LGBTQ Flag

via Amy Goldstein of the Washington Post:

The Biden administration said Monday it will provide protections against discrimination in health care based on gender identity and sexual orientation, reversing a policy of its predecessor’s that had been a priority for social conservatives and had infuriated civil liberties advocates.

The reversal is a victory for transgender people and undoes what had been a significant setback in the movement for LGBTQ rights.

The shift pertains to health-care providers and other organizations that receive funding from the Department of Health and Human Services. Civil rights groups had said the Trump administration policy would allow health-care workers and institutions, as well as insurers, to deny services to transgender individuals.

The reversal is the latest step Biden officials are taking to reorient the federal government’s posture on health care, the environment and other policy areas away from the conservative cast of the Trump era, replacing it with a more liberal stance.

Wyoming

March 31st, 2021:

Senate committee kills Medicaid expansion bill, by Morgan Hughes

Medicaid expansion will not happen in Wyoming this year.

The state’s Senate Labor, Health and Social Services Committee killed a bill Wednesday morning to expand the federal insurance program, which would have insured an estimated 25,000 additional Wyomingites.

Lawmakers have defeated similar proposals for nearly a decade. Advocates hoped this year might be different. Many House Republicans voiced a change of heart after the COVID-19 pandemic and the decline of fossil fuels rocked the state’s economy, leaving many without health coverage. This session was the first in which a bill to expand the program passed a legislative chamber.

Washington HealthPlan Finder

This just in from the Washington Health Benefit Exchange...

Pam MacEwan, CEO Washington Health Benefit Exchange (Exchange), issued the following statement today after the signing of Cascade Care 2.0 into state law:

“Today’s signing of the Cascade Care 2.0 bill sets the stage to improve the quality, availability, and affordability of the health plans offered through Washington Healthplanfinder. 

“This bill establishes a state premium assistance program that will benefit over 100,000 low-income Washingtonians struggling to pay for health insurance; increases statewide availability of the state’s first-in-nation public option program; and builds on the success of the high-quality Cascade Care standard plans – that have created average savings of $1,000 in out-of-pocket costs. 

ACA Signups Logo

With this morning's confirmation of my post from Saturday that over 1 million more people have enrolled in ACA exchange coverage via HC.gov during the ongoing COVID Special Enrollment Period, I was reminded of a headline I wrote back in March:

Exclusive: Official 2021 #ACA Open Enrollment Period Hits 12.0 Million QHPs For First Time Since 2017

At the time I only had estimated 2021 Open Enrollment Period (OEP) data for several states, but my estimate was confirmed a couple of weeks ago when the Centers for Medicare & Medicaid Services (CMS) issued the official 2021 OEP report, which states that the official total number of ACA Qualified Health Plan (QHP) selections for 2021 was 12,004,365 people.

Michigan

A week ago I noted that my year-long tracking of COVID-19 cases and deaths along partisan lines has proven to be very much justified, as recent headlines in major news outs have proven:

Nearly half of Republicans say they don’t want a Covid vaccine, a big public health challenge.

But more than two in five Republicans said they would avoid getting vaccinated if possible, suggesting that President Biden has not succeeded in his effort to depoliticize the vaccines — and leaving open the question of whether the country will be able to achieve herd immunity without a stronger push from Republican leaders to bring their voters on board.

‘I’m still a zero’: Vaccine-resistant Republicans warn that their skepticism is worsening

Medicaid Expansion Map

I ran these numbers last month in my write-up speculating about the prospect of Democrats and the Biden Administration effectively "federalizing" ACA Medicaid expansion altogether by raising the FMAP threshold from 90% to 100%, but it's worth a standalone blog post as well.

The Kaiser Family Foundation estimates that nearly 2.2 million Americans currently fall into the "Medicaid Gap" in the 12 states which haven't expanded Medicaid under the Affordable Care Act yet. They also estimate that another 1.8 million uninsured Americans are eligible for subsidized ACA exchange plans who would be eligible for Medicaid instead if those state actually did expand Medicaid. That's nearly 4.0 million total.

Florida

As I noted recently, I've relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.

For total monthly Medicaid enrollment, the official Medicaid.gov monthly enrollment data is only available dating back to late 2013, and it's only current through November 2020. The Kaiser Family Foundation has also compiled the pre-2014 average enrollment for each state based on the 3rd quarter of 2013. In some states I've been able to find more recent enrollment data for December 2020 or later.

COVID-19 Icon

A picture is worth 1,000 words and all that.

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.

NOTE: I've recently updated the spreadsheet to account for the official 2020 Census Bureau populations of every state. In most cases this has nudged their case & mortality rates down slightly.

Nearly 1 out of every 7 residents of North Dakota, South Dakota and Rhode Island have tested positive for COVID-19 to date.

More than 1 out of every 9 residents of Iowa, Tennessee, Utah, Arizona, South Carolina, Oklahoma, Nebraska and Arkansas.

More than 1 out of 10 in New Jersey, Indiana, Delaware, Mississippi, Kansas, Alabama, Illinois, Florida, New York, Georgia, Idaho, Wisconsin, Nevada, Minnesota, Wyoming, Montana and Texas.

More than 1 out of 20 in every state & territory EXCEPT Guam, Maine, Oregon, Vermont, U.S. Virgin Islands, Hawaii, N. Mariana Islands & American Samoa.

ACA Signups Logo

A few days ago, the Centers for Medicare & Medicaid Services (CMS) posted an updated report on the number of Americans who have selected Qualified Health Plans (QHPs) through HealthCare.Gov, which hosts ACA enrollment for 36 states during the ongoing COVID Special Enrollment Period (SEP) which began on February 15th and is set to continue through August 15th in most states.

In addition to the 940,000 QHPs via the federal exchange (HC.gov) from 2/15 through 4/30, I've compiled officlal SEP enrollment numbers for several of the states which operate their own ACA exchanges as well:

  • Colorado: 17,282 from 2/08 - 5/05
  • Connecticut: 5,890 from 2/15 - 4/15
  • Idaho: 3,600 from 3/01 - 3/31
  • Maryland: 15,150 from 1/01 - 2/28
  • Minnesota: 2,285 from 2/16 - 3/09
  • Nevada: 6,908 from 2/15 - 5/06
  • Pennsylvania: 11,126 from 2/15 - 3/25
  • Washington: 1,700 from 2/15 - 2/23

The total of these, plus the 940,000 via HC.gov, comes to 1,003,516 confirmed so far.

Nevada Health Link Logo

There's no formal press release yet, but I've confirmed that the Nevada Health Link ACA exchange has enrolled 6,908 additional Nevadans in ACA exchange coverage via the COVID Special Enrollment Period as of yesterday (5/06) so far.

This breaks out to around 85 per day from 2/15 - 5/06.

Unfortunately, I don't have Nevada's 2019 or 2020 SEP enrollment handy for comparison, but NV's statewide population (3.10) is right in between Arkansas (3.03 million) and Iowa (3.19 million), which at least allows for a rough comparison:

This strongly suggests that Nevada's 85/day average is perhap 2.5x higher than 2019 and perhaps twice as high as 2020, although 2020 is a fuzzier comparison since HC.gov didn't have a COVID SEP last year while the Nevada Health Link did.

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