Psychedelic Donuts

Note: Yes, I'm aware that the upcoming "unwinding" of Medicaid via the end of the Public Health Emergency provisions is about to blow this entire project up, but that's kind of the point, to see where things stand as of this moment.

Nearly 7 years ago, I compiled the best breakout I could estimate of the healthcare coverage status of the entire U.S. population, in a post (and graphic) which gained quite a bit of praise. It even (to my surprise) ended up as a finalist in the National Institute for Health Care Management (NIHCM) Digital Media Awards in 2017.

Seven years, two administrations, one federal insurrection and one global pandemic later, I figured it was time to finally update the breakout of what I've since decided to refer to as the Psychedelic Donut.

Pennie Logo

via Pennie, Pennsylvania's state-based ACA exchange:

This Tax Season, PA takes the Path to Pennie™ for Quality, Accessible Health Coverage

This tax season, uninsured Pennsylvanians can enroll in quality, low-cost health coverage through Path to Pennie™. The Pennsylvania Department of Revenue and Pennie have teamed up to allow uninsured tax filers the ability to get covered outside of Open Enrollment. When completing their Pennsylvania state income tax return, individuals can indicate interest in getting covered through Pennie.

Uninsured Pennsylvanians will be able to indicate they are without health insurance through an optional tax form called, REV-1882 ‘Health Insurance Coverage Information Request.’ This form creates a simple and straightforward way for Pennsylvanians to specify that they, their spouse, and/or their dependents do not have health coverage and are interested in learning more about the services provided by Pennie.

I'll write more about President Biden's future healthcare agenda wish list after this evening's State of the Union address (let's face it, not much of it will be accomplished given that the GOP has retaken control of the House of Representatives), but in the meantime here's a nice summary of the major healthcare-related accomplishments of his administration so far, via the White House website:

Lowering Health Care Costs for Families

Covered California Logo

via Covered California:

Covered California Provides New Opportunities for People to Sign Up for Health Insurance Through Special Enrollment

SACRAMENTO, Calif. — Covered California is reminding Californians that they still have an opportunity to sign up for quality health insurance and get financial help to lower the cost of their monthly premiums even though open enrollment ended on Jan. 31. Every year, Covered California allows people who have experienced a significant life event to sign up for coverage during special enrollment.

“Californians can still protect themselves and their families with quality health insurance for the rest of the year, if they have had a major change in their lives,” said Jessica Altman, executive director of Covered California. “If you have recently lost your coverage, gotten married, had a baby, or have been affected by California’s winter storms, visit CoveredCA.com to check out what plans are available to you.”

Connect for Health Colorado Logo

via the Colorado Dept. of Regulatory Agencies:

Consumer Advisory: Former Individual Market Bright Health & Oscar Health Enrollees Have Until March 1 to Choose New Coverage 

  • Special Enrollment Period allows them to still get insurance for 2023. 

DENVER - People who had individual health insurance plans (insurance not from an employer) from Bright Health and Oscar Health in 2022 are reminded that they have until the end of February to choose a health plan from another company for 2023 insurance. 

Even though the regular open enrollment for individual health insurance plans concluded on January 15, consumers who had their Bright or Oscar coverage finish at the end of December are allowed a 60-day special enrollment period (SEP) because those companies did not offer plans for 2023. This 60-day SEP started on January 1 and will continue until March 1, 2023.

Washington HealthPlan Finder

via Washington HealthPlanFinder:

Special enrollment remains open for those who qualify for, but are not enrolled in, Cascade Care Savings

More than 60% of Washington Healthplanfinder customers are in a Cascade Care plan

Washington Health Benefit Exchange (Exchange) released its 2023 Enrollment Preview Report today. Nearly 231,000 customers signed-up for a 2023 qualified health plan through Washington Healthplanfinder, including 37,000 new customers.

“We had our highest net enrollment gain and launched the new Cascade Care Savings during open-enrollment for 2023, resulting in our highest percentage of subsidized customers and highest percentage of plan switching,” Exchange interim CEO Jim Crawford said.

The exact QHP total, according to the preview report, was 230,800, down 3.7% from the 2022 Open Enrollment Period.

Georgia

h/t to Wesley Sanders for calling attention to this story by Ariel Hart & Greg Bluestein of the Atlanta Journal-Constitution:

Georgia GOP leaders have proposed a bill that they hope will lead to a state takeover of the health insurance exchange marketplace for Affordable Care Act plans.

...Traditionally a majority of Georgians shop for ACA plans on the federally run marketplace website, healthcare.gov. Eighteen states use their own marketplace website, according to the Kaiser Family Foundation. The key feature of these sites is they allow shoppers to objectively compare their options for price and coverage.

It’s unclear exactly what the state’s replacement would be.

New York State of Health

As I noted this morning, while the 2023 ACA Open Enrollment Period has now officially ended in all states, there's still a lot of Special Enrollment Period (SEP) exceptions for people who have Qualified Life Experiences (QLEs) such as losing their current coverage, turning 26, moving, getting married/divorced, giving birth and so forth.

There's also year-round enrollment available for members of Native American tribes, as well as those eligible for Medicaid and the Children's Health Insurance Program (CHIP).

Finally, in most states, residents are eligible to enroll year-round as long as their income is below a certain threshold--usually 150% of the Federal Poverty Level (FPL), somewhat higher in some states, including New York, where residents earning. up to 200% FPL can enroll in the Essential Plan year-round.

COVID-19

Last month I noted that the partisan COVID death rate gap, which had been significantly higher in the reddest U.S. counties than the bluest counties every month since July 2020, appeared to be on the verge of finally disappearing entirely:

The initial COVID wave in March - May 2020, of course, devastated Blue America, primarily densely populated (and heavily Democratic) New York and New Jersey, while leaving Red America (mostly sparsely populated, rural Republican counties) relatively unscathed.

This situation quickly began to reverse itself only a few months later. Starting in July 2020--the same month the Vanity Fair expose was published, as it happens--the situation had already reversed itself: The reddest fifth of the U.S. was already experiencing a higher COVID death rate than the bluest fifth...and it has stayed that way ever since.

The 2023 ACA Open Enrollment Period has now officially ended in every state.

However, as I keep noting, there's still plenty of people who are eligible to enroll in ACA healthcare coverage during the off-season (thanks to Louise Norris for providing some of the links below):

MOST STATES: If your household income is less than 150% of the Federal Poverty Level (or higher in some states), you can enroll year-round:

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