CMS

So, in addition to their standard Weekly Snapshot Report, CMS issued a more comprehensive mid-OEP (Open Enrollment Period) press release this morning which not only finally breaks out the HealthCare.Gov enrollment data by state, but also includes partial 2022 OEP data for the 18 state-based ACA marketplaces (SBM). Each press release has some unique information, while some of it is duplicated, so this post sort of merges the two together, along with some additional analysis by myself.

First "National Snapshot" press release:

The Centers for Medicare & Medicaid Services (CMS) reports that nearly 4.6 million Americans have signed up for 2022 individual market health insurance coverage through the Marketplaces since the start of the 2022 Marketplace Open Enrollment Period (OEP) on November 1. This includes 3.9 million plan selections in the 33 states using the HealthCare.gov for the 2022 plan year, through December 4, 2021 (Week 5), and 625,000 plan selections in the 17 states and the District of Columbia with State-based Marketplaces (SBMs) that are using their own eligibility and enrollment platforms, through November 27, 2021 (Week 4). Total nationwide plan selections include 923,000 consumers (20% of total) who are new to the Marketplaces for 2022, and 3.6 million consumers (80% of total) who have active 2021 coverage and returned to their respective Marketplaces to renew or select a new plan for 2022.

CMS had already announced this previously but now it's official:

CMS Extends Open Enrollment Period and Launches Initiatives to Expand Health Coverage Access Nationwide

The Biden-Harris Administration, through the Centers for Medicare & Medicaid Services (CMS), is taking a number of steps that will make it easier for the American people to sign up for quality, affordable health coverage and reduce health disparities in communities across the country. Beginning this year, consumers will have an extra 30 days to review and choose health plans through Open Enrollment, which will run from November 1, 2021 through January 15, 2022, on HealthCare.gov.

via CMS:

The Biden-Harris Administration is expanding the number of Navigator organizations to help people enroll in coverage through the Marketplace, Medicaid, or the Children’s Health Insurance Program (CHIP) in 30 states with a Federally-Facilitated Marketplace. Through $80 million in grant awards for the 2022 plan year, 60 Navigator awardee organizations will be able to train and certify more than 1,500 Navigators to help uninsured consumers find affordable and comprehensive health coverage.

via Amy Lotven of Inside Health Policy:

CMS tells Inside Health Policy that it will be releasing a final report on its COVID-19 Special Enrollment Period in September and points out that consumers who submitted their applications by the Aug. 15 SEP deadline still have 30 days to select a plan. Additionally, staffers are contacting the “very small group” of consumers who reached out to the Marketplace Call Center just before the deadline but were unable to get through to a representative so that those individuals have a chance to enroll, the agency confirms.

The final report was obvious, since the 2021 "No Excuses Needed" SEP still ran through August 15th in most states (and is still ongoing in a few), but I figured they'd come out with it in late August, not September.

I admit that I didn't know (or had forgotten?) about those who submitted their apps prior to 8/15 still having a full month to select a plan. Granted, if they wait until mid-September their coverage won't start until October, giving them just 3 months to use up a full 12-month deductible, but still.

via CMS:

HHS Encourages States to Educate Eligible Immigrants about Medicaid Coverage

Today, the US Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS) issued an informational bulletin to states’ Medicaid and Children’s Health Insurance Program (CHIP) agencies reaffirming that the 2019 Public Charge Final Rule – “Inadmissibility on Public Charge Grounds” – is no longer in effect and states should encourage their eligible immigrant populations to access public benefits related to health and housing. 

Thanks to Amy Lotven of Inside Health Politics for the heads up:

CMS Thursday (July 15) announced a new advertising campaign that will run in the final 30 days of the special enrollment period slated to end Aug. 15, and the agency also confirmed Inside Health Policy’sreport that the agency plans to auto-adjust tax credits for consumers who do not return to the federal marketplace starting Sept. 1.

Sure enough, this press release was put out by CMS earlier today:

Last November, regular readers may recall I went on a bit of a personal crusade to rack up as much public comment as possible in opposition to several last-minute time bombs the Trump Administration attempted to plant on their way out the door:

I should also note that not every NBPP rule implemented by the Trump Administration (via CMS Administrator Seema Verma) has been terrible. Some are either perfectly in line with Obama-era NBPPs, inconsequential, and in a few cases have actually been good and helpful.

...Other proposed changes, however, can be either stupid or flat-out devastating. The proposed 2022 rule changes...which were pushed out after hours on Thanksgiving Eve, just 56 days before the Trump Administration ends...includes some OK ideas, but also includes some which would be harmful and one which would be disastrous (I've changed the order they're listed below to put the most troubling ones at the bottom):

The details get wonky, but the bottom line is that there were three proposed rule changes in particular which I was deeply concerned about:

For the past couple of weeks, I've been on a marathon session of analyzing and graphing out total enrollment in Medicaid in every state for each month from 2014 until now (using estimates based on the best available data for the first part of 2021).

Now that I've completed this for all 50 states +DC, I'm bringing it all together into a single national graph showing how enrollment has changed over time.

Aside from the initial ramping up of enrollment after ACA Medicaid expansion went into effect in most states starting in early 2014 (and an odd drop-off/jump in California in the third quarter of 2017), enrollment was pretty steady at the national level...until COVID struck in early 2020.

Since then, the combination of sudden, massive unemployment combined with the Families First & CARES COVID Relief acts (which boost federal funding of Medicaid programs while also prohibiting states from disenrolling current Medicaid enrollees during the public health crisis) have resulted in overall Medicaid enrollment rising dramatically over the past year and a half.

via the Centers for Medicare & Medicaid Services (CMS):

Today, Department of Health and Human Services (HHS) Secretary Xavier Becerra kicked off Asian Pacific Heritage Month by announcing that HHS will be partnering with select, national organizations the first week in May to support and enhance outreach and enrollment efforts for this population during the HealthCare.gov Special Enrollment Period (SEP). During the Asian American and Pacific Islander (AAPI) Week of Action, which runs May 3-7, 2021, HHS and partnering organizations will provide education and enrollment assistance to AAPI consumers and use social media to encourage them to enroll in affordable, quality health coverage available through HealthCare.gov. 

CMS is targeting specific populations more closely in order to reduce racial healthcare coverage inequality:

Department of Health and Human Services (HHS) Secretary Xavier Becerra announced commitments from national organizations to support Black American outreach and enrollment efforts during the Special Enrollment Period (SEP) made available on HealthCare.gov by President Biden due to the COVID-19 Public Health Emergency. Black Americans represent roughly 13% of the U.S. population but 16% of the uninsured.

As part of the Black American Week of Action, April 25 – May 1, HHS and its partnership organizations will combine social media efforts to inform Black American consumers and spur enrollment in affordable, quality health plans through HealthCare.gov. An estimated 66% of Black uninsured adults now may have access to a zero-premium plan and 76% may be able to find a low-premium plan as a result of expanded coverage.