December 2022

via BeWell NM, New Mexico's ACA exchange:

2023 Open Enrollment Report

This report provides a summary of information for week one of the beWellnm health insurance individual Marketplace Open Enrollment Period for plan year 2023 (OEP 2023). The report contains data from the beWellnm eligibility and enrollment platform for OEP 2023, and includes an overview of the following:

• plan selections
• new enrollees
• enrollees renewing coverage
• Customer Engagement Center call volumes
• website traffic

Enrollment

This section contains enrollment data through December 20, 2022.

1. Total Plan Selections (net): Count of unique individuals who have selected a Plan Year (PY) 2023 Marketplace medical plan. Count includes all new and re-enrolling consumers (defined in Indicators 2 and 3), regardless of whether the consumer has paid the first month premium. Count does not include plans that were canceled or terminated.: 37,892

via Maryland Health Connection:

BALTIMORE (Dec. 28, 2022) – Marylanders have until Dec. 31 to get a health plan beginning Jan. 1 on Maryland Health Connection, the state’s health insurance marketplace and the only place to get financial help with coverage. To be covered at the start of the new year, Marylanders must enroll by Dec. 31, 2022. If you enroll in January, your coverage will not start until Feb. 1, 2023. This open enrollment period is for private plans only. Those who qualify for Medicaid may enroll any time of year.

via the New Jersey Dept. of Banking & Insurance (via email; no link yet):

NJDOBI Announces Nearly 300K Have Signed Up for Health Insurance through Get Covered New Jersey 

NJ residents must enroll by Dec. 31 for coverage starting Jan. 1  

9 in 10 People Who Enroll Qualify for Savings; Many Pay $10 a Month or Less for Health Coverage 

TRENTON – New Jersey Department of Banking and Insurance Commissioner Marlene Caride today announced that nearly 300,000 New Jersey residents signed up for a 2023 health insurance plan through the state’s official health insurance marketplace, Get Covered New Jersey, in the first five weeks of the Open Enrollment Period that started on November 1, 2022. Total signups have increased compared to the same timeframe last year, as residents continue to take advantage of record levels of financial help available from the State of New Jersey and the federal government.

Open Enrollment for 2023 health insurance ends January 31st, 2023, but residents must enroll in a plan by December 31st, 2022 for coverage to take effect on January 1st, 2023.

via BeWell NM, New Mexico's ACA exchange:

2023 Open Enrollment Report

This report provides a summary of information for week one of the beWellnm health insurance individual Marketplace Open Enrollment Period for plan year 2023 (OEP 2023). The report contains data from the beWellnm eligibility and enrollment platform for OEP 2023, and includes an overview of the following:

• plan selections
• new enrollees
• enrollees renewing coverage
• Customer Engagement Center call volumes
• website traffic

Enrollment

This section contains enrollment data through December 20, 2022.

1. Total Plan Selections (net): Count of unique individuals who have selected a Plan Year (PY) 2023 Marketplace medical plan. Count includes all new and re-enrolling consumers (defined in Indicators 2 and 3), regardless of whether the consumer has paid the first month premium. Count does not include plans that were canceled or terminated.: 37,056

Yesterday I noted that the big year-end federal omnibus spending bill includes provisions which allow states to start kicking people off of Medicaid who are only eligible thanks to the COVID-19 public health emergency bills passed in 2020 & 2021..but it at least does so in a fairly responsible way by phasing out the extra federal matching funds gradually over a 9-month period, to prevent states from dumping everyone all at once.

The omnibus bill also includes other important positive Medicaid provisions such as letting children who are eligible for the program stay on it for at least 12 months regardless of  household income changes, and letting states offer 12 months of postpartum Medicaid/CHIP coverage to newborn children & their mothers on a permanent basis instead of the current 5-year limit.

As I (and many others) have been noting for over a year now, the official end of the federal Public Health Emergency (PHE), whenever it happens, will presumably bring with it reason to celebrate...but will also likely create a new disaster at the same time:

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):

Back in May, I first wrote about news that two additional states, Oregon and Kentucky, had decided to join New York and Minnesota in launching a Basic Health Plan (BHP) program under a provision allowing them to do so in the Affordable Care Act:

The Basic Health Program (BHP) – section 1331 of the ACA — was envisioned as a solution, although most states did not establish a BHP. Under the ACA (aka Obamacare), states have the option to create a Basic Health Program for people with incomes a little above the upper limit for Medicaid eligibility, and for legal immigrants who aren’t eligible for Medicaid because of the five-year waiting period.

The way BHPs work, once established, is like so:

via Washington HealthPlanFinder:

Washingtonians can still enroll in or change their plan for a Feb. 1, 2023, effective date.

Yesterday, Dec. 15, was the last day to buy a 2023 health plan for it to begin on Jan. 1, 2023. But do not fret! It’s not too late for you to enroll in, or change, your 2023 plan at Washington Healthplanfinder. You can enroll in or change your plan until Jan. 15, for a Feb. 1, 2023, start date.

Thousands of Washingtonians have already visited Washington Healthplanfinder to secure their 2023 health insurance ahead of the Dec. 15 deadline. Additionally, several individuals and families chose to auto-renew into plans, and should their previous plan no longer be available, they’re placed in a comparable plan.

Via Access Health CT's News/Press Releases page:

Stats as of December 16, 2022

Qualified Health Plans (QHP):

• QHP Enrollment In 2023 Coverage: 101,793
• 2022 OE Acquisition Summary: 15,268

Medicaid:

• Completed applications/ redeterminations processed through the integrated eligibility system: 15,938

I've never been entirely sure what the "Acquisition Summary" figure refers to, but I've confirmed that it's already included in the larger number.

OK, I really, really wasn't planning on updating these graphs yet again; it takes forever and I more than made my point with weekly/monthly updates for a solid year and a half period.

But then...this morning, NY Times columnist & Nobel Prize-winning economics professor Paul Krugman prominently featured my most recent COVID Death Rate by Partisan Lean & Vaccination Rate analysis from September in his latest column, so I figured what the hell and decided to dust off my spreadsheet one more time.

I already knew going into this update that the divides in Red/Blue COVID death rates and likely as well as in Vaccination Rate COVID death rates have shrunk over the past few months, for several reasons: First, the overall COVID death rate has dropped dramatically since the summer (which is obviously a good thing); it's been averaging between 300 - 400 per day since mid-October.

via NY State of Health:

• Consumers Must Renew or Enroll by December 15 for January 1 Coverage
• Several Events Scheduled Statewide with Enrollment Assistors on Site to Help Consumers Enroll
• Expanded Federal Tax Credits Continue for 2023 Health Plans

ALBANY, NY. (December 14, 2022) – NY State of Health, the state’s official health plan Marketplace, today announced the December 15 deadline is quickly approaching for New Yorkers who want their coverage in a Qualified Health Plan (QHP) effective by January 1, and urges consumers to take action now to avoid a gap in health insurance coverage.

The ACA includes a long list of codified instructions about what's required under the law, but many of the specific details are left up to the agency responsible for implementing it since the legal text itself can't possibly cover every conceivable detail involved. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS).

Each year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of tweaks to some of the specifics of how the ACA is actually implemented.

The ACA includes a long list of codified instructions about what's required under the law, but many of the specific details are left up to the agency responsible for implementing it since the legal text itself can't possibly cover every conceivable detail involved. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS).

Each year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of tweaks to some of the specifics of how the ACA is actually implemented.

The ACA includes a long list of codified instructions about what's required under the law, but many of the specific details are left up to the agency responsible for implementing it since the legal text itself can't possibly cover every conceivable detail involved. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS).

Each year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of tweaks to some of the specifics of how the ACA is actually implemented.

With South Dakota becoming the latest holdout state to finally expand Medicaid to adults earning up to 138% of the Federal Poverty Level (FPL) under the Affordable Care Act last month, there's now just 11 states remaining which still haven't done so.

The smallest of these, which is also the smallest state in the country, is Wyoming, which has had a long & storied history when it comes to Medicaid expansion fakeouts. The "Equality State" legislature has considered expanding Medicaid to the roughly 19,000 residents who would become newly eligible for the program eight times since the ACA was signed into law in 2010, only to see approval of it fail at one stage or another every time.

 Well, according to this article by Katie Roenigk at "County 10" in Fremont County, Wyoming, it looks like the 9th time may be the charm:

via Covered California:

SACRAMENTO, Calif. — A new federal rule takes effect on Monday, opening the door for nearly 400,000 people to enroll in a more-affordable health plan through Covered California. The change means families who have been ineligible for financial help because one member is insured through an employer may now be eligible for subsidies to lower the cost of their premiums if they enroll in a health plan offered through Covered California.

“The door to more-affordable health coverage is opening today for hundreds of thousands of Californians,” said Jessica Altman, executive director of Covered California. “There are families across California who will now be able to save hundreds of dollars a month, and thousands of dollars a year, if they switch from employer-sponsored coverage to a Covered California plan.”

What You Need to Know

Disclosure: Health Sherpa is a paid sponsor of this site.

Enhanced Direct Enrollment:

Enhanced direct enrollment (EDE) is a new pathway for consumers to enroll in health insurance coverage through the Federally-facilitated Exchange. This pathway allows CMS to partner with the private sector to provide a more user-friendly and seamless enrollment experience for consumers by allowing them to apply for and enroll in an Exchange plan directly through an approved issuer or web-broker without the need to be redirected to HealthCare.gov or contact the Exchange Call Center.

In short, EDEs are basically a private version of HealthCare.Gov which are authorized by the federal government to hook directly into the HC.gov back end. This means that people who enroll via an EDE website are enrolling in on-exchange ACA coverage (including ACA financial subsidies as appropriate); they're just doing so via a 3rd party web interface. There's actually several dozen different EDEs, several of which have advertised on this site.

A few weeks ago I wrote about a bill pending in the District of Columbia Council, of all legislative bodies, which, had it passed, would have seriously undermined ACA protections for thousands of DC residents with employer-based healthcare coverage, as well as potentially setting precedent for similar bills in other states:

Yes, that's right: This is an attempt to bypass ACA rules for an industry which employs over 4 million people nationally (I don't know how many in DC specifically).

Again, here's what PEOs are:

via MNsure, Minnesota's ACA exchange:

ST. PAUL, Minn.—Minnesotans have just one week left to sign up for health insurance through MNsure before the December 15, 2022, deadline for coverage starting January 1, 2023.

MNsure, Minnesota’s health insurance marketplace, is where Minnesotans can select medical and dental coverage and access premium tax credits (discounts) to lower the cost of monthly premiums. Tax credits aren’t available anywhere else, and next year households receiving tax credits are expected to save an average of $560/month.

“Many Minnesota families who have never been eligible for discounts through MNsure now qualify for tax credits in 2023 because of recent changes to federal rules,” said MNsure CEO Nate Clark. “If your family has been relying on health insurance you get through an employed family member, now is the time to check MNsure.org/newoptions and see whether you can access lower-cost health insurance for next year.”

via Connect for Health Colorado:

Thousands of Residents Have Used the Marketplace to Enroll in 2023 Health Insurance

DENVER— This Thursday, December 8, is Get Covered Colorado Day. This day of action encourages as many Coloradans as possible to enroll in 2023 health coverage during the annual Open Enrollment Period, which runs through January 15. In the first five weeks of this year’s Open Enrollment, approximately 145,000 residents enrolled in a plan through Colorado’s official health insurance marketplace, Connect for Health Colorado.

Seeing how Connect4HealthCO announced 57.5K enrollees just 6 days ago, it's pretty safe to assume that they didn't have over 87,000 more Coloradans suddenly enroll in less than a week. Presumably the 145K figure includes auto-renewals of the remaining current enrollees who haven't actively signed up for a 2023 policy yet.

As I noted earlier today, the Centers for Medicare & Medicaid Services have released an updated 2023 ACA Open Enrollment Period data report, which runs through 12/03/22 for the 33 states hosted by the federal exchange and 11/26/22 for the 18 states which operate their own exchanges.

There were several major takeaways, including an overall 18% year over year enrollment increase so far, with new enrollments up 28%, active renewals for current enrollees up 17% and so forth.

However, there's another important factor to look at when comparing 2023 ACA enrollment to date vs. the same point in 2022 (actually one day less): Medicaid expansion.

The table below breaks out every state's 2023 enrollment vs. the same point in 2022, including which type of exchange they use as well as their ACA Medicaid Expansion status as of this writing:

November 29th, 2022, via the Centers for Medicare & Medicaid Services:

Today, the Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). These programs serve as key connectors to care for more millions of Americans.

As of August 2022, 64,942,984 people are enrolled in Medicare. This is an increase of 111,278 since the last report.

• 34,939,872 are enrolled in Original Medicare.
• 30,003,112 are enrolled in Medicare Advantage or other health plans. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage. 

• ...As of August 2022, 90,550,412 people are enrolled in Medicaid and CHIP. This is an increase of 587,411 since the last report.
• 83,494,001 are enrolled in Medicaid
• 7,056,411 are enrolled in CHIP

As I noted at the time:

via Covered California:

Covered California joined leading health officials in San Diego to encourage enrollment in a quality insurance plan and improve access to address an increased need for behavioral health care across the state.

“The pandemic took a toll on us in so many ways, including our behavioral and mental health, which are critical to our ability to live happy, healthy and productive lives,” said Jessica Altman, executive director of Covered California. “Getting the right behavioral health care starts with making sure people have health insurance with access to quality providers, and that can be done right now through Covered California’s open enrollment.”

What You Need to Know

via Amy Lotven of Inside Health Policy:

Advocates To CMS: Fix Rate Misalignment In Next Exchange Reg

A coalition of patient advocates is urging HHS to address high out-of-pocket costs by demanding that insurers selling marketplace coverage strictly adhere to the Affordable Care Act’s rate-setting requirements. Insurers have strayed from the mandate in recent years by underpricing silver-tier plans and overpricing the more-generous gold-level products, the advocates say, highlighting an issue that experts have been raising for years and that some states are already addressing at the local level.

But health experts also say that HHS must fix misalignments in the risk adjustment program - and that exchanges must have strong consumer decision support tools -for a policy fix to be sustainable.

By clarifying and enforcing the ACA’s single risk pool requirement, HHS could significantly reduce consumers’ cost-sharing burdens while also discouraging gaming, the advocates say.

via the NJ Dept. of Banking & Insurance:

Department Releases Study and Begins Rulemaking Process to Require Health Benefit Plans Cover Abortion Services Without Exceptions that Limit Coverage; Requests that Insurers Implement Change for 2023

TRENTON — The New Jersey Department of Banking and Insurance today announced that it has released a study on access to comprehensive reproductive health care that found a need for regulatory action to require coverage for abortion services under health benefits plans regulated by the department, and has begun the formal rulemaking process to implement the requirement. The department performed this study as part of the implementation of the historic Freedom of Reproductive Choice Act signed by Governor Phil Murphy earlier this year, which codifies the constitutional right to freedom of reproductive choice in New Jersey.  

via CoverME.gov, Maine's new state-based ACA exchange:

Plan Selection Snapshot

The Maine Department of Health and Human Services (DHHS) Office of the Health Insurance Marketplace (OHIM) will release biweekly updates on plan selections through CoverME.gov, Maine’s Health Insurance Marketplace.  

Plan selections provide a snapshot of activity by new and returning consumers who have selected a plan for 2023. “Plan selections” become “enrollments” once consumers have paid their first monthly premium to begin insurance. These numbers are subject to change as consumers may modify or cancel plans after their initial selection.   

The deadline to select a plan for coverage beginning January 1, 2023 is December 15, 2022. Consumers who select a plan after that date will have coverage beginning February 1, 2023. 

CoverME.gov Activity Through November 26th, 2022 

via Maryland Health Connection:

Set a Goal: Enroll Statewide Events Dec. 3-15 Feature Extended Hours

BALTIMORE (Nov. 29, 2022) — Maryland Health Connection will have trained experts to help Marylanders understand their options and enroll in a health plan for 2023 at upcoming statewide events. Shoppers can take advantage of free assistance at a local Set a Goal: Enroll event. Help is also available virtually or by phone with weekend and extended hours.

Last year, the average Maryland Health Connection customer buying private health insurance saved $289 a month on their monthly premium. Many Marylanders ages 18-34 can get special discounts for 2023 health plans — on top of other savings available through Maryland Health Connection.

“We are pleased that our navigators, who are so knowledgeable and helpful, are providing extra help in December to help Marylanders choose and enroll in a private health plan for the new year,” said Michele Eberle, executive director of the Maryland Health Benefit Exchange.