For months I posted weekly looks at the rate of COVID-19 cases & deaths at the county level since the end of June, broken out by partisan lean (i.e, what percent of the vote Donald Trump received in 2020), as well as by the vaccination rate of each county in the U.S. (nonpartisan). This basically amounts to the point when the Delta Variant wave hit the U.S., although it had been quietly spreading under the radar for a few months prior to that.
More recently, I've switched to posting the same data starting on December 15th, which is (roughly) the start of the Omicron variant wave (although this is fuzzier than the start of the Delta wave).
NOTE: Given how much the national pace of vaccination shots has slowed down recently (the 7-day average is down to around ~330,000/day), going forward this will be a MONTHLY update, unless the pace picks up again significantly.
Methodology reminders:
I go by county residents who have received the 2nd COVID-19 shot only (or 1st in the case of the J&J vaccine).
I base my percentages on the total population via the 2020 U.S. Census as opposed to adults only or those over 11 years old (or even over 4 years old).
For most states + DC I use the daily data from the Centers for Disease Control, but there are some where the CDC is either missing county-level data entirely or where the CDC data is less than 90% complete at the county level. Therefore:
Section 673(2) of the Omnibus Budget Reconciliation Act (OBRA) of 1981 (42 U.S.C. 9902(2)) requires the Secretary of the Department of Health and Human Services to update the poverty guidelines at least annually, adjusting them on the basis of the Consumer Price Index for All Urban Consumers (CPI-U). The poverty guidelines are used as an eligibility criterion by Medicaid and a number of other Federal programs.
The poverty guidelines issued here are a simplified version of the poverty thresholds that the Census Bureau uses to prepare its estimates of the number of individuals and families in poverty.
As required by law, this update is accomplished by increasing the latest published Census Bureau poverty thresholds by the relevant percentage change in the Consumer Price Index for All Urban Consumers (CPI-U). The guidelines in this 2022 notice reflect the 4.7 percent price increase between calendar years 2020 and 2021.
However, I deliberately left out a section because I wanted to discuss it separately. If you scroll down to pages 31 & 32, you'll see a summary of two important pieces of ACA-related legislation which have been introduced in the California state legislature.
One of these is SB 967, introduced by CA State Senator Robert Hertzberg, which would do the following:
Hmmmm...a few weeks ago I posted a press release from Covered California which seemed to indicate that total 2022 Open Enrollment Period (OEP) plan selections had broken 1.8 million people.
Today I was directed to Covered CA's official 2022 OEP Executive Summary report, and it turns out the final numbers were a bit lower than that...but still record-breaking and impressive:
AMERICAN RESCUE PLAN LEADS TO HISTORIC OPEN ENROLLMENT
Governor Murphy and DOBI Commissioner Caride Announce Record Health Insurance Sign-Ups During Open Enrollment, Introduce Effort to Further Expand Health Care Access for NJ Residents
New Jersey Residents at Certain Incomes Can Now Enroll Year-Round In Free or Nearly Free Coverage
Residents with a Qualifying Life Event Also Have Options to Get Covered
TRENTON – Governor Phil Murphy and Department of Banking and Insurance Commissioner Marlene Caride today announced more than 324,000 New Jerseyans signed up for health coverage through Get Covered New Jersey during the Affordable Care Act Open Enrollment Period – an increase of 20 percent compared to last year – and a record high in New Jersey, as residents benefited from increased affordability from expanded federal and state financial help.
Last summer, I pulled together the occasional vaccination rate scatter plot graphs I'd been compiling for months into a single animated GIF image to show how both the correlation (R^2) and steepness (slope) of the partisan COVID vaccination divide grew from almost nothing at all to a gaping chasm over a six month period, from February 2021 through August 2021.
Today, I'm presenting an updated version of this animation which not only includes the following six months as well (September 2021 - February 2022), but also cleans up & standardizes the layout of each graph as much as possible. This includes making sure the thru date is in the upper right-hand corner on all of them, moving the population key to the lower-right corner, removing the (naive in retrospect) "herd immunity target" line, and moving the R^2 stamp immediately below the thru date to make the graph itself as clean as possible.
For months I posted weekly looks at the rate of COVID-19 cases & deaths at the county level since the end of June, broken out by partisan lean (i.e, what percent of the vote Donald Trump received in 2020), as well as by the vaccination rate of each county in the U.S. (nonpartisan).
This basically amounts to the point when the Delta Variant wave hit the U.S., although it had been quietly spreading under the radar for a few months prior to that.
Now that we're a full two months into the Omicron Variant wave, I've updated my case/death rate tracking to reflect that as well...because the data so far is showing a completely new chapter as we enter the 3rd year of the Coronavirus Pandemic.
I go by county residents who have received the 2nd COVID-19 shot only (or 1st in the case of the J&J vaccine).
Note: I've temporarily stopped tracking boosters again, as it appears that the data on this front is still too confused to get an accurate county-level national read.
I base my percentages on the total population via the 2020 U.S. Census as opposed to adults only or those over 11 years old (or even over 4 years old).
For most states + DC I use the daily data from the Centers for Disease Control, but there are some where the CDC is either missing county-level data entirely or where the CDC data is less than 90% complete at the county level. Therefore:
For Virginia, I'm using theofficial state health department dashboard, but am only updating it once a month since it doesn't allow you to export, view or download all 95 counties/city-counties at once, making this a tedious effort.
As part of the Biden-Harris Administration’s work to advance health equity and reduce health disparities, the Centers for Medicare & Medicaid Services (CMS) is seeking feedback on topics related to health care access, such as enrolling in and maintaining coverage, accessing health care services and supports, and ensuring adequate provider payment rates to encourage provider availability and quality. This Request for Information (RFI) is one of many actions CMS is taking to develop a more comprehensive access strategy in its Medicaid and CHIP programs.
“We are committed to providing equitable access to quality health care and removing any barriers to quality health care,” said Health and Human Services Secretary Xavier Becerra. “We want to hear directly from stakeholders so we can strengthen our programs for the more than 80 million Americans with Medicaid or CHIP health insurance. Together, by advancing health equity, we can ensure quality health care is within reach for everyone who needs it.”
...Extending the Open Enrollment Period for QHP’s aligns with the coverage rules for public programs also administered through NY State of Health. New Yorkers need to enroll by January 15 for coverage starting February 1 and by February 15 for coverage starting March 1.
In other words, they've bumped out the final deadline by another 2 weeks, through 2/15. Why this isn't mentioned until 5 paragraphs in, I have no idea, but whatever.
At the time, I assumed that they had extended their 2022 Open Enrollment Period deadline through February 15th, as I didn't see any other press releases clarifying things.
As I just noted, the end of the official COVID-19 Public Health Emergency, whenever it happens (it's currently scheduled to end as of April 16th but could be extended once again at any point before then) will cause a new problem:
Millions of Americans currently enrolled in Medicaid will likely no longer be legally eligible to remain on the public healthcare program, threatening to cause a massive overload of agencies and potentially leaving many of them stranded without any healthcare coverage at all.
Legislation to help about 300,000 Oregonians on Medicaid to maintain their coverage after the Covid-19 public health emergency ends advanced out of committee on Monday.
What goes up usually goes back down eventually, and that's likely to be the case with Medicaid enrollment as soon as the public health crisis formally ends...whenever that may be.
Well, yesterday Ryan Levi and Dan Gorenstein of of the Tradeoffs healthcare policy podcast posted a new episode which attempts to dig into just when that might be, how many people could be kicked off of the program once that time comes and how to mitigate the fallout (I should note that they actually reference my own estimate in the program notes):
Last chance to shop and enroll in a 2022 health plan
(BALTIMORE) — Marylanders have less than two weeks left to enroll in health coverage that begins March 1, 2022. This year, open enrollment through Maryland Health Connection was extended due to the public health emergency. Maryland residents can enroll in a private health insurance plan until Feb 28, 2022.
“More than 180,000 people have signed up for a health plan since open enrollment began in November. Maryland Health Connection has seen 9% growth over 2021,” said Michele Eberle, executive director of the Maryland Health Benefit Exchange. “This is the last chance for Marylanders to get health insurance this year, and there are more savings for young adults and those with higher incomes than ever.”
This enrollment period is for private health plans only. Those who qualify for Medicaid may enroll any time of year.
Access Health CT Announces Special Enrollment Period For Covered Connecticut Program
Eligible Connecticut residents have until June 30 to enroll
HARTFORD, Conn. (Feb. 15, 2022) — Access Health CT (AHCT) today announced a Special Enrollment Period for the Covered Connecticut Program that provides health insurance at no cost to Connecticut residents who meet eligibility requirements. This Special Enrollment Period runs now through June 30.
Created and funded by the State of Connecticut, the Covered Connecticut Program pays the customer’s portion of the monthly payment (premium) directly to their insurance company. The program also covers the cost-sharing amounts they would typically have to pay with a health insurance plan, such as co-pays, co-insurance, deductibles and maximum out-of-pocket costs.
Covered California Names Jessica Altman as Its New Chief Executive Officer
Jessica Altman comes to Covered California from Pennsylvania, where she currently serves as the Commonwealth’s insurance commissioner, regulating the fifth-largest insurance market in the nation.
Altman brings a wealth of experience and knowledge from serving as chair of the Pennsylvania Health Insurance Exchange Authority and having led the establishment of Pennie, Pennsylvania’s state-based marketplace under the Affordable Care Act.
Altman will step into this new role following the planned departure of Peter V. Lee, Covered California’s founding executive director, who has led the organization since its inception more than a decade ago.
For months I posted weekly looks at the rate of COVID-19 cases & deaths at the county level since the end of June, broken out by partisan lean (i.e, what percent of the vote Donald Trump received in 2020), as well as by the vaccination rate of each county in the U.S. (nonpartisan).
This basically amounts to the point when the Delta Variant wave hit the U.S., although it had been quietly spreading under the radar for a few months prior to that.
Now that we're a full two months into the Omicron Variant wave, I've updated my case/death rate tracking to reflect that as well...because the data so far is showing a completely new chapter as we enter the 3rd year of the Coronavirus Pandemic.
The "start" of the Delta Wave was easy to lock in for my purposes; both cases and deaths from COVID had dropped off dramatically right up until around the end of June. The Delta Wave started showing up in the daily deaths pretty quickly as July started. The transition from the Delta to Omicron was a lot fuzzier, but I've decided to go with December 15th as my transition point.
I go by county residents who have received the 2nd COVID-19 shot only (or 1st in the case of the J&J vaccine).
Note: I've temporarily stopped tracking boosters again, as it appears that the data on this front is still too confused to get an accurate county-level national read.
I base my percentages on the total population via the 2020 U.S. Census as opposed to adults only or those over 11 years old (or even over 4 years old).
For most states + DC I use the daily data from the Centers for Disease Control, but there are some where the CDC is either missing county-level data entirely or where the CDC data is less than 90% complete at the county level. Therefore:
For Virginia, I've (reluctantly) switched back to using COVID Act Now data even though it's had some strange data lately. I'd normally use theofficial state health department dashboard, but theirs doesn't allow you to export, view or download all 95 counties/city-counties at once, making this a tedious effort.
I've spent the past few days documenting the explosion of states implementing Tax Time Special Enrollment Periods. These are new policies, pioneered by Maryland a couple of years ago, which allow uninsured residents to simply check off a new box on their state tax returns which gives permission to the state treasury department and/or ACA exchange to determine whether the tax filer is eligible for free or low-cost healthcare coverage.
If the state determines that the filers/their families are indeed eligible for either Medicaid, CHIP, or a fully-subsidized ACA exchange policy, the new program then allows state agencies to contact the tax filer to let them know they're eligible and to either enroll them automatically or work with them to get them enrolled.
As I noted in a bunch of posts yesterday, several states have launched "Tax Time Special Enrollment Periods" (Maryland launched theirs a couple years ago; Colorado, Massachusetts & Pennsylvania are bringing their programs online right now). New Mexico is also moving their own version through the legislative process.
Well, it turns out (thanks to Louise Norris for the heads up) that Virginia also passed their own version of this bill last year...although in their case it's being phased in over a two year time period:
Continuing today's theme of "state tax filing easy healthare enrollment programs," it appears that Pennsylvania has also joined several other states, including Maryland, Colorado, Massachusetts and New Mexico (pending) in implementing a new program which allows uninsured residents who didn't enroll in healthcare coverage during the normal Open Enrollment Period a second chance by checking a box when they file their state tax return.
Pennsylvania easy enrollment program expected to be in use by early 2022
Pennsylvania lawmakers considered House Bill 1030 in 2021, to create an “easy enrollment” program in Pennsylvania, much like the system that Maryland debuted in 2020, and which Colorado will start using in 2022. New Jersey lawmakers passed a similar bill in 2021.
New Mexico Easy Healthcare Enrollment Bill Passes House With Unanimous Support
SANTA FE — HB 95, which would make it easier for New Mexicans to enroll in health insurance, passed the House floor with a unanimous vote Wednesday.
The bill would give New Mexico taxpayers the option to consent to the transfer of their information to the Human Services Department or to the New Mexico Health Insurance Exchange, to help them enroll in health insurance and other programs for which they might qualify.
“All New Mexicans deserve access to quality health care for themselves and their families,” Rep. Thomson said. “More than 23,000 uninsured New Mexicans will now gain easy access to the affordable health care that they deserve.”
This legislation was sponsored by Representatives Elizabeth “Liz” Thomson (D-Albuquerque) and Christine Chandler (D-Los Alamos), Senators Elizabeth “Liz” Stefanics (D-Cerrillos) and Brenda McKenna (D-Corrales).
Simple Sign-up health insurance enrollment is as easy as checking a box on the state tax form
New program will simplify sign up for coverage through the Health Connector
February 7, 2022 – Uninsured Massachusetts residents can check a box on their state tax forms to quickly start the process of getting health insurance through the Massachusetts Health Connector’s new Simple Sign-up program. The program will increase access to health insurance, and provide assistance signing up for coverage to thousands of residents.
Through the Simple Sign-up program, when checking the box on the tax form, individuals authorize the Department of Revenue to communicate select elements of the tax filer’s information with the Health Connector. The Health Connector will use this information to create and send tailored information to the tax filer, and to work with residents towards obtaining the most appropriate health plan.
Colorado Launches Tax Time Enrollment Program for Health Coverage
A new way to get health insurance outside of the annual enrollment period
Denver – There’s something new that Coloradans can look forward to when filing their 2021 State tax return—an opportunity to enroll in free or low-cost health coverage.
It's also important to note that after both the R2 (correlation) and slope formulas have pretty much plateaued over the past few weeks.
It'll be interesting to see what happens starting around Thanksgiving now that the FDA has given final approval to the Pfizer vaccine for 5-11 year olds (remember, I only track fully-vaccinated people, and the second Pfizer shot isn't given until 3 weeks after the first; assuming the first batch of younger kids starts getting their initial dose tomorrow (November 3rd), that means they should start getting their second dose around November 24th).
For months I posted weekly looks at the rate of COVID-19 cases & deaths at the county level since the end of June, broken out by partisan lean (i.e, what percent of the vote Donald Trump received in 2020), as well as by the vaccination rate of each county in the U.S. (nonpartisan).
This basically amounts to the point when the Delta Variant wave hit the U.S., although it had been quietly spreading under the radar for a few months prior to that.
Now that we're a full seven weeks into the Omicron Variant wave, I've updated my case/death rate tracking to reflect that as well...because the data so far is showing a completely new chapter as we enter the 3rd year of the Coronavirus Pandemic.
The "start" of the Delta Wave was easy to lock in for my purposes; both cases and deaths from COVID had dropped off dramatically right up until around the end of June. The Delta Wave started showing up in the daily deaths pretty quickly as July started. The transition from the Delta to Omicron was a lot fuzzier, but I've decided to go with December 15th as my transition point.
I go by county residents who have received the 2nd COVID-19 shot only (or 1st in the case of the J&J vaccine).
Scroll down to also see 3rd/Booster shots, with some important caveats of its own.
I base my percentages on the total population via the 2020 U.S. Census as opposed to adults only or those over 11 years old (or even over 4 years old).
For most states + DC I use the daily data from the Centers for Disease Control, but there are some where the CDC is either missing county-level data entirely or where the CDC data is less than 90% complete at the county level. Therefore:
For Virginia, I've (reluctantly) switched back to using COVID Act Now data even though it's had some strange data lately. I'd normally use theofficial state health department dashboard, but theirs doesn't allow you to export, view or download all 95 counties/city-counties at once, making this a tedious effort.
(sigh) It's a bit silly for me to write about this now, given that the 2022 Open Enrollment Period ended a few weeks ago, but it's still relevant going forward.
As long-time readers know, I was one of a handful of healthcare wonks who coined the phrase "Silver Loading" to describe a wonky policy pricing strategy which insurance carriers started using back in late 2017 to counteract the Trump Administration's decision to terminate Cost Sharing Reduction subsidy reimbursement payments:
Let's say in 2017 a carrier projected that overall claim expenses in 2018 would increase around 5%. To keep things simple, let's say they offered just 3 plans: One Bronze, one Silver (which happends to also be the "benchmark Silver" used to determine subsidies) and one Gold, priced at an average of $450, $600 and $750/month.
240,000 Washingtonians signed up for coverage; Cascade Care enrollment more than doubled in year two
Washington Health Benefit Exchange (Exchange) released today its initial 2022 open enrollment data. A record 240,000 Washingtonians signed up for 2022 coverage through Washington Healthplanfinder, the state’s online health insurance marketplace. This represents an increase of more than 6% over 2021.
This morning, George Conway (yes, that George Conway) asked a reasonable question on Twitter:
Has anyone estimated how many American lives would have been saved if the entire country had gotten vaccinated at the rates at which people in, say Vermont or Portugal, or at which registered Democrats, have gotten vaccinated?
A couple of weeks ago I ran an updated analysis which attempted to estimate a grim but vitally important number: Just how many Trump voters vs. Biden voters have become fatal victims of the GOP/FOX News coordinated anti-vaxx/anti-mask campaign to date, and what sort of impact might this end up having on the midterm elections this November?
I'm not going to attempt to justify this cynical bean counting anymore...the evidence is now overwhelming that Republican leadership, in coordination with outlets like FOX News and other right-wing outlets, made a conscious decision in spring 2021 to push hard against Americans getting vaccinated against COVID-19.
Over 600,000 Americans have died of COVID-19 since the 2020 election, but assuming the death rate is similar among adults who voted and those who didn't, less than 2/3 of those actually voted in the 2020 general election. Besides children under 18 and undocumented immigrants, the sad reality is that there are tens of millions of American adults who are eligible to vote but either aren't registered or are registered but don't cast a ballot every election cycle.
