Way back in March 2020, I launched my own COVID-19 case/fatality tracking spreadsheet project which mostly duplicates any number of existing sites, including one important addition:
I've added the Presidential partisan lean of each state as well as which party holds the governor's seat. This may seem incredibly inappropriate (and it is), but it's sadly necessary because Donald Trump has apparently decided to only grant his favor and any substantial assistance to states which a) voted for him and b) whose governors kiss his ass enough.
I took a lot of criticism at the time from people who got the vapors and claimed that I was the one "politicizing" the pandemic, which was laughable in the Trump era, where everything has been politicized by the Trump Administration.
Since the collapse of the Build Back Better Act in the U.S. Senate last December (reminder: It passed the House but came to a screeching halt when all 50 Republican Senators along with conservative Democrat Joe Manchin refused to support it), Congressional Democrats have been quietly trying to put at least some of the pieces of the bill back together in an attempt to salvage something out of President Biden's signature social spending agenda.
Personally, I'm most focused on making the enhanced/expanded ACA subsidies under the American Rescue Plan (ARP) permanent, of course, which the Congressional Budget Office estimated would cost roughly $220 billion over 10 years to implement. If the ARP subsidies are allowed to expire (which would revert the ACA back to the original subsidy formula, including bringing back the hated "Subsidy Cliff"), over 13 million Americans would find their health insurance premiums jump by an average of over $700/year apiece, with some households seeing theirs skyrocket by as much as $17,000/year (that's not a typo).
Today, the Centers for Medicare & Medicaid Services (CMS) released the 2021-2030 National Health Expenditure (NHE) report, prepared by the CMS Office of the Actuary, that presents health spending and enrollment projections for the coming decade. The report notably shows that despite the increased demand for patient care in 2021, the growth in national health spending is estimated to have slowed to 4.2%, from 9.7% in 2020, as supplemental funding for public health activity and other federal programs, specifically those associated with the COVID-19 pandemic, declined significantly.
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), this is now 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:
As you might expect, there's a clear drop-off in new COVID cases per capita as the vaccination rate of the counties goes up. There seems to bea slight drop-off starting around 50% fully vaccinated, followed by a steep drop-off starting around 65% vaxxed.
There's a third drop-off at around 75%, but there's literally only a handful of counties which have achieved that high a vaccination rate so far anyway.
HOWEVER, there's one major outlier over the 65% threshold...Miami-Dade County.
According to the Centers for Disease Control, Miami-Dade has fully vaccinated 68% of their entire population (1.84 million out of 2.72 million residents). I use the slightly lower official 2020 U.S. Census popualtion count for Miami-Dade County (2,701,767), which makes the vaccination rate slightly higher still: 68.24%.
For months I've posted weekly looks at the rate of COVID-19 cases & deaths at the county level since the point at which every U.S. adult could theoretically have received 2 COVID vaccination doses, 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).
For a long time I used July 1st, 2021 as my start point, but more recently I decided to back this up to May 1st, 2021 instead. Pinning down an exact date for this is a bit tricky since a) different populations were made eligible at different points in 2021, and b) it takes 3-4 weeks after getting your first vaccination dose before you can get the second one, but May 1st is what I've finally settled on. As it happens, this didn't change things that much since June 2021 in particular was the nadir of the pandemic's death rate since it began.
Pam MacEwan, CEO of the Washington Health Benefit Exchange (Exchange), today announced that she will be stepping down from guiding the state’s health insurance marketplace, Washington Healthplanfinder, an organization she has served for nearly 10 years. She has held the role of CEO for more than six years.
The move will be effective as of June and the Exchange Board will be appointing an interim CEO in the coming weeks.
“It has been the capstone of my career to serve the people of Washington as CEO of the Exchange,” said MacEwan. “What we have been able to accomplish in my time at the Exchange has been nothing short of remarkable. Given the strength of our organization, I feel that now is the right time. The Exchange has emerged as an innovative leader in health care and is poised to continue to break new ground in bringing access to health to all Washingtonians.”
HARTFORD, Conn. (March 25, 2022) — Access Health CT (AHCT) today announced that it was honored by the Hartford Business Journal (HBJ) and Best Companies Group as one of the “Best Places to Work in Connecticut.” This is the third, consecutive year AHCT has been named as a top workplace by the HBJ. The honorees were recognized at a ceremony at Farmington Gardens last night. The annual program was created by the Hartford Business Journal and the third-party research firm, Best Companies Group.
“Everything we do at Access Health CT supports our mission and is guided by our company values,” said Access Health CT Chief Executive Officer, James Michel. “Our values — authenticity, integrity, excellence, ownership, one team and passion — were created by our staff and are the driving force behind our strong company culture.”
As noted yesterday, it's the12th Anniversary of President Obama signing the ACA into law. To mark the occasion, the Centers for Medicare & Medicaid Services (CMS) has released the final, official 2022 Open Enrollment Period (OEP) report, which I've broken into multiple entries.
In this entry, I'm looking at the metal level breakout of the plans selected by ACA exchange enrollees. As a reminder, ACA policies fall into four categories: Bronze, Silver, Gold, Platinum, plus a special fifth "Catastrophic" category.
The 4 metal level categories represent policies which cover roughly 60%, 70%, 80% or 90% of the average enrollee's in-network healthcare expenses over the cours of the year. This doesn't mean that a Silver (70%) plan, for instance, will cover 70% of your specific medical expenses; it's an aggregate average.
As noted yesterday, it's the12th Anniversary of President Obama signing the ACA into law. To mark the occasion, the Centers for Medicare & Medicaid Services (CMS) has released the final, official 2022 Open Enrollment Period (OEP) report, which I've broken into multiple entries.
In this entry, I'm looking at enrollment from the angle of various demographic factors, including Age, Gender, Race/Ethnicity and Rural status.
There's a ton of data in the big table below (click the image for a high-res version), so I've also included percentage summaries at the bottom:
On the 12th anniversary of the signing of the Affordable Care Act, Covered California reminds consumers that eligible Californians can sign up through special enrollment if they have a qualifying life event.
Californians who have recently lost their health insurance, got married, had a baby, have been affected by the COVID-19 pandemic, or paid a penalty for not having coverage are among those eligible for special enrollment.
Coverage is more affordable than ever thanks to the increased financial help available through the American Rescue Plan, and consumers can benefit from lower premiums throughout 2022.
ST. PAUL, Minn.—March 23 marks the 12th anniversary of the Affordable Care Act (ACA), which enacted patient protections that make health coverage fairer and easier to understand, and the financial help that makes it more affordable. With the help of the ACA and MNsure, Minnesota’s health insurance marketplace, Minnesota’s uninsured rate has gone from above 9% in 2010 to 4% today.
While the ACA helped thousands of Minnesotans access comprehensive health coverage, the 2021 federal American Rescue Plan (ARP) COVID Relief package made the most significant improvements to the law since its inception. In Minnesota, the ARP lowered costs for tens of thousands, and expanded access to subsidies to those who had previously been ineligible. The cost savings made available through the ARP drove the highest enrollment on record for MNsure. Over 134,000 Minnesotans -- a 10% increase from last year -- signed up for coverage for 2022.
Over 100,000 Nevadans are enrolled with health coverage thanks to the ACA
(CARSON CITY, Nev.) – Today marks the 12th anniversary since the Affordable Care Act (ACA) was signed into law by President Obama on March 23, 2010. The ACA has been one of the most significant health care reform landmarks in the United States and has had a great impact on providing more affordable and qualified health care in Nevada.
The ACA is credited for the creation and ongoing operations of the Silver State Health Insurance Exchange (Exchange), Nevada’s state agency that helps individuals get connected to budget-appropriate health coverage through the online marketplace, Nevada Health Link.
State's Health Insurance Marketplace Served as a Critical Safety Net for Over 6.5 Million New Yorkers During the COVID-19 Pandemic
Governor Encourages Congress to Extend American Rescue Plan Tax Credits to Preserve This Critical Health Insurance Coverage for New Yorkers
2022 Open Enrollment Period for NY State of Health Qualified Health Plans Will Remain Open for the Duration of the Federal Public Health Emergency
Governor Kathy Hochul today recognized the 12th anniversary of the Affordable Care Act and the resulting historic levels of health insurance coverage through NY State of Health, the state's official health plan Marketplace. NY State of Health serves as a critical safety net for over 6.5 million New Yorkers.
"In Congress, I fought tooth and nail against attempts to repeal the Affordable Care Act because it was the right thing to do for millions of Americans," Governor Hochul said. "As Governor, I remain committed to making sure that every New Yorker can obtain quality, affordable health care."
As noted yesterday, it's the12th Anniversary of President Obama signing the ACA into law. To mark the occasion, the Centers for Medicare & Medicaid Services (CMS) has released the final, official 2022 Open Enrollment Period (OEP) report, which I've broken into several entries.
This entry covers two types of ACA policies which don't get nearly enough attention. The first is the ACA's Basic Health Plan (BHP) program, which is currently only operating in two states: Minnesota and New York.
Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.
As noted this morning, today marks the 12th Anniversary of President Obama signing the ACA into law. To mark the occasion, the Centers for Medicare & Medicaid Services (CMS) has released the final, official 2022 Open Enrollment Period (OEP) report, which I'll be breaking into several entries.
In this entry, I'm looking at the financial aid breakout for Qualified Health Plan (QHP) enrollees. ACA financial assistance falls into two categories: Advance Premium Tax Credits (APTC) and Cost Sharing Reductions (CSR). APTC reduces enrollees monthly premium costs; CSR reduces their deductibles, co-pays and other out-of-pocket expenses.
Thanks to the American Rescue Plan, APTC financial assistance is far more generous for most enrollees in 2022 than in prior years, as you can see by looking at the 3rd & 4th columns (avg. premium and avg. premium after APTC):
As I just noted, today marks the 12th Anniversary of President Obama signing the ACA into law. To mark the occasion, the Centers for Medicare & Medicaid Services (CMS) has released the final, official 2022 Open Enrollment Period (OEP) report, which I'll be breaking into several entries.
In this entry, I'm looking at the weekly Qualified Health Plan (QHP) selections by state and nationally. This first table shows the cumulative numbers for every week of OEP 2022. The final column includes additional enrollments after 1/15/22 in the states which had later deadlines, as well as some oddball clerical data corrections:
As I just noted, today marks the 12th Anniversary of President Obama signing the ACA into law. To mark the occasion, the Centers for Medicare & Medicaid Services (CMS) has released the final, official 2022 Open Enrollment Period (OEP) report, which I'll be breaking into several entries.
The next two tables look at the number of renewing enrollees who kept their existing (2021) ACA exchange policy vs. those who switched to a different policy for 2022. It's important to note that CMS only has data on this from the 33 states hosted on the federal exchange (HealthCare.Gov).
Of those, over 56% of renewing enrollees switched to a different policy (either through the same carrier or a different one). The other 44% either kept whatever policy they were enrolled in at the end of 2021 or were automatically switched to the closest equivalent in cases where that exact policy had been discontinued by the insurance carrier (this is known as being "crosswalked"):
As I just noted, today marks the 12th Anniversary of President Obama signing the ACA into law. To mark the occasion, the Centers for Medicare & Medicaid Services (CMS) has released the final, official 2022 Open Enrollment Period (OEP) report, which I'll be breaking into several entries.
First up is the top line numbers: Just how many people selected Qualified Health Plans (QHPs) during the 2022 OEP, which ran from November 1st, 2021 through different ending dates depending on the state. In the 33 states hosted via the federal ACA exchange (HealthCare.Gov), as well as 9 of the 18 state-based marketplaces (SBMs), the ending date was January 15th, 2022.
For the remaining SBMs, the ending date was: 12/22/21 in Idaho; 1/19/22 in Colorado; 1/28/22 in Massachusetts; 1/31/22 in DC, Kentucky, New Jersey, New York & Rhode Island; and 2/04/22 in California:
Today is the 12th Anniversary of President Obama signing the Patient Protection & Affordable Care Act, aka the ACA (also aka "Obamacare"). This is the first in a series of posts based on press releases & reports released by the Centers for Medicare & Medicaid Services today (CMS).
On 12-Year Anniversary of the Affordable Care Act, New HHS Report Shows Ways the Biden-Harris Administration’s American Rescue Plan Investments Are Lowering Health Care Costs and Expanding Coverage
Way back in the summer of 2020, then-Presidential candidate Joe Biden rolled out his official healthcare policy proposal. Part of the plan included the following:
Expanding coverage to low-income Americans. Access to affordable health insurance shouldn’t depend on your state’s politics. But today, state politics is getting in the way of coverage for millions of low-income Americans. Governors and state legislatures in 14 states have refused to take up the Affordable Care Act’s expansion of Medicaid eligibility, denying access to Medicaid for an estimated 4.9 million adults.
Biden’s plan will ensure these individuals get covered by offering premium-free access to the public option for those 4.9 million individuals who would be eligible for Medicaid but for their state’s inaction, and making sure their public option covers the full scope of Medicaid benefits. States that have already expanded Medicaid will have the choice of moving the expansion population to the premium-free public option as long as the states continue to pay their current share of the cost of covering those individuals.
It's been another six weeks since my last attempt 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?
As I said at the time, 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 for purely cynical political math reasons.
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 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).
For years now, I've been a tireless advocate for dramatically expanding & improving the Affordable Care Act's Advance Premium Tax Credit (APTC) formula. This is the table which determines a) just how generous the ACA's health insurance premium tax credits are at different income levels and b) how far up the income ladder those financial subsidies extend.
Just over a year ago, the American Rescue Plan (ARP), passed by Democrats in Congress and signed into law by President Biden, did exactly what I've been clamouring for all this time: It made ACA subsidies far more generous while also removing the completely arbitrary income eligibility cut-off threshold (otherwise known as the "Subsidy Cliff."
As a refresher, the way the ACA subsidies work is as follows:
More than 65,000 Access Health CT enrollees would be impacted
HARTFORD, Conn. (March 16, 2022) — Access Health CT (AHCT) today announced that more than 65,000 Connecticut residents would be negatively impacted by reduced or eliminated financial help for health insurance if the increased financial assistance from the American Rescue Plan Act (ARPA) expires at the end of 2022.
The $178 million per year ($14.8 million per month) of assistance residents receive through ARPA will end unless the enhanced premium tax credits continue past 2022 through federal legislation.
“Ending increased financial help would have a significant impact on Connecticut residents,” said James Michel, Access Health CT Chief Executive Officer, “including progress made toward addressing health disparities. The American Rescue Plan Act makes health insurance coverage more affordable and accessible – greatly reducing the impact of social determinants of health.”
Over the past two years, I've run a lot of county-level COVID data analysis. I've plotted the data as scatter-plot graphs and bar graphs, and I even created a couple of animations which showed how the data changed over time.
Last November, while creating one of these animations, I also noticed something which made my jaw drop. I talked about it at the time, but it didn't seem to generate as much interest as I thought it merited, so today I'm plotting the data using a different layout: A simple line graph of COVID-19 death rates in the deepest Red and deepest Blue counties of the United States, plotted over time. As a bonus, in the process, a few other useful points revealed themselves visually as well.
DENVER— Connect for Health Colorado, the state’s official health insurance marketplace, is accepting applications from new and returning organizations, as well as licensed Brokers, to operate Assistance Sites and Enrollment Centers across the state.
“Assistance Sites and Enrollment Centers provide a crucial one-on-one service to help Coloradans get covered,” said Connect for Health Colorado’s Chief Executive Officer, Kevin Patterson. “They help us make sure local communities, especially those who face barriers to health coverage, can access the plans and savings we offer. I encourage interested organizations and current partners to apply for this opportunity.”
For awhile now, in spite of overwhelming evidence that COVID-19 deaths have been undercounted nationally by as much as 25%, skeptics and deniers have insisted that they're actually being overcounted because (as the now-cliche saying puts it) many are dying "with COVID but not of COVID."
For a long time now, I've been tracking & graphing COVID data at the county level, which provides a more granular look at how things are progressing on both the vaccination front as well as in terms of case & death rates. After all, there are plenty of other sources tracking & reporting state-level data.
However, once in awhile it's not a bad idea to step back and compare the two, which I'm doing today.
Starting in 2023, Health Connector coverage will include new benefits, protections, and reduced cost-sharing to advance health equity objectives. The Health Connector is among the leaders of state-based marketplaces in leveraging its plan certification process to explicitly advance and invest in targeted health equity priorities.
Informed by state and national health policy research and data, and stakeholder engagement, Health Connector staff identified health equity concerns in the health coverage landscape and designed its 2023 Seal of Approval plan certification process to advance objectives tailored to address those equity issues.
Of all the problems the ACA has encountered over the 11 years since it was first signed into law by President Obama, one of the stupidest and most irritating ones had nothing to do with Republican sabotage. The call on this one was made by the IRS (then under the Obama Administration), based on their interpretation of a few bits of language within the legislative text itself back in 2013: The Family Glitch.
We still get calls on a regular basis from people who are shopping for individual insurance because adding dependents to their employer plan is prohibitively expensive. We estimate that roughly 20 percent of the people who contact us are in this situation.
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 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).
Today is the 1-year anniversary of President Biden signing the American Rescue Plan.
Along with many other important provisions, the ARP included dramatic (but temporary) improvements to the Affordable Care Act...the most significant upgrade to the ACA since it was first signed into law by President Obama eleven years earlier.
Certified Assistors Provide Enrollment Support on SUNY and CUNY Campuses Throughout the State
March 15 is the Deadline to Enroll for April 1, 2022 Coverage
ALBANY, NY (March 10, 2022) -NY State of Health, the state’s official health plan Marketplace, today announced its partnership with SUNY and CUNY colleges throughout the State to educate students about how to enroll in affordable, quality health coverage. Informational events will take place during March, with certified enrollment assistors onsite to answer questions and provide enrollment assistance.
A few days ago, Peter Hotez MD PhD, Dean of the National School of Tropical Medicine and Professor of Pediatrics and Molecular Virology & Microbiology at Baylor College of Medicine where he is also the Co-director of the Texas Children’s Center for Vaccine Development (CVD) and Texas Children’s Hospital Endowed Chair of Tropical Pediatrics, estimated that a stunning 250,000 U.S. COVID-19 deaths have been caused specifically due to people refusing to get vaccinated.
Thousands of Coloradans Are Using Special Enrollment Periods to Sign Up for Health Insurance
Uninsured Residents Can Enroll in Health Coverage Now
DENVER – The state’s official health insurance marketplace, Connect for Health Colorado, reports that more than 6,000 Coloradans have signed up for a health insurance plan since the annual enrollment period closed mid-January using Special Enrollment Periods; about 1,000 enrollments per week. That brings Colorado’s total marketplace enrollments for the 2022 coverage year to nearly 205,000; a milestone that Connect for Health Colorado didn’t see until July last year.
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).
RECORD-SETTING 182,000+ ENROLL IN COVERAGE THROUGH MARYLAND HEALTH CONNECTION DURING OPEN ENROLLMENT
Uninsured Marylanders can enroll through the state tax form's Easy Enrollment or, if eligible, through Medicaid
BALTIMORE – Gov. Larry Hogan today announced that a record number of Marylanders enrolled for health coverage for 2022 in the annual open enrollment that just ended through Maryland Health Connection. The 182,861 enrollments marked a new record for the state-based health insurance marketplace, a 10% increase over the 2021 open enrollment total of 166,038.
Maryland was one of four state marketplaces, along with Colorado, New York and the District of Columbia, that extended their original open enrollment deadlines in response to the hospitalization surge driven by the Omicron variant of Covid-19. Maryland’s open enrollment was originally scheduled to run from Nov. 1, 2021 to Jan. 15, 2022, but was extended through February.
In March 2020, Congress offered states additional Medicaid funding as long as they agreed to keep everyone enrolled in the program for the duration of the federal public health emergency, regardless of their eligibility status. As of January 2021, nearly 10 million had joined Medicaid or the Children’s Health Insurance Program (CHIP) during the pandemic, pushing enrollment to a record high of more than 80 million people. (Some independent analyses put the current total higher, closer to 90 million.)
I'm not going to mince words here: While the Omicron variant wave of the COVID pandemic appears to have mostly subsided nationally (the 7-day new case average has plummeted from an all-time high of around 800,000/day nationally in mid-January to around 55,000/day now), I think the seemingly across-the-board abandonment of mask mandates at the federal, state and local levels is still a big mistake.
I would have waited until new daily cases drop further (to perhaps 10 per 100,000 per day, or around ~33,000/day nationally) and hold at that rate or lower for a solid month before giving the "all clear" for vaccinated folks to remove their masks at most indoor settings.
For unvaccinated people, of course, I'd want them to be required to wear masks indoors in public until they actually get vaccinated (which, aside from young children, nearly all of them should have done already; it's been nearly a year since they've been widely available, for God's sake).
A new Covered California analysis describes the potential impact to consumers if the increased health insurance subsidies that were part of the American Rescue Plan are allowed to expire at the end of 2022.
In California, all consumers would face premium increases, including 1 million lower-income consumers (individuals earning less than $32,200 per year), who would see their premiums more than double.
In addition, middle-income individuals and families (for individuals, those earning more than $51,520 per year), would no longer be eligible for any financial help and would face higher monthly premium costs that for many will mean annual cost increases in the thousands of dollars.
The increase in costs could force more than 150,000 people in California and more than 1.7 million nationally to drop their health insurance.
