New Mexico is the latest state to post their preliminary 2021 rate change filings for both the individual and small group markets. There's several key things to note here:
Michigan is the 8th state (by my count) where the insurance carriers have posted their preliminary 2021 premium rate change filings. Every year brings some new twist (in 2018 it was CSR reimbursement payments being cut off; in 2019 it was the zeroing out of the ACA's federal individual mandate penalty; in 2020 it was sort of the repeal of the ACA's health insurer tax (HIT), although that didn't actually happen until after 2020 premiums had already been locked in; and for 2021...it's the COVID-19 pandemic, of course.
I've therefore added a new column for my weighted average rate change spreadsheets. So far only a handful of carriers have tacked on any substantial rate changes due to expected cost increases from testing & treatment of COVID-19 next year...the general rule of thumb seems to be that the added costs are pretty much gonna be cancelled out by reduced claims from non-COVID healthcare services (delayed/cancelled treatments/procedures, etc).
In Red State Oklahoma, Medicaid Expansion Nears 2020 Ballot
A campaign in Oklahoma to expand Medicaid via the ballot box far eclipsed the necessary number of signatures needed to put the measure before voters next November 2020, supporters said Thursday.
The submission of 313,000 signatures to put a constitutional amendment on next year’s general election ballot shattered the required 178,000 needed by the Oklahoma Secretary of State’s office, organizers said. Media reports in Oklahoma said supporters of Medicaid expansion broke a state record when it comes to signatures needed for a statewide ballot initiative.
Over at healthinsurance.org, Louise Norris has already done the work for me in tracking down the preliminary 2021 individual and small group market rate changes for the state of Maine:
Average premiums expected to decrease Maine’s exchange in 2021
Maine’s three individual market insurers filed proposed rates for 2021 in June 2020 (average proposed rate changes are summarized here by the Maine Bureau of Insurance). For the second year in a row, average rates are expected to decrease for 2021:
House Democrats on Monday passed a bill that would bolster the Affordable Care Act by hiking premium subsidies and incentivizing states to expand Medicaid.
UPDATE 9/29/20: There have been several important developments in the #TexasFoldEm case since I posted this back in June.
For one thing, another 81,000 Americans have died of COVID-19 and another 4.7 million Americans have tested positive for it.
For another, Supreme Court Justice Ruth Bader Ginsburg has passed away, and Donald Trump has already formally nominated an ultra-right wing zealot who is on the record as wanting the ACA to be struck down to replace her. His nominee's confirmation hearings have already been scheduled to start in mid-October, meaning that there's a very good chance that she'll be confirmed by the GOP-controlled Senate before Election Day...in which case the Texas Fold'em case to strike down the entire ACA could end up being the very first case she hears as a U.S. Supreme Court Justice on November 10th.
With this in mind, I figured this would be a good time to re-up the analysis below.
Here's my weekly update of the spread of COVID-19 across all 50 states, DC & PR over time, from March 20th through June 27th, 2020, in official cases per thousand residents.
I've given up trying to tie every trend line to the state name; it simply gets too crowded near the bottom even with a small font size, so I've grouped some of them together where necessary.
Note that this graph doesn't take into account any of the rumored undercounts in Florida, Georgia etc...these are based on the official reports from the various state health departments. If and when those are ever modified retroactively I'll update the data accordingly.
I've highlighted the three states with the ugliest increases in per capit cases over the past week or so (Arizona, Florida and Texas), along with New York and Michigan for reference.
Click the image itself for a high-resolution version.
Note: The sudden jumps in New York and Massachusetts reflect reporting methodology changes; MA started including probable COVID-19 cases, while New York added a batch of 15,000 positive antibody tests results they hadn't been previously including.
Now that I've brought all 50 states (+DC & the U.S. territories) up to date, I'm going to be posting a weekly ranking of the 40 U.S. counties (or county equivalents) with the highest per capita official COVID-19 cases and fatalities.
Again, I've separates the states into two separate spreadsheets:
Most of the data comes from either the GitHub data repositories of either Johns Hopkins University or the New York Times. Some of the data comes directly from state health department websites.
Here's the top 40 counties ranked by per capita COVID-19 cases as of Saturday, June 27th:
Yesterday, the Trump Administration formally submitted their official brief with the Supreme Court of the United States asking SCOTUS to completely and fully strike down the entire Patient Protection & Affordable Care Act. This is the latest development in the utterly insane "California vs. Texas" lawsuit (formerly "Texas vs. U.S.", "Texas vs. Azar", or as I prefer to label it, "Texas Fold'em", a name originally coined by U of M law professor Nicholas Bagley but which doesn't seem to have caught on with anyone other than me so far.
I've written about this completely absurd lawsuit more times than I care to remember, but as a reminder, here's what it comes down to.
The image below is the "3-legged stool" of the Affordable Care Act.
The blue leg represents the various patient protections which the ACA requires health insurance carriers to provide--guaranteed issue, community rating, essential health benefits and so on.
For the past few months, I've been keeping track, to the best of my ability, of how many people have been enrolling in ACA exchange policies utilizing the COVID-19-specific Special Enrollment Periods which have been offered by 12 of the 13 state-based exchanges (SBEs). My most recent update brings the grand total of confirmed SEP enrollments to at least 260,000 across 8 states, averaging around 3,500 per day.
The actual number is obviously higher than this, of course, since I don't have any data from the other four state exchanges (DC, New York, Rhode Island and Vermont), although three of those four are pretty small anyway...and even in New York, their unique "Essential Plan" (the Basic Health Plan program established under the ACA itself) has likely been sucking up the bulk of individual market enrollees earning up to 200% FPL anyway...and you can enroll in the Essential Plan year-round regardless of the pandemic. I therefore doubt that NY's COVID SEP numbers for those earning more than 200% FPL are that dramatic. All told, I'd expect NY, RI, VT & DC to only add perhaps another 25,000 or so QHP enrollees to the table below:
