There's a lot on everyone's plate at the moment. A global pandemic which has already killed over 230,000 Americans and infected 9 million more. The entire West Coast is on fire while the Gulf Coast is being hit with hurricanes. And there's some sort of election coming up on Tuesday, I hear.
Meanwhile, in just eleven days the Republican-controlled Supreme Court will hear oral arguments in a case brought by Republican plaintiffs (and sided with by a Republican Justice Department) over whether the Affordable Care Act should be struck down en masse because a Republican-controlled House and Republican-controlled Senate decided to change the individual mandate penalty amount from $695 to $0.
However, there's one other important thing happening with the ACA in just two days: The 2021 ACA Open Enrollment Period begins on Sunday, November 1st.
As I do every year, here's a list of important things to remember when selecting a health insurance policy. Some of these are the same every year and apply nationwide; others are specific to the 2021 enrollment period and/or to particular states.
Information About Approved Rates for January 2021 Health Plan Offerings on DC Health Link
Open Enrollment for Plan Year 2021 DC Health Link’s open enrollment begins November 1, 2020 through January 31, 2021. DC Health Link is an online marketplace created for individuals, families, and small business owners in the District of Columbia to shop, compare, and select health insurance that meets their health needs and budgets. For more information, visit dchealthlink.com or call (855) 532-5465.
This page contains approved health plan rate information for the District of Columbia’s health insurance marketplace, DC Health Link, for plan year 2021.
My 2021 Rate Change project still isn't complete yet for two reasons: First, I only have the final/approved 2021 rate filings for 28 states as of today (vs. preliminary rates for all 50 states + DC). Second, a higher-than-usual number of carriers have made it impossible (or at least highly difficult) to dig up their effectuated enrollment data for 2020.
Without that number, I have no way of running weighted averages for that state's individual market; those are listed in grey below. In a few cases (like Florida), the state insurance dept. actually provided the weighted average but I still had to guess at the total enrollment number (also in grey).
This is a bigger problem than you might think. Let's say a state has 3 carriers requesting a 5% rate reduction, a 2% increase and a 15% increase. The unweighted average would be +4%....but if it turns out that the first carrier holds 90% of the market share this year, the weighted average would be more like -4%. You see the problem here.
Five weeks ago, right after Supreme Court Justice Ruth Bader Ginsburg passed away, I once again wrote about the different options available to Democrats to save the ACA from a potentially disastrous SCOTUS ruling next spring...each of which would require them holding a trifecta in the House, the Senate and of course the Presidency:
1. Pass a simple bill changing the federal mandate penalty to an amount higher than $0.00.
2. Pass a simple bill clarifying that the mandate is separate from the rest of the ACA.
3. Pass a simple bill striking out the underlying mandate language itself.
As I understand it, two of these would also require the newly-Dem controlled Senate to also kill the filibuster (or to somehow convince enough Republicans to agree to hit the 60-vote threshold), while the third (raising the penalty back over $0.00) could be done with just 50 votes (+ VP Kamala Harris as the tiebreaker) via the reconciliation process...which itself gets messy.
Q: "IF the Affordable Care Act is overturned, how will you ensure that Colordans who have healthcare through the Affordable Care Act's Medicaid expansion will continue to be covered?"
New Mexico Superintendent of Insurance Announces Premium Decreases for 2021
Santa Fe, NM –New Mexico Superintendent of Insurance Russell Toal announced today that health insurance premiums will decrease significantly for individuals and families purchasing their own coverage through beWellnm (New Mexico’s Health Insurance Exchange). Average plan prices dropped in the Bronze, Silver, and Gold plan categories across the state. Silver plans, the most common plan purchased on the individual Exchange, will decrease between 8.1 and 13.5 percent on average. Small businesses will experience a 6.7 percent average premium decrease on beWellnm.
The Office of Superintendent of Insurance (OSI) reviews health insurance filings annually to determine whether rates are reasonable and fair.
“After a rigorous review of health insurance filings, our office is pleased to report that premiums are going down in 2021,” said Superintendent Toal. “Not only are rates decreasing, but New Mexico will have more health plans competing in the marketplace than ever before”
Way back in July (a lifetime ago!), Michigan's Dept. of Financial Services posted the state's preliminary 2021 individual & small group rate filings. At the time, the average premium changes being asked for were around a 1.3% increase on the individual market and 1.4% on the small group market.
Last week, a few days ahead of the launch of the 2021 Open Enrollment Period, they posted the approved 2021 rates...and there's almost no changes at all. The only significant change was to Meridian's request, which was dropped from a 2.7% increase to a 5.6% decrease. Also, National Health Insurance dropped out of the Small Group market, but they don't appear to have anyone enrolled this year anyway:
BISMARCK, N.D. – Insurance Commissioner Jon Godfread today released the approved health insurance rates for both individual and small group plans for 2021, and encourages consumers to start early, stay informed and shop around.
The data below comes from the GitHub data repositories of Johns Hopkins University, except for Utah, which come from the GitHub data of the New York Times due to JHU not breaking the state out by county but by "region" for some reason.
Note that a few weeks ago I finally went through and separated out swing districts. I'm defining these as any county which where the difference between Donald Trump and Hillary Clinton was less than 6 percentage points either way in 2016. There's a total of 198 Swing Counties using this criteria (out of over 3,200 total), containing around 38.5 million Americans out of over 330 million nationally, or roughly 11.6% of the U.S. population.
With these updates in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Saturday, October 24th (click image for high-res version). Blue = Hillary Clinton won by more than 6 points; Orange = Donald Trump won by more than 6 points; Yellow = Swing District
Back in early August, the Pennsylvania Insurance Dept. issued the preliminary rate filings for PA's individual and small group market carriers. At the time, the weighted average rate change being requested on the individual market came to a 2.6% reduction in unsubsidized premiums, while the average small group plan was set to increase by 2.3%.
Last week, the PA DOI issued their final decisions for the long list of carriers on each market, and the changes were...minimal, really. In fact, there was no change at all made to most requested rate filings--only two of the 17 indy market carriers saw a change (reductions for each), and only four of the 21 small group carriers did...and even then, the changes aren't terribly dramatic, just a few percentage points in most cases.
A month later, the RI DOI issued their approved 2021 rate decisions, and made some small tweaks to each. In fact, it looks like there was at least one revision in between, as the new press release lists slightly different numbers for the "preliminary" requests.
In any event, Rhode Island indy & sm. group enrollees will be looking at roughly 4.2% increases on the individual market and 2.6% increases for small group plans:
Way back in June, the Washington Insurance Dept. posted the state's preliminary 2021 preliminary individual & small group market premium rate filings. At the time, the weighted average across all carriers was a 1.8% drop in individual market premiums and a 3.4% increase in small group rates. They also announced the addition of two new carriers to the individual market: Community Health Network and UnitedHealthcare of Oregon. It's important to note that both of these new carriers will only be providing WA's new (quasi) Public Option plans.
Last month, however, the WA DOI announced the approved 2021 rates...for the individual market only, and even then it's missing two carriers which are still under review (Asuris and Health Alliance NW). The missing carriers only have 1,200 enrollees between them, however, so any changes to their requested rates won't move the needle noticeably:
Last night, during the final Presidential debate of 2020, Joe Biden noted:
Biden: Take a look at what New York has done in terms of turning the curve down, in terms of the number of people dying. And I don’t look at this in terms of the way he does, blue states and red states. They’re all the United States. And look at the states that are having such a spike in the coronavirus. They’re the red states, they’re the states in the Midwest, they’re the states in the upper Midwest. That’s where the spike is occurring significantly. But they’re all Americans. They’re all Americans. And what we have to do is say, wear these masks, number one. Make sure we get the help that the businesses need. That money’s already been passed to do that. It’s been out there since the beginning of the summer, and nothing’s happened.
Of course Biden's entire point was that ALL the states are American states, and thus we shouldn't treat them differently depending on their political lean.
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):
I bravely watched it so you don't have to. Here's the full segment about the ACA and the Trump/GOP lawsuit to strike it down, set to be heard by the Supreme Court on November 10th:
(starting around 15 minutes in):
STAHL: "You promised that there was gonna be a new health package.
TRUMP: "Yeah."
STAHL: "You said it was gonna be great, you said it'll be ready, it'll be here in two weeks, it was gonna be like nothing you've ever seen before...and of course we haven't seen it...so why didn't you develop a health plan?"
TRUMP:"It is developed. It is fully developed, it's going to be announced very soon, when we see what happens with Obamacare, which is not good. And...when we see what happens with Obamacare.
The final/approved rates have recently been posted, and rates in both markets have been significantly cut down: Individual market rates are now averaging a 1.4% reduction while the increase on the small group market is down to 3.8%.
The Alabama Department of Insurance (ALDOI) has approved the final 2021 premium rates for the Affordable Care Act Individual Market in Alabama. The rates will be effective on January 1, 2021. The two carriers in the Alabama individual market are Blue Cross Blue Shield of Alabama (BCBS) and Bright Health Insurance Company of Alabama (BHIC). In general, rates for BCBS increased five percent and rates for BHIC increased 22 percent. The actual rates and the supporting material may be found by clicking on the links below.
Unfortunately, the linked documents are still redacted and thus don't include the enrollment numbers for Bright (and this press release says nothing about the small group market), but as far as I can tell this doesn't change the averages of either market much from the preliminary filings. Assuming Bright still only has a tiny part of the market, even its 22% average increase doesn't move the needle much.
I've written at least a dozen explainers about what I've termed the Risk Corridor Massacre over the past five years, starting with this one from 2015, and I pray to God that this is the last time I have to do so. Here we go:
The Affordable Care Act made massive changes to many parts of the U.S. healthcare system, but by far the most radical changes were made to the individual, or "non-group" market. This is health insurance for people who aren't covered by Medicare or Medicaid but who also don't have coverage through their employer (or who are self-employed, as I am).
Before the ACA, individual market carriers could cherry-pick their enrollees, either denying coverage to those with pre-existing conditions, covering them but charging massively higher rates for doing so, or covering them but exempting themselves from coverage of the very conditions which were most in need of treatment.
The data below comes from the GitHub data repositories of Johns Hopkins University, except for Rhode Island, Utah and Wyoming, which come from the GitHub data of the New York Times due to the JHU data being incomplete for these three states. Some data comes directly from state health department websites.
Note that a few weeks ago I finally went through and separated out swing districts. I'm defining these as any county which where the difference between Donald Trump and Hillary Clinton was less than 6 percentage points either way in 2016. There's a total of 198 Swing Counties using this criteria (out of over 3,200 total), containing around 38.5 million Americans out of over 330 million nationally, or roughly 11.6% of the U.S. population.
With these updates in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Saturday, October 10th (click image for high-res version). Blue = Hillary Clinton won by more than 6 points; Orange = Donald Trump won by more than 6 points; Yellow = Swing District
RE-UPPED 1/31/22: It was announced this morning that John James, who lost not one but two statewide U.S. Senate races back to back in 2018 & 2020, is taking a third swing at elected office in 2022. This time he's setting his sights lower, going for Michigan's new open 10th Congressional district, which is still competitive but which definitely has more of a GOP-tilt to it. In light of that, I decided to dust off this post again.
A month ago, incumbent Democratic Senator Gary Peters of Michigan and his Republican challenger John James were both interviewed as part of a Detroit Regional Chamber series on several issues, including healthcare policy and the ACA.
Nolan Finley is the conservative editorial page editor of The Detroit News.
On July 29th, he tweeted this out in response to criticism of the COVID-19 policy recommendations by himself and Michigan Republican legislative leadership:
Florida 20 million population, 6100 deaths. Michigan 10 million population, 6400 deaths. https://t.co/O1tNoyWwB0
Here's a graph of official COVID-19 positive test cases and fatalities per capita for both Michigan and Florida. Cases are per 1,000 residents; deaths are per 10,000 in order to make the trendlines more visible:
My 2021 Rate Change project isn't complete yet for two reasons: First, I only have the final/approved 2021 rate filings for 18 states as of today (vs. preliminary rates for all 50 states + DC). Second, a higher-than-usual number of carriers have made it impossible (or at least highly difficult) to dig up their effectuated enrollment data for 2020.
Without that number, I have no way of running weighted averages for that state's individual market; those are listed in grey below. In a few cases (like Florida), the state insurance dept. actually provided the weighted average but I still had to guess at the total enrollment number (also in grey).
This is a bigger problem than you might think. Let's say a state has 3 carriers requesting a 5% rate reduction, a 2% increase and a 15% increase. The unweighted average would be +4%....but if it turns out that the first carrier holds 90% of the market share this year, the weighted average would be more like -4%. You see the problem here.
At long last, I've finally wrapped up my 50-state (+DC) 2021 Rate Change project...or at least the preliminary rate filings; I have the final/approved rate changes for 18 states as of this writing.
I'm finishing things off with New Jersey, and unlike the past half-dozen or so states, I am able to run a properly weighted average for both the individual and small group markets in the Garden State even though, like many other states, the actuarial memos are either unavailable or heavily redacted.
In any event, based on the Q2 2020 report (which includes enrollment data updated through the end of June), 2021 enrollees in New Jersey's individual market are looking at average premium increases of around 4.1%, while small group plans are going up by roughly 2.6% on average.
Massachusetts, which is arguably the original birthplace of the ACA depending on your point of view (the general "3-legged stool" structure originated here, but the ACA itself also has a lot of other provisions which are quite different), has ten different carriers participating in the individual market. MA (along with Vermont) has merged their Individual and Small Group risk pools for premium setting purposes, so I'm not bothering breaking out the small group market in this case.
Getting a weighted average is tricky. On the one hand, only one or two of the rate filings included actual enrollment data. On the other hand, the Massachusetts Health Connector puts out monthly enrollment reports which do break out the on-exchange numbers by carrier. This allowed me to run a rough breakout of on-exchange MA enrollment. I don't know whether the off-exchange portion has a similar ratio, but I have to assume it does for the moment.
Louisiana joins the disturbingly-long list of states where the 2021 individual & small group market rate filings are either completely missing or heavily redacted, thus making it impossible for me to break out the market share by carrier and thus running a weighted average rate change.
I really hope this trend is reversed in the future, whether via HHS transparency regulations or through legislation.
In any event, the unweighted average rate increase for the Louisiana indy market is around 6.9%, and for the small group market it's roughly 5.2%.
Once again, I'm afraid the actuarial memos for Kansas' 2021 individual and small group market carriers are either absent or redacted, so I have to run unweighted average rate changes, which are likely off significantly (for instance, the individual market is +7.8% unweighted, but if it turns out that, say, Oscar Insurance has 95% of the market share, the weighted average would be more like a 7% decrease).
Unfortuantely, without knowing the actual enrollment data for each carrier, this is the best I can do for now. The small group market's unweighted average increase is 8.2%.
(sigh) Once again, I only have actual enrollment data for a one of the five carriers offering individual market policies in Illinois next year, and for two of the eleven selling small group plans. That means I can't run a weighted average rate change for either market, just unweighted ones.
That being said, the unweighted average change on the individual market is a 1.8% premium reduction, while the small group market is increasing by 5.2%.
Mississippi once again has two carriers offering ACA-compliant individual market coverage in 2021 and six on the small group market. Unfortunately, few filing forms don't seem to be available and the ones which are are redacted, so I can't run weighted averages for either.
The unweighted average rate increases are 2.7% on the individual market and basically flat for small group plans.
Unfortunately, Alaska's 2021 rate filings aren't available via the state insurance department website or the SERFF database, and the actuarial memos posted to the federal Rate Review database are heavily redacted, so I can't run a weighted average rate change for either the individual or small group market.
The unweighted average changes, however, are a 2.0% reduction on the indy market and a 1.9% reduction for small group plans.
Here's North Dakota's 2021 individual & small group market rate change filings. Note that all of the small group filings are heavily redacted and the memos aren't available in the SERFF database for any of them, so I can't run a weighted average and had to go with the unweighted 5.0% increase.
For the individual market, Blue Cross Blue Shield's memo isn't available, so I had to plug in an estimate based on the average 2019 enrollment; I'm assuming it's fairly close to that this year as well. Weighted average on the indy market is a 7.4% increase.
The South Carolina Insurance Dept. released their final/approved 2021 Individual and Small Group Market premium rate changes.
I actually never got around to analyzing the preliminary rate filings for SC, so I don't actually know whether any of these are changes from the original filings, but whatever. In the end, the Palmetto State's individual market premiums will be dropping by about 1.5%, while their small group rates will be increasing by 4.7% on average.
It's also worth noting that UnitedHealthcare of SC is joining the South Carolina small group market for the first time next year (not to be confused with "UnitedHealthcare Insurance Co." and "UnitedHealthcare Insurance Co. of the River Valley...no confusion there I'm sure...)
South Dakota's 2021 individual & small group market rate filings are up, and there's not much to say about any of them: Individual premiums are going up around 2.6%, small group market policies around 2.8% overall statewide.
Now I have most of the data needed to analyze the individual market for 2021: Assuming no major changes in the approved rates, carriers are averaging around a 7.4% premium increase next year. This is actually unusually high for 2021 so far...other states are averaging less than 2% overall.
Most of the rate hike seems to be caused by Celtic/Ambetter ("Superior Health Plan"), which holds 1/3 of the entire market and is raising rates by nearly 12%. Blue Cross Blue Shield, which has another 36% market share, is only raising rates 3%, while the third and fourth largest carriers in the market, Molina and Oscar, are raising rates by 5.3% and 14.7% respectively.
There's also a couple of misleading numbers--both divisions of "Scott & White" are massively DROPPING their premiums for 2021, by 33% and 54%...but they have fewer than 2,000 people enrolled total to begin with; make of that what you will.
Utah's preliminary (and possibly final?) 2021 individual and small group market rate filings are listed below. Unless there's a change in the final/approved rates, individual marekt plan premiums will drop slightly by around 1.2% on average next year, while small group plans will increase by around 4.3%.
There are three insurance carriers offering ACA-compliant individual market plans in West Virginia: CareSource, Highmark BCBS and Optum, although Optum has barely any enrollees at all, and the other two combined only total around 21,000 people in the state. The preliminary 2021 rate filings for the WV individual marekt is around a 4.8% average increase.
I have no idea what the enrollment numbers are for WV's small group carriers, so I can't run a weighted average, but the unweighted average increase for 2021 comes in at around 3.8% across the five sm. group carriers:
Not much to this one: Wyoming has just a single carrier selling ACA-compliant individual market policies to their 577,000 residents, Blue Cross Blue Shield...which, after raising rates 1.6% for 2020 is now reducing them by a solid 10% on average for 2021. The ~25,000 enrollment figure is an estimate.
For the small group market there are two carriers: BCBSWY and UnitedHealthcare, asking for an unweighted average rate reduction of 0.2% (I don't have a clue how many enrollees either one has).
First, CA's Small Group Market premiums are increasing by just 1.5% in 2021 (the lowest average increase since the ACA passed)
Second, CA's Individual Market premiums are increasing by just 0.6% on average in 2021 (identical to the preliminary rate requests)
Third, that Open Enrollment technically already started back on October 1st...sort of.
The official launch of Open Enrollment in every state isn't until November 1st, but for the past couple of years California has allowed current enrollees already in their system to actively renew/re-enroll for the upcoming year starting on October 15th. This year, it turns out they quietly moved that date back even earlier--current enrollees have been able to re-enroll starting as early as October 1st! I don't recall them ever making a big public announcement about this; I sort of stumbled upon it by accident.
Any music fan eager to bulk up their collection in the ’90s knew where to go to grab a ton of music on the cheap: Columbia House. Started in 1955 as a way for the record label Columbia to sell vinyl records via mail order, the club had continually adapted to and changed with the times, as new formats such as 8-tracks, cassettes, and CDs emerged and influenced how consumers listened to music. Through it all, the company’s hook remained enticing: Get a sizable stack of albums for just a penny, with no money owed up front, and then just buy a few more at regular price over time to fulfill the membership agreement. Special offers along the way, like snagging discounted bonus albums after buying one at full price, made the premise even sweeter.
The data below comes from the GitHub data repositories of Johns Hopkins University, except for Rhode Island, Utah and Wyoming, which come from the GitHub data of the New York Times due to the JHU data being incomplete for these three states. Some data comes directly from state health department websites.
Note that a few weeks ago I finally went through and separated out swing districts. I'm defining these as any county which where the difference between Donald Trump and Hillary Clinton was less than 6 percentage points either way in 2016. There's a total of 198 Swing Counties using this criteria (out of over 3,200 total), containing around 38.5 million Americans out of over 330 million nationally, or roughly 11.6% of the U.S. population.
With these updates in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Saturday, October 10th (click image for high-res version). Blue = Hillary Clinton won by more than 6 points; Orange = Donald Trump won by more than 6 points; Yellow = Swing District
Way back in May (a lifetime ago!), the Oregon Insurance Dept. was one of the first states to release their preliminary 2021 ACA premium rate filings for the individual and small group markets.
At the time, the carriers were asking for a weighted average 2.4% increase on the indy market (OR DOI put it at 2.2%) and a 4% increase for small group policies.
They issued some slightly revised rates later on in the summer, and sometime in August I believe they issued the final approved rates...which are just slightly lower on a few carriers.
In the end, 2021 Oregon enrollees are looking at weighted average premium hikes of 2.1% for indy plans and 3.7% for small group policies:
Back in early August, Covered California issued an extensive analysis of their upcoming 2021 individual market offerings, including the preliminary weighted average premium rate changes of just a 0.6% increase. Officially, this was just the average of the preliminary requests; the approved rates were presumably forthcoming at a later date.
Well, the 2021 Open Enrollment Period has technically already started in California...while new enrollees still have to wait until November 1st, current CoveredCA enrollees have apparently been able to re-enroll for 2021 since October 1st! (In previous years, CoveredCA opened up the renewal period starting on Oct. 15th)
Oklahoma Consumers to Have More Health Options for 2021 ACA Plans
OKLAHOMA CITY – Insurance Commissioner Glen Mulready announced today the 2021 preliminary rate filings for health insurance plans under the Affordable Care Act (ACA). Insurers that currently offer coverage through the Oklahoma Marketplace filed plans requesting average statewide increases of 2.7 percent.
In August, the Nevada Insurance Dept. issued their preliminary 2021 rate filings for the individual and small group markets. Unfortunately, while the filing summaries were easy to find, the actual enrollment numbers weren't. As a result, I only had the department's press release to go on for the weighted overall average on the individual market, and I had to go with an unweighted average for the small group market.
Fortunately, now that the NV Insurance Dept. has issued the approved 2021 rates, they've also added more detailed summaries for both markets, meaning I have effectuated enrollments for every carrier. This allows me to run a proper weighted average rate change across both:
Back in June, Maryland's Insurance Dept. posted the preliminary 2021 rate requests for the individual and small group markets. At the time, carriers were seeking an average 4.8% premium reduction on the individual market and a 5.1% average increase for the small group market.
In early August, the Kentucky Insurance Dept. posted preliminary 2021 rate filings for the individual and small group markets. At the time, the carriers were requesting average increases of 11.6% on the individual market (unusually high this year) and 9.7% for the small group market.
Normally by early October I have the preliminary rate filings analyzed & posted for nearly every state and the approved rate changes for at least half of them. This year I'm lagging way behind for several reasons, some personal, some professional.
Having said that, I'm trying to play catch-up this week. Case in point, today I'm posting Iowa's preliminary individual and small group market filings for 2021.
Wellmark is dropping their premiums by a jaw-dropping 42% next year, which would normally be a huge story except that they only have around 3,000 Iowans enrolled to begin with (which may explain the massive rate drop, of course). Oscar Insurance appears to be expanding into the Iowa individual market, while Medica continues to hold nearly 95% of the market and is only raising premiums by around 2.5%. Overall, 2021 rates are essentially flat on averae.
The small group market is much the same...there's a bunch of carriers which only have a few dozen enrollees statewide, and four which hold over 90% of the market share (realistically more like 2-3 carriers depending on how you define UnitedHealthcare and Wellmark subsidiaries).
"If you have a pre-existing condition...heart disease; diabetes; breast cancer...they're coming for you. If you love someone who has a pre-existing condition...they're coming for you. If you're under the age of 26 on your parents' coverage...they're coming for you."
Wednesday night's Vice-Presidential debate between Kamala Harris and Mike Pence wasn't as bad as last week's dumpster fire of a Presidential "debate" between Donald Trump and Joe Biden. The questions were mostly better, and neither Pence nor Harris screamed at each other. On the other hand, the moderator did a terrible job of cutting Pence off when he ran over his time limit or interrupted Harris, and just as importantly, Pence flat-out refused to answer most of the questions at all, often instantly changing the subject to whatever he happened to feel like talking about with zero pushback from moderator Susan Page.
The Delaware Insurance Dept. has posted the approved 2021 individual market rates and it's about as unexciting as you can imagine: There's a single carrier in the state (Highmark BCBS), which asked for a 0.5% average premium reduction and was approved for...a 1.0% average premium reduction. Unsubsidized Delaware enrollees will average around $80 in savings per year.
In early August, the Arkansas Insurance Dept. posted the preliminary 2021 rate filings for the individual & small group market. At the time, the carriers were requesting average increases of 7.0% for ACA indy market plans and a slight drop of 0.3% for the small group market.
The approved rate filings have now been published, and the increases have been cut in half on the individual market to just 3.4%, while the small group market is slightly lower still (-0.4%) due to a revision in the estimated number of current enrollees:
2021 Minnesota health insurance rates continue to show stability for another year; expanded consumer choice across the state
ST. PAUL, Minn.—The Minnesota Department of Commerce announced final 2021 Minnesota health insurance rates today, which will remain stable across the state. For the 2021 plan year, 80 counties have three or more health insurance companies offering plans on the exchange, compared to just 31 counties with three or more in 2020. Ninety-seven percent of Minnesotans buying health insurance through MNsure will have an average of 30 different qualified health plans and three or more carriers to choose from.
Five health insurance companies are partnering with MNsure for the 2021 plan year: BluePlus, HealthPartners, Medica, UCare, and newly added Quartz, a Madison-based insurer offering plans in some southeastern Minnesota counties. Quartz will be offering 14 qualified health plans on the exchange. Additionally, dental plans will be available from Delta Dental and Dentegra.
The data below comes from the GitHub data repositories of Johns Hopkins University, except for Rhode Island, Utah and Wyoming, which come from the GitHub data of the New York Times due to the JHU data being incomplete for these three states. Some data comes directly from state health department websites.
Note that a few weeks ago I finally went through and separated out swing districts. I'm defining these as any county which where the difference between Donald Trump and Hillary Clinton was less than 6 percentage points either way in 2016. There's a total of 198 Swing Counties using this criteria (out of over 3,200 total), containing around 38.5 million Americans out of over 330 million nationally, or roughly 11.6% of the U.S. population.
With these updates in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Saturday, October 3rd (click image for high-res version). Blue = Hillary Clinton won by more than 6 points; Orange = Donald Trump won by more than 6 points; Yellow = Swing District
November 3rd is just 33 days away. At least 2.2 million Americans have already voted as of this writing. The #TexasFoldEm Trump/GOP lawsuit to strike down the entire ACA is scheduled to be heard by the Supreme Court on November 10th...and Donald Trump, Mitch McConnell & Lindsey Graham are pushing as hard as possible to ram through ultra-right wing ideologue and anti-ACA zealot Amy Coney Barrett as quickly as they can.
Meanwhile, 1,000 people are still dying and 40,000 or so are still testing positive for COVID-19 each day.
Needless to say, tensions are high and Democrats have a much weaker hand when it comes to saving the ACA from oblivion than they did a couple of weeks ago.
So, as the clock ticks down to both 11/03, 11/10 and 1/20, both GOP Senate Majority Leader Mitch McConnell and Democratic Senate Minority Leader Chuck Schumer are playing a few mostly symbolic cards along the way.
It was a little over a year ago that New Jersey legislators passed, after some last-minute drama, a bill to follow in the footsteps of Nevada and split off from the federal ACA exchange, HealthCare.Gov (there's actually a dozen other states which also operate their own full state-based exchanges as well, but 11 of them were never hosted by the federal exchange in the first place. The exception is Idaho, which was hosted by HC.gov for one year before splitting off, but that was always their plan from the start).
New Jersey's ACA portal website, Get Covered NJ, has actually been live for two enrollment periods already, but until now it was just that--an information portal only. The actual healthcare policy shopping/enrollment process was still handled through HealthCare.Gov.
