Press Release: As Key Enrollment Deadline Approaches, NY State of Health is Urging Consumers to Sign up Today for Health Coverage Starting January 1
ALBANY, N.Y. (December 29, 2020) - NY State of Health, New York’s official health plan Marketplace today is reminding New Yorkers who are applying for Qualified Health Plan coverage, there is still time to enroll for health coverage effective January 1, 2021. In response to the COVID-19 pandemic, NY State of Health is giving New Yorkers more time to enroll in Qualified Health Plan Coverage – consumers who sign up by December 31, 2020, will have coverage starting January 1, 2021.
“High-quality, affordable health coverage is more important than ever as the pandemic continues to surge,” said NY State of Health Executive Director, Donna Frescatore. “With the December 31 deadline quickly approaching we encourage anyone who needs coverage to view their options, sign up today and start the New Year with appropriate coverage.”
It's unsurprising the nation's hospital lobby lost its latest legal challenge in the case to force hospitals to reveal the negotiated rates they reach with insurers for services provided to patients.
The three-judge panel was highly skeptical of the hospital lobby's claims when it heard oral arguments in October and pushed back in their line of questioning.
...The undoing of the case may have been when AHA's litigator told judges certain prices are "unknowable."
That only provoked more questions from primarily two of the three judges who seemed baffled by the assertion that prices were unknowable. Judges Merrick Garland and Tatel — both appointed by former President Bill Clinton — launched into a lively line of questioning about the cost of X-rays.
...The hospital lobby had argued that it's impossible to know the rates because in some instances a patient may require more care than was originally anticipated.
Normally I receive notices about these types of data reports directly from CMS via their mailing list, but this time around it wasn't emailed and in fact isn't even posted on the CMS newsroom archive (at least not yet). Fortunately, my eagle-eyed colleague Andrew Sprung grabbed the link from a Health Affairs article and wrote up his own analysis of it.
Final Days to Enroll in Health Insurance at Get Covered New Jersey for January 1st Coverage
Residents Must Enroll by Dec. 31 for Coverage Beginning in the New Year; 8 in 10 Qualify For Financial Help
TRENTON – Department of Banking and Insurance Commissioner Marlene Caride today reminded New Jersey residents that there are three days left to enroll in health coverage that starts on the first of the year. New Jersey residents can shop for quality, affordable health insurance at the state’s official health insurance marketplace, Get Covered New Jersey. Residents must select a plan by December 31, 2020 for coverage beginning January 1, 2021.
Final Deadline for Health Insurance in Idaho is December 31
Your Health Idaho anticipates increased activity following deadline extension
BOISE, Idaho – Idahoans looking to find 2021 health insurance coverage still have a few days left to enroll through the state health insurance exchange, Your Health Idaho.
After extending the original deadline from Dec. 15, exchange officials are urging Idahoans to apply for the monthly health insurance tax credit and make their final plan selection by 11:59 p.m. (MT) on Thursday, Dec. 31.
“I cannot stress enough how important this final deadline is for Idahoans,” said Pat Kelly, Your Health Idaho Executive Director. “Even if you are unsure if you will qualify, this is the last chance to complete an application and find out if you are eligible for lower-cost coverage through Your Health Idaho.”
The first major open-enrollment deadline is this week: Consumers who want their coverage to start on Jan. 1 need to sign up by Dec. 30.
The deadline comes as COVID-19 infections and deaths continue to rise across California, with hospitals overloaded with patients and limited ICU bed capacity.
Having health care coverage, staying COVID-safe and getting vaccinated when you are able to are critical to helping overcome the pandemic.
More than 1.2 million Californians are uninsured right now, even though they are eligible for financial help from Covered California, or low-cost or no-cost coverage through Medi-Cal.
Covered California’s open-enrollment period runs through Jan. 31.
The data below comes from the GitHub data repositories of Johns Hopkins University, except for Utah, which comes 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.
I've made some more changes:
I've now completed updating the partisan lean for every county except Alaskato the 2020 Biden/Trump results. Alaska still uses the Clinton/Trump 2016 results, although I can't imagine more than one or two regions changed status there this year.
I've also added columns listing the actual Biden/Trump vote percentage for each county to give a feel for how partisan it is. Again, I'm defining "Swing District" as any county where the difference is less than 6.0%. There's 188 swing districts (out of over 3,100 total), with around 33.8 million Americans out of 332 million total, or roughly 10.2% of the U.S. population.
I've also added all U.S. territories, including a county-equivalent breakout for Puerto Rico, as well as American Samoa, Guam and the U.S. Virgin Islands. None of these vote in the general Presidential election, of course, but I'm still tracking their COVID-19 case & death rates. None show up in the top 100 of either ranking, however. Note that Puerto Rico only includes the case breakout, not deaths, which are unavailable for some reason.
With these updates in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Friday, December 25th (click image for high-res version).
Blue = Joe Biden won by more than 6 points; Orange = Donald Trumpwon by more than 6 points; Yellow = Swing District
I've done my best to label every state/territory, which obviously isn't easy to do for most of them given how tangled it gets in the middle. For cases per capita, the most obvious point is that New York and New Jersey, which towered over every other state last spring, are now utterly dwarfed by North & South Dakota, although their surge seems to be finally dropping (although "dropping" is a relative term...it's still pretty awful everywhere).
North and South Dakota are the first two states where more than 10% of the entire population has tested positive (in fact, North Dakota is about to hit 12%). A few other states could all potentially hit the 10% milestone by New Year's Eve as well.
UPDATE 12/31/20: The deadline to submit public comments has passed. In the end, there are 320 comments, 243 of which were submitted after I posted this entry. The wording on a random check of some finds that at least a couple dozen appear to have been guided by my own sample comment below, which I'm glad to see.
Now we'll just have to wait and see. Thank you to everyone who helped out!
Last month, I wrote about the annual Notice of Benefit & Payment Parameters for 2022 (NBPP) from the Centers for Medicare & Medicaid (CMS). This is a long, wonky document published each year which includes a bunch of proposed modifications to various aspects of how the ACA is administered and implemented.
Some of the proposed changes each year are pretty much mandatory. Some are completely up to whoever is running CMS/HHS at the time. Some are nominal tweaks; some are major changes.
Way back in October 2013, I launched the ACA Signups project as a light, nerdy hobby thing which was only supposed to last around six months, through the end of the first ACA Open Enrollment Period (March 31, 2014). Instead...well, let's just say that it's more than seven years later and I'm still doing this.
The reality is that The Graph itself doesn't serve a whole lot of useful function anymore. The enrollment patterns were erratic the first couple of years but have since settled into a pretty predictable...if not downright boring pattern for both the federal and state exchanges. The main reason I keep doing it each year is mostly out of tradition these days; after all, without The Graph, there wouldn't be an ACA Signups and I wouldn't have become a healthcare policy wonk in the first place.
There's a bunch of useful wonky data stuff, but for purposes of this entry, it's slides 18 & 19 which are of particular interest. Most state-based ACA exchanges don't launch Open Enrollment until November 1st, but Covered California opens up re-enrollment for current members earlier. Usually they let current members renew for the upcoming year as early as October 15th, but this year they moved that up even sooner, to October 1st.
As a result, while they haven't put out any official press releases about it, as of November 16th, over 1.4 million of their ~1.5 million existing enrollees had already been re-enrolled for 2021. In addition, they had another 32,000 Californians sign up in the first two weeks of November.
NJ Department of Banking and Insurance Cautions Residents Shopping for Health Insurance Against Health Plans that Do Not Provide Comprehensive Coverage
Warning Follows Action Against Aliera, Trinity for Using Deceptive Practices and Misleading Consumers
TRENTON — New Jersey Department of Banking and Insurance Commissioner Marlene Caride today urged residents shopping for health insurance this open enrollment period to be aware of health plans with limited coverage that – unlike the health plans available at Get Covered New Jersey, the state’s official health insurance Marketplace – do not cover basic services and pre-existing conditions.
MNsure sees 4% increase in signups during this year's open enrollment period
More than 155,000 Minnesotans found coverage through MNsure.org
ST. PAUL, Minn.—From November 1 to December 22, 2020, more than 155,000 Minnesotans found health insurance coverage during MNsure's eighth open enrollment period. A total of 122,269 Minnesotans signed up for private health plans through the exchange, which is 4,729 more than the previous open enrollment period.
It's worth noting that the way MNsure categorizes ACA exchange enrollees is slightly different than how CMS does...according to the official 2020 Open Enrollment Period Report Public Use File, Minnesota only actually enrolled 110,042 people during last year's OEP. I'm not sure what happened to the 12,227 QHP selection difference, but assuming this year's 122.3K figure holds by CMS, it means they're actually up 11.1% year over year, not just 4.0%.
This is interesting...I just received the following email from the Michigan Dept. of Insurance & Financial Services
Michigan Joins Group of State Insurance Commissioners to Provide ACA Policy Recommendations to President-elect Biden
Anita Fox, Director of the Michigan Department of Insurance and Financial Services (DIFS), has joined a group of state insurance commissioners in a pledge to work with President-elect Joe Biden by providing health policy recommendations to the incoming administration.
The commissioners share President-elect Biden’s vision that no American should have to go without health care coverage. They believe comprehensive and progressive health care is essential to addressing urgent public health priorities, such as the COVID-19 and opioid crises, addressing racial disparities in the health care system, and ensuring enforcement of mental health parity.
DENVER (KDVR) — Laura Packard was diagnosed with stage 4 Hodgkins-Lymphoma cancer in 2017. The 44-year-old moved from Nevada to Colorado in 2019 for one reason: the state’s heath insurance exchange that provides affordable options to individuals who otherwise can’t get coverage.
Doctors at UCHealth have continued to treat Packard to make sure she stays cancer-free.
I'm not gonna dig back through the past 5 election cycles to verify whether this claim is accurate or not, but I did at least check into it for the most recent election last month.
Covered California Joins African-American Health Leaders Urging Californians to Get COVID-19 Vaccinations and Encouraging Consumers to Get Covered in 2021
MNsure's Open Enrollment Period Ends Tuesday, December 22 at Midnight
December 21, 2020
ST. PAUL, Minn.—Minnesotans looking for private health insurance beginning January 1, 2021, have until 11:59 p.m. on Tuesday, December 22 to enroll in coverage through MNsure.
"Don't miss your chance to get health insurance coverage in the new year," said MNsure CEO Nate Clark. "Come to MNsure.org to compare your options and see if you qualify for financial benefits to lower the cost of your insurance—most Minnesotans do! Get enrolled today and have the peace of mind that comes with knowing you’ve got comprehensive health coverage."
MNsure's Contact Center is open from 8 a.m. to 9 p.m. on Monday, December 21 and 8 a.m. to midnight on Tuesday, December 22.
Most people qualify for financial help. Minnesotans can see their estimated eligibility for financial help by using MNsure's plan comparison tool.
I'm over a month late on this, but the DC Health Benefit Exchange Authority issued a mid-OEP enrollment report at their November board meeting (unfortunately they don't appear to have done so at their December meeting), so here it is as of 11/16.
Ther's not a whole lot of interest here, but it's worth noting that DC's effectuated enrollment in November was 7.6% higher than a year ago. This is again likely due to the extended "open" COVID-19 Special Enrollment Period in 2020:
Well, for good or for bad, it's finally here: The stripped-down-but-bipartisan COVID19 relief bill.
You can read the whole thing here...if you have a LOT of spare time on your hands. It's 5,600 pages long, 1.1 million words. For context, the entire Lord of the Rings trilogy is only half that length (576,000 words).
There's 1,000 explainers being written today about the most obvious stuff (the $600 direct relief checks, the extended & enhanced unemployment funding, etc etc), most of which falls far short of what's actually needed. Instead, I'm focusing on the ACA-related provisions. I already wrote about the surprise billing prohibition this morning, of course, but a quick initial scan of the text (which isn't easy...again, 5,600 pages...) reveals several other items directly related to the Affordable Care Act, so let's take a look! (Note: I'm sure I'm missing a few):
Over six months after House Democrats passed a robust COVID-19 relief bill (only to see it continuously blocked by Republican Senate Majority Leader Mitch McConnell), it looks like Congress is finally set to compromise on a vastly stripped-down bipartisan bill which would provide at least a small amount of relief for hundreds of millions of American families and businesses.
While the bill is underwhelming (to put it mildly) overall, it does include several important provisions, one of which is a long-sought solution to a massive healthcare problem which existed long before COVID came knocking at our door nearly a year ago: Surprise Billing.
The data below comes from the GitHub data repositories of Johns Hopkins University, except for Utah, which comes 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.
I've made some more changes:
I've now completed updating the partisan lean for every county except Alaska (I'm having trouble getting that broken out by "County-Equivalent Region") to the 2020 Biden/Trump results. Alaska still uses the Clinton/Trump 2016 results, although I can't imagine more than one or two regions changed status there this year.
I've also added columns listing the actual Biden/Trump vote percentage for each county to give a feel for how partisan it is. Again, I'm defining "Swing District" as any county where the difference is less than 6.0%. There's 188 swing districts (out of over 3,100 total), with around 33.8 million Americans out of 332 million total, or roughly 10.2% of the U.S. population.
I've also added all U.S. territories, including a county-equivalent breakout for Puerto Rico, as well as American Samoa, Guam and the U.S. Virgin Islands. None of these vote in the general Presidential election, of course, but I'm still tracking their COVID-19 case & death rates. None show up in the top 100 of either ranking, however. Note that Puerto Rico only includes the case breakout, not deaths, which are unavailable for some reason.
Finally, I corrected a significant error on my part in the Blue/Red County Ratio graph (see below)
With these updates in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Friday, December 18th (click image for high-res version).
Blue = Joe Biden won by more than 6 points; Orange = Donald Trumpwon by more than 6 points; Yellow = Swing District
From the state totals one obvious pattern leaps out: enrollment is up 9.7% in states that have not enacted the ACA Medicaid expansion -- and down 0.5% in states that have expanded the expansion (including Nebraska, which opened the Medicaid expansion doors in October of this year).
Access Health CT, Connecticut's state-based ACA exchange, has updated their enrollment summary and now reports 102,049 residents have selected policies for 2021, including 15,310 new enrollees.
Last year they had a total of 107,833 QHP selections during Open Enrollment, which they're just 5.4% away from breaking.
In addition, as noted a few days ago, they're also extending their deadline by a full month (whcih they also did last year):
I was doing this earlier in the summer but stopped updating it in August; I've started over with a fresh spreadsheet and have expanded it to include every U.S. territory, including not just DC & Puerto Rico but also American Samoa, Guam, the U.S. Virgin Islands and even the Northern Mariana Islands.
I've done my best to label every state/territory, which obviously isn't easy to do for most of them given how tangled it gets in the middle. The most obvious point is that New York and New Jersey, which towered over every other state last spring, are now utterly dwarfed by North & South Dakota, which are skyrocketing.
North and South Dakota are the first two states where more than 10% of the entire population has tested positive (in fact, North Dakota is about to hit 12%. Iowa, Wisconsin, Nebraska and Utah could all potentially hit the 10% milestone by New Year's Eve as well.
Way back in October 2013, I launched the ACA Signups project as a light, nerdy hobby thing which was only supposed to last around six months, through the end of the first ACA Open Enrollment Period (March 31, 2014). Instead...well, let's just say that it's more than seven years later and I'm still doing this.
The reality is that The Graph itself doesn't serve a whole lot of useful function anymore. The enrollment patterns were erratic the first couple of years but have since settled into a pretty predictable...if not downright boring pattern for both the federal and state exchanges. The main reason I keep doing it each year is mostly out of tradition these days; after all, without The Graph, there wouldn't be an ACA Signups and I wouldn't have become a healthcare policy wonk in the first place.
In Week Six of the 2021 Open Enrollment period, 4,416,057 people selected plans using the HealthCare.gov platform or were automatically re-enrolled in a plan. While past snapshots this year have measured enrollment weeks Sunday through Saturday, this week’s snapshot for week six also includes the final few days of the Open Enrollment Period.
Deadline to Get Health Insurance Extended Idahoans have until December 31 to get covered for 2021
Today, for the first time ever, the Your Health Idaho Board of Directors voted to extend the Open Enrolment deadline. Idahoans now have until Dec. 31, 2020, to sign up for health insurance coverage that begins Jan. 1, 2021.
Your Health Idaho saw the largest single-day enrollment since 2018 on Tuesday, Dec. 15, the original deadline date. This increased activity coupled with ongoing impacts from the coronavirus pandemic spurred Your Health Idaho to extend the deadline.
“An unprecedented year calls for unprecedented measures,” said Your Health Idaho Chairman of the Board, Stephen Weeg. “Given the challenges faced by Idahoans in 2020 and the renewed need for comprehensive health insurance, we hope that by extending the deadline a few more weeks, every Idahoan will have access to the coverage they need for the coming year.”
Earlier this week California bumped out their "soft" enrollment deadline for January coverage from 12/15 to 12/30. Yesterday Colorado bumped theirs out to 12/18, and Connecticut tacked on an entire extra month to their Open Enrollment Period (though enrollees there won't start coverage until February at this point).
Press Release: NY State of Health Reminds New Yorkers There is Still Time to Sign up for Coverage that Begins on January 1, 2021
Dec 17, 2020
(ALBANY, N.Y) December 17, 2020-- NY State of Health, New York’s official health plan Marketplace today announced New Yorkers applying for Qualified Health Plan coverage have until December 31 to sign up for health coverage starting January 1, 2021. Individuals who were unable to enroll by the December 15 deadline should enroll now by visiting the NY State of Health website.
DENVER – Connect for Health Colorado®, the official health insurance marketplace for Coloradans, has formally launched a Public Benefit Corporation (PBC).
The PBC will offer health care ancillary products and services across the state as well as work to increase Coloradans’ health literacy.
This new organization will be a wholly-owned subsidiary of Connect for Health Colorado and will be a separate entity from Connect for Health Colorado. It will not affect residents’ ability to buy Qualified Health Plans and apply for financial help through our Marketplace.
On the surface, the purpose of this PBC seems a bit vague...it sounds like it has something to do with the ACA Navigator program to help people shop for insurance on the exchange, to help them enroll in Medicaid and so forth...and those may still be part of its mission.
Total national healthcare spending in 2019 grew 4.6%, which was similar to the 4.7% growth in 2018 and the average annual growth since 2016 of 4.5%, according to a study conducted by the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS) and published today ahead of print by Health Affairs.
This report includes health expenditure data though 2019 and therefore does not include any of the effects of the coronavirus disease 2019 (COVID-19) pandemic on health care spending. Future reports for 2020 forward will measure health expenditures based on the latest available data and will reflect the impacts of the pandemic on total health care spending as well as on the distribution of spending among the services, payers, and sponsors of health care.
Way back in October 2013, I launched the ACA Signups project as a light, nerdy hobby thing which was only supposed to last around six months, through the end of the first ACA Open Enrollment Period (March 31, 2014). Instead...well, let's just say that it's more than seven years later and I'm still doing this.
The reality is that The Graph itself doesn't serve a whole lot of useful function anymore. The enrollment patterns were erratic the first couple of years but have since settled into a pretty predictable...if not downright boring pattern for both the federal and state exchanges. The main reason I keep doing it each year is mostly out of tradition these days; after all, without The Graph, there wouldn't be an ACA Signups and I wouldn't have become a healthcare policy wonk in the first place.
Governor Hogan and Maryland Health Connection Announce Record Enrollment for Health Coverage
ANNAPOLIS, MD—Governor Larry Hogan today announced that more than 166,000 Marylanders enrolled in private health coverage for 2021 through Maryland Health Connection—the largest enrollment ever on the state’s health insurance marketplace—which represents a 4.5% increase of about 7,100 enrollees since the previous year.
“I am pleased to see so many Marylanders taking advantage of our state’s impressive health insurance marketplace, especially as we battle the COVID-19 pandemic, ” said Governor Hogan. “With one of the longest COVID-19 special enrollment periods in the country, we continue to work to increase healthcare access and affordability in Maryland.”
In the spring of 2017, I was diagnosed with cancer (stage 4 Hodgkin’s Lymphoma). After a grueling 6 months of chemotherapy and a month of radiation treatment, I am in remission. For now. Hopefully forever.
The Affordable Care Act saved my life. But all the time I was fighting cancer, I had to fight my own U.S. Senator and my President in order to keep my health insurance. The day after my first chemotherapy session, the Republican House voted to dismantle the ACA. The “skinny repeal” of Obamacare was voted down in the Senate by one vote a couple days before my 7th chemo session. And the day after my 15th radiation session, I was thrown out of my (former!) U.S. Senator’s public forum for asking him about his health care record.
Washington Healthplanfinder Sees Surge in Customers as Final 2021 Deadline Approaches
Select a plan by Jan. 15 for coverage that begins Feb. 1
People statewide flocked to Washington Healthplanfinder this week to beat the Dec. 15 deadline for health coverage that would start the first of the year. With that date now passed, Washingtonians still seeking 2021 health coverage have until Jan 15, 2021 to shop on Washington Healthplanfinder for coverage that begins February 1.
“We were glad to see the large number of enrollees come in and secure coverage that starts Jan. 1,” said Chief Executive Officer Pam MacEwan. “This year, in response to the public health emergency, we are providing additional time for those who didn’t enroll prior to Dec. 15 to sign up for 2021 coverage over the next month.”
According to IRS National Taxpayer Advocate Erin Collins, IRS sent 1.8 million letters seeking more information from taxpayers who either failed to reconcile their tax credits or had discrepancies on their forms this year. But staff cuts and other problems stemming from the pandemic have stymied IRS’ work, and the agency still has about 1 million returns waiting to be processed, 3 million pieces of unopened mail and about 6.8 million individual returns still in process. As a result, even if taxpayers provided all requested information, the data that IRS shared with the marketplace might be inaccurate or incomplete, Collins says in a Nov. 25 blog published by the IRS’ Taxpayer Advocacy Service.
It's turned into an annual tradition: The official annual ACA Open Enrollment Period (OEP) runs from November 1st - December 15th, but most of the state-based ACA exchanges have later deadlines. hThen, right around the 12/15 point, it begins: One by one, some of the state-based exchanges announce further extensions of their deadlines to #GetCovered for the upcoming year.
In some cases they simply bump out the deadline for coverage starting in January, with the final "hard" deadline for February or March coverage staying where it is. In other cases they were never allowing Open Enrollment start dates past January to begin with, so it's the hard deadline which is being extended.
In any event, here's this year's batch of announcements; note that this list could grow longer over the next week or two:
Access Health CT Extends 2021 Annual Open Enrollment Period As A Result Of Current Health Crisis
CT residents can shop and enroll in health insurance coverage until January 15, 2021
Access Health CT extended the 2021 Annual Open Enrollment period until January 15, 2021 as a result of the current health crisis, providing more time for CT residents to get covered.
If individuals choose a plan during the extension, the coverage will start on February 1, 2021.
If customers are already covered by an insurance plan through Access Health CT for January 2021 and would like to pick a new plan starting in February 2021, they must first pay their January monthly bill (premium).
HARTFORD, Conn. (December 16, 2020)—Access Health CT (AHCT) today announced an extension for the 2021 Annual Open Enrollment period until January 15, 2021 as a result of the current health crisis, providing more time for CT residents to get covered.
Connect for Health Colorado Offers Coloradans Through Dec. 18 to Enroll in Health Insurance Starting Jan. 1
DENVER — To help as many people as possible sign up for health insurance that begins on the first day of 2021, Connect for Health Colorado has decided to extend the deadline for January 1 coverage to this Friday, Dec. 18.
“Too many Coloradans have been left unemployed, uninsured and are struggling to get by as the pandemic grows,” said Chief Executive Officer Kevin Patterson. “By giving people a few extra days this week to get the coverage they need right on January 1st, we can ease some of the strain people are feeling. Financial help is available to reduce costs and local experts can also provide free enrollment assistance.”
Today, they posted a much more detailed breakout of their enrollment data so far, as well as reminding residents that unlike most states, New Jersey's Open Enrollment Period isn't over until the end of January, although they have to enroll by December 31st for coverage starting January 1st:
There's no formal press release, but Pennie, Pennsylvania's brand-new state-based ACA exchange just noted via their official Twitter account that they're extending the enrollment deadline for coverage starting January 1st by one week:
IMPORTANT ANNOUNCEMENT! We have extended the deadline! You now have until Tuesday, December 22 to select health coverage that begins New Year’s Day.
The Final Countdown; MNsure's Open Enrollment Period Ends December 22 at Midnight
ST. PAUL, Minn.—Minnesotans looking for health insurance coverage starting January 1, 2021, have until 11:59 p.m. on Tuesday, December 22 to enroll in coverage through MNsure.org. The federal health insurance exchange, HealthCare.gov, ends its enrollment period today, but Minnesotans have an extra week to enroll through MNsure.
"There is still time to get 2021 health care coverage through MNsure," said MNsure CEO Nate Clark. "Minnesotans have through December 22 to sign up for comprehensive health insurance and access the financial help that makes it more affordable. But, don’t wait! Visit MNsure.org today so you can be sure you’re covered in the new year."
Need help? MNsure's Contact Center will provide extended hours leading up to the deadline:
Washington Healthplanfinder Urges Customers to Act Now for Jan. 1 Health Coverage
People need to enroll in their desired 2021 health plan by midnight, Tuesday Dec. 15
Washington Healthplanfinder is urging individuals needing 2021 health and dental coverage beginning Jan. 1 that they have less than 36 hours to take action and sign up. Customers wanting coverage that starts Jan.1 must select a plan through Washington Healthplanfinder by 11:59 p.m. this Tuesday, Dec. 15.
“For those who have left this decision to the last minute, now is the time to sign up for 2021 health and dental coverage,” said the Exchange Chief Executive Officer Pam MacEwan. “There are plenty of resources available to help people understand their options and secure health insurance coverage.”
While most of the country’s Exchanges prepare to conclude their Open Enrollment Periods, Nevada Health Link remains open through January 15, 2021 to purchase 2021 coverage
Nevadans have 30 more days to get covered Nearly 72,000 Nevadans have enrolled to date
Carson City, Nev. – While most of the country prepares to conclude their open enrollment periods s this week on Dec. 15, Nevadans have an additional 30 days to enroll in health insurance coverage for 2021. Now through Jan. 15, 2021, Nevada Health Link, the online health insurance marketplace operated by the Silver State Health Insurance Exchange (Exchange), remains open and available for Nevadans to purchase comprehensive, Affordable Care Act (ACA) compliant health plans for 2021. As a State Based Exchange (SBE), Nevada Health Link makes its own decisions and is autonomous from the federal marketplace – HealthCare.gov – therefore allowing for an extended Open Enrollment Period (OEP), which is one of the many advantages to operating as a SBE.
The COVID-19 pandemic continues to surge across the nation, endangering Americans and filling our hospitals from coast to coast. In the middle of this rising crisis, nearly 80 percent of the health insurance marketplaces, including all of those supported by the federally facilitated exchange (FFE) and a small number of state-based exchanges, are set to close their open-enrollment periods on December 15th.
We are writing to recommend that the Centers for Medicare and Medicaid Services (CMS) extend the Healthcare.gov open-enrollment period through January 31st or, at a minimum through December 30th, to allow Americans more time to sign up for health care coverage during this pandemic.
As COVID-19 Pandemic Surges Across the State, Covered California Takes the Unprecedented Step of Giving Consumers Until Dec. 30 to Sign up Up for Coverage that That Begins on Jan. 1
The data below comes from the GitHub data repositories of Johns Hopkins University, except for Utah, which comes 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.
I've made some more changes:
I've now completed updating the partisan lean for every county except Alaska (I'm having trouble getting that broken out by "County-Equivalent Region") to the 2020 Biden/Trump results. Alaska still uses the Clinton/Trump 2016 results, although I can't imagine more than one or two regions changed status there this year.
I've also added columns listing the actual Biden/Trump vote percentage for each county to give a feel for how partisan it is. Again, I'm defining "Swing District" as any county where the difference is less than 6.0%. There's 188 swing districts (out of over 3,100 total), with around 33.8 million Americans out of 332 million total, or roughly 10.2% of the U.S. population.
Finally, new this week: I've added all of the U.S. territories, including a county-equivalent breakout for Puerto Rico, as well as American Samoa, Guam and the U.S. Virgin Islands. None of these vote in the general Presidential election, of course, but I'm still tracking their COVID-19 case & death rates. None show up in the top 100 of either ranking, however.
With these updates in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Friday, December 11th (click image for high-res version).
Blue = Joe Biden won by more than 6 points; Orange = Donald Trumpwon by more than 6 points; Yellow = Swing District
I was doing this earlier in the summer but stopped updating it in August; I've started over with a fresh spreadsheet and have expanded it to include every U.S. territory, including not just DC & Puerto Rico but also American Samoa, Guam, the U.S. Virgin Islands and even the Northern Mariana Islands.
I've done my best to label every state/territory, which obviously isn't easy to do for most of them given how tangled it gets in the middle. The most obvious point is that New York and New Jersey, which towered over every other state last spring, are now utterly dwarfed by North & South Dakota, which are skyrocketing.
North and South Dakota are the first two states where more than 10% of the entire population has tested positive (in fact, North Dakota is past 11% already. Iowa, Wisconsin, Nebraska and Utah could all potentially hit the 10% milestone by New Year's Eve as well.
Access Health CT, Connecticut's ACA exchange, is posting updates to their Open Enrollment Period (OEP) numbers every Friday. Last week they reported 91,965 Qualified Health Plan (QHP) selections during the first 34 days of the 2021 OEP, which sounds more impressive than it is, since most of those were current enrollees having their auto-renewals front-loaded; only 7,500 of them were actually new enrollees. Nothing wrong with that, of course.
I'm pretty sure the reason for the discrepancy is that, like some other state-based exchanges, AccessHealthCT front-loads auto-renewals of all of their current enrollees, then allows them to actively go in and manually cancel their renewals. So, if they have 100K enrolled this year, they'd plug all of them in for 2021, then wait and see how many choose not to stay enrolled for 2021.
Way back on January 17th, 2020, I posted a long, wonky blog entry about how important risk pools are, using my own family making the move from an ACA exchange plan to a university student plan as an example. It included several data-entry system errors which made the switch more complicated than it should have been, though everything was straightened out in the end.
This morning, in response to a tweet by Sarah Kliff referencing an article by Margot Sanger-Katz about the difficulty of choosing the right health insurance policy, I was reminded of my own post from nearly a year ago and decided to re-read it.
Way back in October 2013, I launched the ACA Signups project as a light, nerdy hobby thing which was only supposed to last around six months, through the end of the first ACA Open Enrollment Period (March 31, 2014). Instead...well, let's just say that it's more than seven years later and I'm still doing this.
The reality is that The Graph itself doesn't serve a whole lot of useful function anymore. The enrollment patterns were erratic the first couple of years but have since settled into a pretty predictable...if not downright boring pattern for both the federal and state exchanges. The main reason I keep doing it each year is mostly out of tradition these days; after all, without The Graph, there wouldn't be an ACA Signups and I wouldn't have become a healthcare policy wonk in the first place.
Governor Wolf Declares Dec. 10 Get Covered 2021 Pennsylvania Day in Support of the National Initiative, Get Covered 2021
Pennie stressed the December 15 plan selection deadline and the connection between health coverage and COVID-19 safety
Harrisburg, PA – December 10, 2020 – Today, Pennsylvania leadership announced a statewide partnership with Get Covered 2021 and re-emphasized the vital role that health coverage plays in the overall health and well-being of all Pennsylvanians. Improving access to affordable, quality health coverage is a priority for Pennie, Pennsylvania’s new state-based health insurance marketplace.
Get Covered 2021 is a national initiative promoting COVID-19 safety precautions and the importance of having health coverage. Pennie, in partnership with Pennsylvania leadership, along with 15 other states and Washington D.C., hundreds of health associations, sports figures, and celebrities have joined together to help spread the word to “mask up and get covered.”
Governor Murphy Designates December 10th “Get Covered Day,” Encourages New Jerseyans to Get Covered During Open Enrollment
Proclamation is part of Get Covered 2021, a National Campaign to Prevent the Spread of COVID-19 & Encourage Residents to Enroll in Health Coverage
TRENTON — Joining with state partners from across the country in encouraging residents to enroll in health insurance during the Affordable Care Act Open Enrollment Period, Governor Phil Murphy issued a proclamation designating today, December 10, 2020, as “Get Covered Day” in New Jersey. Department of Banking and Insurance Commissioner Marlene Caride reminded residents that the deadline to enroll for coverage starting in the New Year is December 31st.
Over 200,000 have signed up for health coverage; Get covered by December 15 on Washington Healthplanfinder
Beat the rush by signing up today on Get Covered Day #GetCovered2021
OLYMPIA, Wash. -- As sign ups continue to increase, Washington Healthplanfinder reminds individuals today, Get Covered Day, to visit WA HealthPlan Finder to secure their health and dental coverage by Dec. 15 to ensure a start date of Jan. 1, 2021.
As of Dec. 10, over 200,000 Washingtonians have signed up for 2021 coverage, 5% more than last year at this time, and one person every 17 seconds. Among the 20,000 new customers, over 40% have selected a new Cascade Care plan. These new plans offer deductibles that are on average $1,000 less than other plans, and cover more services prior to meeting a deductible, including primary care visits, mental health services, and generic drugs.
Less Than One Week to Enroll in 2021 Health Insurance
Your Health Idaho extends customer support hours ahead of Dec. 15 deadline
BOISE, Idaho – Idahoans have until 11:59 p.m. (MT) on Tuesday, Dec. 15, to enroll in 2021 health insurance coverage through Your Health Idaho, the state insurance exchange. After open enrollment ends, Idahoans will not be able to enroll in coverage unless they qualify for a Special Enrollment Period.
“As expected after the Thanksgiving holiday, we have seen an increased interest from Idahoans looking to enroll in 2021 health insurance coverage,” said Your Health Idaho Executive Director, Pat Kelly. “To ensure consumers are getting the help they need, Your Health Idaho has expanded business hours through December and implemented new contact options.”
Way back in October 2013, I launched the ACA Signups project as a light, nerdy hobby thing which was only supposed to last around six months, through the end of the first ACA Open Enrollment Period (March 31, 2014). Instead...well, let's just say that it's more than seven years later and I'm still doing this.
The reality is that The Graph itself doesn't serve a whole lot of useful function anymore. The enrollment patterns were erratic the first couple of years but have since settled into a pretty predictable...if not downright boring pattern for both the federal and state exchanges. The main reason I keep doing it each year is mostly out of tradition these days; after all, without The Graph, there wouldn't be an ACA Signups and I wouldn't have become a healthcare policy wonk in the first place.
In Week Five of the 2021 Open Enrollment period, 915,118 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday.
Every week during Open Enrollment, the Centers for Medicare & Medicaid Services (CMS) will release enrollment snapshots for the HealthCare.gov platform, which is used by the Federally-facilitated Exchange and some State-based Exchanges. These snapshots provide point-in-time estimates of weekly plan selections, call center activity, and visits to HealthCare.gov or CuidadoDeSalud.gov.
The final number of plan selections associated with enrollment activity during a reporting period may change due to plan modifications or cancellations. In addition, the weekly snapshot only reports new plan selections and active plan renewals and does not report the number of consumers who have paid premiums to effectuate their enrollment.
“Get Covered America Day” — Dec. 10 — is a call to wear a mask to prevent the spread of COVID-19 and a public statement that you want your family and friends to get health insurance.
With COVID-19 cases surging nationally, the day is a call to action to encourage people to post a picture of themselves wearing a mask on social media, include a personal message about the importance of being COVID-safe and how friends, family and neighbors can get financial help for insurance now, sharing the website GetCovered2021.org and using the hashtag #GetCovered2021.
With an estimated 16 million uninsured Americans eligible for financial help — through their Affordable Care Act marketplace, or free coverage through Medicaid — Get Covered 2021 encourages people to check their health care options and get insured.
December 15 is the Deadline for Individuals to Enroll in Health Insurance Coverage for January
Pennie urges all Pennsylvanians seeking 2021 coverage to enroll this Open Enrollment
Harrisburg, PA – December 7, 2020 – Pennie, the state’s new health insurance marketplace is approaching its first enrollment deadline. December 15th is the last day for individuals and families to purchase health coverage starting January 2021. Current and potential customers are encouraged to select a plan by December 15 to ensure continuous coverage.
Pennie allows customers to compare and shop for medical and dental insurance from participating insurers, who are required to offer qualified, comprehensive plans. Pennie is also the only source for financial assistance to help lower the cost of coverage and care and nearly 9 out of 10 of customers qualify for financial assistance
Marketplace Enrollments Trending Higher During Pandemic; Deadline for Jan. 1 Coverage Approaches
DENVER – Through Dec. 6, more than 148,000 Coloradans have signed up for a health insurance plan through Connect for Health Colorado. Initial enrollment totals show that more Coloradans are getting covered this Open Enrollment Period as the pandemic grows in Colorado.
“I’m encouraged that so many people have signed up for a medical plan that will give them the coverage they need. I hope this also gives them some peace of mind going into the new year,” said Chief Executive Officer Kevin Patterson. “I urge Coloradans who haven’t enrolled yet to take advantage of the free enrollment assistance we offer. We’re here to help as many Coloradans as possible get covered for January 1st.”
Of all the elected officials who have been aping Donald Trump's horrific COVID-19 pandemic denialism, perhaps none have been worse (at least in terms of actual policy impact) than Republican South Dakota Governor Kristi Noem.
Not only has Gov. Noem refused to take any significant action to slow the spread of COVID-19, she's openly mocked those who do and is even starring in TV ads encouraging tourism of South Dakota based on her refusal to impose any reasonable measures using federal COVID-19 relief funding...even as South Dakota has become the second worst COVID hot spot in the nation (first place? SD's neighbor to the north...North Dakota).
The other day this depressing tweet was posted by the Dean of Brown University School of Public Health:
There were 225,000 new cases identified yesterday
Sat through Monday, cases will dip (usually do)
But we are now seeing Thanksgiving effect
Based on yesterday's cases alone Expect 5K-6K hospitalizations 12/11 (if hospitals can accommodate) and 4,000 deaths on 12/26
This was a very specific projection (especially the 4,000 deaths on 12/26) so I decided to do the math. Deaths have been lagging positive tests by around three weeks, give or take, so in theory you should just have to go back to see how many people tested positive 21 days earlier to get an idea of how many people will die on a given day...as well as letting you project the death toll up to three weeks ahead, as Dr. Jha did above.
I suppose this was inevitable, but it's grating nonetheless, and especially so given that we're in the middle of a pandemic which has caused tens of millions of Americans to lose their jobs:
The Supreme Court agreed Friday to consider a Trump administration plan to let states impose work requirements on some who receive health-care benefits under the Medicaid program for the poor.
Arkansas and New Hampshire want to continue programs halted by lower courts, and more than a dozen other states say they want to impose similar requirements.
But despite the Supreme Court’s willingness to take up the issue, the incoming Biden administration might have other ideas, and opponents called on it to reverse endorsement of the work requirements.
Physicians and health centers across the state announce they are reaching out personally to all their patients to encourage them to stay safe from COVID and get insurance coverage if they are eligible — many will receive Covered California’s masks to get the message out that now is the time to get covered and stay covered.
California’s leading provider organizations — including the California Hospital Association, California Medical Association, California Academy of Family Physicians, the California Primary Care Association and America’s Medical Groups — are making sure the trusted voice of physicians and other health care heroes are speaking to millions of Californians with the message of remaining vigilant until the vaccine arrives.
According to a survey conducted by Covered California, the pandemic continues to touch most Californians, finding that 52 percent of Californians say the pandemic has affected their lives significantly, more than 40 percent personally know someone who has tested positive for the virus, and more than one in four people knows someone who has died from COVID-19.
President-elect Joseph R. Biden Jr. has selected Xavier Becerra, the Democratic attorney general of California, as his nominee for secretary of health and human services, tapping a former congressman who would be the first Latino to run the department as it battles the surging coronavirus pandemic.
Mr. Becerra became Mr. Biden’s clear choice only over the past few days, according to people familiar with the transition’s deliberations, and was a surprise. Mr. Becerra has carved out a profile on the issues of criminal justice and immigration, and he was long thought to be a candidate for attorney general.
But as attorney general in California, he has been at the forefront of legal efforts on health care, leading 20 states and the District of Columbia in a campaign to protect the Affordable Care Act from being dismantled by his Republican counterparts. He has also been vocal in the Democratic Party about fighting for women’s health.
I was doing this earlier in the summer but stopped updating it in August; I've started over with a fresh spreadsheet and have expanded it to include every U.S. territory, including not just DC & Puerto Rico but also American Samoa, Guam, the U.S. Virgin Islands and even the Northern Mariana Islands.
I've done my best to label every state/territory, which obviously isn't easy to do for most of them given how tangled it gets in the middle. The most obvious point is that New York and New Jersey, which towered over every other state last spring, are now utterly dwarfed by North & South Dakota, which are skyrocketing.
North Dakota recently became the first state to cross the 10% infection threshold, with South Dakota not far behind. Iowa, Wisconsin, Nebraska and Utah could all potentially hit the 10% milestone by New Year's Eve as well.
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.
I made some important changes starting last week:
First: I had been using the 2016 Trump/Clinton election results for partisan lean for each county. Now that the dust has (mostly) settled on the 2020 election, I've updated this to the Biden/Trump results for 2020. There's a few states where I don't have county-level data for 2020 yet (AK, CT, NY). I hope to have the final three states updated by next weekend, but am using 2016 data until then.
Second: I've also added columns listing the actual Biden/Trump vote percentage for each county to give a feel for how partisan it is. Again, I'm defining "Swing District" as any county where the difference is less than 6.0%. There's 185 swing districts (out of over 3,100 total), with around 35 million Americans out of 331 million total, or roughly 10.6% 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, December 5th (click image for high-res version).
Blue = Joe Biden won by more than 6 points; Orange = Donald Trumpwon by more than 6 points; Yellow = Swing District
Access Health CT, Connecticut's ACA exchange, is posting updates to their Open Enrollment Period (OEP) numbers every Friday. Last week they reported 100,345 Qualified Health Plan (QHP) selections during the first 33 days of the 2021 OEP, which sounds more impressive than it is, since 94,713 of those were current enrollees having their auto-renewals front-loaded; only 5,632 of them were actually new enrollees. Nothing wrong with that, of course.
CMS tells Inside Health Policy that Affordable Care Act enrollees who have reconciled their 2019 advanced premium tax credits (APTCs) as required can keep their 2021 subsidies, even if they were notified that they’re at risk of losing them, by checking a box on their exchange application. But Sen. Mark Warner (D-VA) tells IHP he wants the government to do more to help enrollees.
...The ACA requires exchange enrollees to estimate their next year’s income to determine their eligibility for tax credits and then reconcile that prediction with actual income during tax filing season. Regulations also require CMS to cut off future year tax credits if IRS data show that an applicant filed a return yet failed to reconcile their APTCs.
Way back in October 2013, I launched the ACA Signups project as a light, nerdy hobby thing which was only supposed to last around six months, through the end of the first ACA Open Enrollment Period (March 31, 2014). Instead...well, let's just say that it's more than seven years later and I'm still doing this.
The reality is that The Graph itself doesn't serve a whole lot of useful function anymore. The enrollment patterns were erratic the first couple of years but have since settled into a pretty predictable...if not downright boring pattern for both the federal and state exchanges. The main reason I keep doing it each year is mostly out of tradition these days; after all, without The Graph, there wouldn't be an ACA Signups and I wouldn't have become a healthcare policy wonk in the first place.
In Week Four of the 2021 Open Enrollment period, 523,020 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday.
Every week during Open Enrollment, the Centers for Medicare & Medicaid Services (CMS) will release enrollment snapshots for the HealthCare.gov platform, which is used by the Federally-facilitated Exchange and some State-based Exchanges. These snapshots provide point-in-time estimates of weekly plan selections, call center activity, and visits to HealthCare.gov or CuidadoDeSalud.gov.
The final number of plan selections associated with enrollment activity during a reporting period may change due to plan modifications or cancellations. In addition, the weekly snapshot only reports new plan selections and active plan renewals and does not report the number of consumers who have paid premiums to effectuate their enrollment.
It is no secret that 2020 has been a challenging year for Idahoans. In addition to the health implications and long-term consequences of COVID-19, living in a global pandemic has changed the way Idahoans work, learn, and interact with friends and family.
Over the past year, COVID-19 has also highlighted the undeniable need for comprehensive health insurance and access to quality healthcare. However, in a year with so much uncertainty and change, it may seem like health insurance is unaffordable or something that we can go without. At Your Health Idaho we understand that budgets are tight, we also know that the peace of mind that comes with having coverage in the event of an emergency is priceless.
As 2020 draws to a close, so does the annual Open Enrollment period for health insurance. Right now, at YourHealthIdaho.org you can shop and compare hundreds of health insurance plans to find the right coverage for you and your family.
Compare plans through MNsure and see if you can save
More plan options available this year than ever before
ST. PAUL, Minn.—MNsure is reminding all Minnesotans, regardless of insurance status, to compare plans before the December 22 open enrollment deadline. Individuals who currently have health insurance elsewhere, are uninsured, or are already enrolled through MNsure are encouraged to see if they can save money. With new plan options available in every county in Minnesota, MNsure recommends using the plan comparison tool to view plans side by side and explore details about premiums, deductibles, out-of-pocket costs and more. Minnesotans who sign up by the deadline will have coverage beginning on January 1, 2021.
Nevada Health Link reminds Nevadans there are 45 days remaining to secure health insurance for 2021 coverage
Nevadans have until Dec. 31 to enroll in a Qualified Health Plan effective Jan. 1, 2021
Nevada Health Link, the online health insurance marketplace operated by the Silver State Health Insurance Exchange (Exchange), reminds Nevadans that Open Enrollment for a comprehensive, Affordable Care Act (ACA) compliant health plan for 2021 ends on Jan. 15, 2021. All plans offered through the Exchange cover the ten essential health benefits including pre-existing conditions and all COVID-19-related diagnosis and treatment. Consumers should know they must enroll in a plan by Dec. 31, 2020 to have health coverage effective Jan. 1, 2021. Anyone who enrolls between Jan. 1 and Jan. 15 will have coverage effective Feb. 1, 2021.
