has over 40 daily worksheets; apparently the addition of the county-level sheets was slowing it down)
Second, my 8-year old laptop had a meltdown (literally, of sorts...the battery overheated and swelled up); I had to scramble to replace it (it was overdue anyway), which wasn't easy to do on short notice in the middle of a shelter-at-home pandemic. I've been spending the week transferring over gobs of data, updating software and/or getting replacement software for incompatible versions. It's a painstaking process.
Anyway, I'm more than a little backed up and plan on catching up ASAP.
Since tracking and analyzing data is what I'm best known for...and since I'm mostly stuck sitting in front of the computer all day whether I like it or not these days anyway...I've started my own daily COVID-19 spreadsheet.
Again, I'm not the one who compiled the data itself--many other teams with far better resources than I have are doing that--but I'm pulling their work together and adding some additional context, such as per capita info by state/territory.
10 days remain to enroll in a Qualified Health Plan through Nevada Health Link during the Exceptional Circumstance Special Enrollment Period
WHAT: Nevadans have 10 days remaining to enroll in a Qualified Health Plan through Nevada Health Link, the online health insurance marketplace operated by the state agency, the Silver State Health Insurance Exchange (Exchange), which announced an Exceptional Circumstance Special Enrollment Period (SEP) in March for qualified Nevadans who missed the Open Enrollment Period (OEP). The SEP, originally introduced in response to Governor Sisolak’s March 12th Emergency Declaration, runs through May 15. Consumers who enroll by May 15 will have coverage effective June 1, 2020.
Massachusetts Health Connector continues extended enrollment as nearly 45,000 people enroll in new plans, update current coverage
April 28, 2020 – The Massachusetts Health Connector continues to help people who need health insurance after losing coverage or income due to the coronavirus, with a May 23 deadline ahead for June 1 coverage.
In order to help residents who lose their employer-sponsored coverage during the economic crisis created by the coronavirus, the Health Connector has created an extended enrollment period through May 25, so that anyone who needs health insurance can come to the exchange and get into coverage. Additionally, current Health Connector members are encouraged to update their income information if they lost their jobs or working hours have changed, to ensure they are in the plan that provides appropriate financial help paying for their coverage.
Washington Healthplanfinder Urges Uninsured to Act Fast to Meet Friday, May 8 Deadline
In response to the Coronavirus (COVID-19) pandemic, Washington Health Benefit Exchange (Exchange) today is urging individuals who did not secure health insurance for 2020 to sign up for coverage by 5:30 p.m. on Friday, May 8, the deadline of the limited-time special enrollment period (SEP) through Washington Healthplanfinder for coverage beginning May 1, 2020.
“Now is the time to sign up for health coverage if you are currently uninsured,” said Exchange Chief Executive Officer Pam MacEwan, “There are many resources available to help individuals understand their options and secure health coverage before the special enrollment period ends.”
As you can tell, I've become a bit obsessed with tracking the COVID-19 outbreak on the county level within each state, along with the corresponding partisan divide.
Today, I'm looking at North Carolina. The good news is that I was able to acquire daily case & death data going back over a month. The bad news is that it stops a month ago...that is, the earliest day I could find county-level data for was April 4th, which means I'm missing about two weeks worth of numbers from the second half of March (most states I've looked at so far start around March 20th).
Still, even with the first two weeks missing, the trendline is pretty clear: Once again, what started out as a "Democratic area problem" has quickly shifted into an Everyone problem. It looks like things have stabilized at roughly a 50/50 divide, with around the same number of cases appearing in counties which voted for Donald Trump in 2016 as HIllary Clinton:
Since tracking and analyzing data is what I'm best known for...and since I'm mostly stuck sitting in front of the computer all day whether I like it or not these days anyway...I've started my own daily COVID-19 spreadsheet.
Again, I'm not the one who compiled the data itself--many other teams with far better resources than I have are doing that--but I'm pulling their work together and adding some additional context, such as per capita info by state/territory.
Minnesota was an obvious choice, given that it was the closest swing state won by Donald Trump. Texas may seem like an unusual choice given that it's considered to be a solid red state and that it hasn't seen the type of ugly outbreak of COVID-19 (yet) that several other states have, but I happened to discover that unlike states like Florida and Georgia, Texas's Health Dept. dashboard makes it quite easy to download the historic case and fatality data I need to compile these charts, so I decided to go for it. The results in both states are interesting for different reasons.
MNsure releases Request for Proposal for the Minnesota Insulin Safety Net Program’s Public Awareness Campaign
Submissions accepted until May 26, 2020
ST. PAUL, Minn.—On April 15, 2020, Governor Walz signed the Alec Smith Insulin Affordability Act to provide relief to Minnesotans struggling to afford their insulin. MNsure, the state’s health insurance exchange, is responsible for a creating a public awareness campaign to promote the Insulin Safety Net Program. The public awareness campaign will inform Minnesotans in urgent need of insulin how to access the state’s safety net program, and highlight the availability of insulin manufacturers' patient assistance programs.
The request for proposal (RFP) seeks proposals from qualified firms or contractors capable of producing a statewide public awareness campaign to increase awareness of the Insulin Safety Net Program. The anticipated time frame of the campaign is July 2020 through June 2023.
For weeks now, I've been tracking the daily COVID-19 numbers at the county level in several states; particularly Michigan, Wisconsin and Pennsylvania. While the pandemic hit the more densely-populated areas first (which tend to lean Democratic), the trendlines in Michigan and Wisconsin have been clearly moving towards the more rural, Republican-leaning counties increasing their share of the cases and corresponding deaths as time has passed.
Pennsylvania has been different--after a less dramatic shift from blue to red counties in late March, PA seems to have levelled off, with new cases holding pretty steady between the two.
It's been another week, so I figured I should post and update...and it's more of the same in all three cases. First up, Michigan:
Since tracking and analyzing data is what I'm best known for...and since I'm mostly stuck sitting in front of the computer all day whether I like it or not these days anyway...I've started my own daily COVID-19 spreadsheet.
Again, I'm not the one who compiled the data itself--many other teams with far better resources than I have are doing that--but I'm pulling their work together and adding some additional context, such as per capita info by state/territory.
