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Written by: Covered California

Published: 24 December 2019

SACRAMENTO – While a federal court ruling last week leaves the federal individual mandate in legal limbo, Californians are reminded that a state law will take effect on Jan. 1 requiring all Californians to have health insurance.

“Open enrollment is underway right now. That means now is the time to sign up for a quality health plan through Covered California so you are protected in case you get sick or injured, and so you do not have to worry about a possible penalty,” said Covered California Executive Director Peter V. Lee. “Writing a check to the Franchise Tax Board when you file your 2020 taxes isn’t the real penalty – it’s getting hurt or ill and ending up with $50,000 hospital bill.”

California created a new state individual mandate penalty that is similar to the Patient Protection and Affordable Care Act’s penalty. It will be administered by the Franchise Tax Board, or FTB, and collected when people file their 2020 taxes starting in 2021.

“It’s important that everyone acts now to get health insurance starting in January 2020 to avoid the penalty when filing state tax returns in 2021,” said FTB Executive Officer Selvi Stanislaus.

For those facing a penalty, a family of four would pay at least $2,000, and potentially more, for not having health insurance throughout 2020.

The return of the penalty was an important element in Covered California’s record-low rate change of 0.8 percent in 2020, meaning consumers have already benefited from the new policy.

New financial help

In addition to the penalty, California is making new financial help available to eligible consumers to help further lower the cost of their coverage. On average, consumers between 200 and 400 percent of the federal poverty level will receive $21 per household, per month on top of their federal tax credits.

Meanwhile, for the first time in the nation, people who earn between 400 and 600 percent of the federal poverty level will be receiving an average of $460 per household, per month.

“More than half a million Californians have already found out they will benefit from this new money,” Lee said. “Consumers have through the end of January to see what plans are available to them and whether they qualify for financial help from the federal government, the state, or both.”

Gov. Gavin Newsom also reiterated his support of the Affordable Care Act when he joined Covered California during a teleconference last week.

“The Affordable Care Act is alive and well here in the state of California,” Newsom said. “We are saving lives, we’re expanding coverage, we’re deepening subsidies, and we’re doubling down on our commitment to fulfill the law’s promise and its potential.”

Californians already set to benefit from the state subsidy program include:

– Yuriana and Hector, who say their daughter is a Covered California miracle because without their health insurance they would not have been able to afford getting pregnant.

– Shannon and John, who were surprised when they received the news in the mail that they would be saving more than $1,200 a month because of the new state subsidies. Now they are able to focus on completing a longtime dream.

“We do not want people to miss out on this opportunity. We don’t want them to leave money on the table, and we don’t want them to get stuck with a big bill when they pay their taxes in 2021,” Lee said.

Recent court ruling

California’s individual mandate and penalty remain in place as state leaders prepare to respond to the recent ruling by a three-judge panel of the U.S. 5th Circuit Court of Appeals. On Wednesday, the panel ruled that the individual mandate was unconstitutional, but remanded the case to a lower court.

“The court ruling will not impact California and should not deter anyone from signing up during the current open-enrollment period,” Lee said. “The legal battle will continue for the foreseeable future, and Covered California will be working to educate people about the penalty and enroll as many as possible.”

Getting help enrolling

Consumers can easily find out if they are eligible for financial help and see which plans are available in their area by entering their ZIP code, household income and the ages of those who need coverage into Covered California’s Shop and Compare Tool.

Those interested in learning more about their coverage options can:

– Visit www.CoveredCA.com.
– Get free and confidential in-person assistance, in a variety of languages, from a certified enroller.
– Have a certified enroller call them and help them for free.
– Call Covered California at 800-300-1506.

California’s open-enrollment period continues through Jan. 31, 2020.

New health laws for 2020

Critical new laws will affect Californians and their health care in 2020.

Senate Bill (SB) 106 provides the appropriations for the state subsidy program, along with income eligibility and specified funding allocation by eligibility levels. (SB 106, Committee on Budget and Fiscal Review, Chapter 55, Statutes of 2019.)

SB 78 is the omnibus health trailer bill that establishes the individual mandate and penalty, as well as the requirements for the state subsidy program. (SB 78, Committee on Budget and Fiscal Review, Chapter 38, Statutes of 2019.)

Assembly Bill (AB) 1309 expands the individual market open-enrollment period to Nov. 1 to Jan. 31. It sets Feb. 1 as the effectuation date for those who enroll between Dec. 16 and Jan. 31. This will give consumers additional time to sign up for coverage, thereby helping more Californians to become insured. (AB 1309, Bauer-Kahan, Chapter 828, Statutes of 2019.)

AB 5 limits California companies’ use of workers as independent contractors rather than as employees. This bill may affect the provision of health insurance to these employees. (AB5, Gonzalez, Chapter 296, Statutes of 2019.)

SB 104 authorizes the provision of full-scope Medi-Cal to adults aged 19-25 regardless of their immigration status. (SB 104, Committee on Budget and Fiscal Review, Chapter 67, Statutes of 2019.)

SB 276 standardized the provision of medical exemptions for vaccination by requiring the California Department of Public Health to develop a statewide electronic request form, tracking school immunization levels and addressing physicians who submit an unusually high number of medical exemption forms. (SB 276, Pan, Chapter 278, Statutes of 2019.)

Details

Written by: Elizabeth Larson

Published: 23 December 2019

SACRAMENTO – New preliminary data from the Centers for Medicare and Medicaid Services indicates that the federal marketplace saw relatively stable enrollment during the open-enrollment period that closed Wednesday, following three years of very significant declines, particularly among new enrollees.

Overall, enrollment in the federal marketplace has declined from 9.6 million in 2016 to 8.3 million in 2020, a drop of 14 percent.

In addition, new enrollment has dropped from 4 million in 2016 to 2.1 million in 2020, a decrease of 49 percent.

“While things may appear to be holding steady in the federal marketplace, this is not a one-year story, as millions of people have been priced out of coverage by federal policies that have hurt enrollment,” said Covered California Executive Director Peter V. Lee. “The lack of marketing and outreach at the federal level means fewer healthy people have enrolled, driving up premiums and forcing unsubsidized people to either drop their coverage or sign up with junk plans.”

The federal marketplace, which handles Affordable Care Act enrollment in 38 states, wrapped up its open-enrollment period on Wednesday, which was extended by more than two days because of technical problems on www.healthcare.gov.

Compared to last year, new enrollment increased by 2 percent, while the number of renewing consumers dropped 3 percent. Overall enrollment decreased by 2 percent compared to last year.

It is important to note that this data is not final and does not account for the fact that the federal marketplace no longer includes Nevada, which transferred to a state-based marketplace for 2020, and that Maine and Virginia expanded their Medicaid programs, meaning those eligible consumers would not need to purchase coverage on the federal marketplace.

However, the slight increase in year-to-year new enrollment contrasts with the steep losses the federal marketplace has seen recently.

“New enrollment is the lifeblood of any individual market because those consumers who are not signing up are more likely to be healthier, which means a sicker risk mix and higher premiums for everyone,” Lee said. “In California, we have enacted new policies and our marketplace has shown stability in the face of multiple policies that are aimed at undercutting the Affordable Care Act.”

While Covered California is a little more than halfway through its open enrollment period, which runs through Jan. 31, the exchange recently reported that 230,000 new consumers had signed up for coverage through Dec. 16. The total is approximately 16 percent over last year’s total at the same time.

Lee noted that Covered California saw a 31 percent decline in new enrollments from 2016-2019. However, most of that came during the 2019 open enrollment period after Congress removed the individual mandate penalty. From 2016 to 2018 Covered California saw only a 9.2 percent decrease in new enrollment, compared to a drop of 38.9 percent in the federal marketplace.

“Policies matter and the decisions at the federal level have undercut the Affordable Care Act across the country,” Lee said. “California remains an example of what the Affordable Care Act can do – and is doing – when it is allowed to work.”

Last week, Covered California released two extensive reports which detailed how the state has used all the tools of the Affordable Care Act to benefit millions of Californians. The first report, “Covered California’s First Five Years: Improving Access, Affordability and Accountability,” highlights the key strategies undertaken by the state and Covered California to hold health insurance companies accountable, lower costs and build on the Affordable Care Act.

The other report, “Covered California Holding Health Plans Accountable for Quality and Delivery System Reform,” summarizes how the 11 health insurance companies Covered California contracts with have met the contractual requirements imposed on them to foster better quality, healthier populations and lower costs, with particular attention to health equity and their efforts to promote changes in how health care is delivered.

In addition to the two reports, Covered California released a chart pack that illustrates many of the improvements made in the past five years.

“These reports are important because implementing the Affordable Care Act effectively is not about just one open-enrollment period or changes of one year to the next,” said Lee. “These reports detail the actions taken over five years and the impacts of those actions, demonstrating how California has put consumers first, saving individual Californians thousands of dollars and holding health insurance companies accountable. These results show the Affordable Care Act going strong and working well in California despite concerted national efforts to take us and the rest of the nation backward.”

California enacts new policies to encourage enrollment

While the open-enrollment period in the federal marketplace is closed, Californians can still sign up for coverage. Those who enroll before the end of today will have their coverage start on Jan. 1. Covered California’s open-enrollment period runs through Jan. 31.

Heading into the new year, California lawmakers put two new policies in place for 2020 that were designed to encourage enrollment and lower costs.

First, they restored the individual mandate penalty that was part of the Affordable Care Act from 2014 to 2018, meaning consumers who do not get covered could face a penalty when they file their 2020 taxes in the spring of 2021.

For those facing a penalty, a family of four would pay at least $2,000, and potentially more, for not having health insurance throughout 2020.

Covered California is working with the Franchise Tax Board, which will administer the penalty, to alert Californians about the new law and reduce the number of uninsured people in our state.

The second new policy for 2020 is new financial help for eligible Californians that will lower the cost of their coverage. Last week, Covered California announced that nearly 540,000 people who had already signed up for coverage in 2020 will be receiving the new subsidies.

On average, consumers between 200 and 400 percent of the federal poverty level will receive $21 per household, per month on top of their federal tax credits. Meanwhile, for the first time in the nation, people who earn between 400 and 600 percent of the federal poverty level will be receiving an average of $460 per month, per household.

Californians can still enroll

While the open enrollment period in the federal marketplace is closed, Californians can still sign up for coverage. Those who enroll before the end of Friday, Dec. 20 will have their coverage start on Jan. 1. Covered California’s open enrollment period runs through Jan. 31.

Consumers can easily find out if they are eligible for financial help and see which plans are available in their area by entering their ZIP code, household income and the ages of those who need coverage into Covered California’s Shop and Compare Tool.

Those interested in learning more about their coverage options can:

– Visit www.CoveredCA.com .
– Get free and confidential in-person assistance, in a variety of languages, from a certified enroller.
– Have a certified enroller call them and help them for free.
– Call Covered California at 800-300-1506.

Details

Written by: Covered California

Published: 17 December 2019

SACRAMENTO – In response to a strong surge in enrollment, Covered California extended the deadline for consumers to sign up for health insurance that would start on Jan. 1.

They will now have through Friday, Dec. 20, to sign up and have their coverage go into effect on New Year’s Day.

“Covered California is still open for business and making sure consumers can have a health plan in place on Jan. 1,” said Covered California Executive Director Peter V. Lee. “Covered California is putting consumers first, making sure they have time to find the plan that best fits their needs.”

Beginning late last week, Covered California saw tens of thousands of people sign up for coverage on Wednesday, Thursday and Friday.

“Open enrollment is full-steam ahead, and this year’s enrollment period is more important than before,” Lee said. “Sign up now and you may be eligible for new financial help that is available for the first time, and you can avoid the possibility of paying a significant penalty for not being covered.”

Gov. Gavin Newsom took to social media this weekend to help remind all Californians they can get help paying for their health insurance. The governor used the holiday season as a way to spread the news about the first-in-the-nation state subsidies that are available and that Californians have until the end of Friday to sign up for coverage that begins Jan. 1.

California lawmakers put two new policies in place for 2020 that were designed to encourage enrollment and lower costs.

First, they restored the individual mandate penalty that was part of the Patient Protection and Affordable Care Act from 2014 to 2018, meaning consumers who do not get covered could face a penalty when they file their 2020 taxes in the spring of 2021.

For those facing a penalty, a family of four would pay at least $2,000, and potentially more, for not having health insurance throughout 2020.

Covered California is working with the Franchise Tax Board, which will administer the penalty, to alert Californians about the new law and reduce the number of uninsured people in our state.

New state subsidies

The second new policy for 2020 is new financial help for eligible Californians that will lower the cost of their coverage.

Last week, Covered California announced that nearly 500,000 people who had already signed up for coverage in 2020 will be receiving the new subsidies.

On average, consumers between 200 and 400 percent of the federal poverty level will receive $21 per household, per month on top of their federal tax credits. Meanwhile, for the first time in the nation, people who earn between 400 and 600 percent of the federal poverty level will be receiving an average of $460 per month, per household.

“California will be making history this year, becoming the first state in the nation to make coverage more affordable for middle-income people like small-businesses owners and entrepreneurs,” Lee said. “If you have checked Covered California out before, check again, because you could be eligible for new financial help that will lower the cost of your coverage by hundreds of dollars a month.”

Getting help enrolling

Consumers can easily find out if they are eligible for financial help and see which plans are available in their area by entering their ZIP code, household income and the ages of those who need coverage into Covered California’s Shop and Compare Tool.

Those interested in learning more about their coverage options can:

– Visit www.CoveredCA.com.
– Get free and confidential in-person assistance, in a variety of languages, from a certified enroller.
– Have a certified enroller call them and help them for free.
– Call Covered California at 800-300-1506.

California’s open-enrollment period continues through Jan. 31, 2020, but people who enroll after Dec. 20 will have their coverage start Feb. 1.