But that's not all! In addition to the actual 2018 MLR rebates, I've gone one step further and have taken an early crack at trying to figure out what 2019 MLR rebates might end up looking like next year (for the Individual Market only). In order to do this, I had to make several very large assumptions:
A week or so ago I reported that Covered California had released their preliminary 2020 ACA individual market premium rate changes, with a record-low 0.8% average increase statewide. They detailed in the report how the combination of reinstating the ACA's individual mandate penalty and using that funding to provide additional financial subsidies to the enrollees lowered the average rate increases from 4.0% to 0.8%, saving unsubsidized enrollees around 3.2 points or $167/year on average.
Today, CoveredCA has posted more details about some of the specifics:
Covered California Releases Regional Data Behind Record-Low 0.8 Percent Rate Change for the Individual Market in 2020
As I've noted several times, one of the biggest flaws in the Affordable Care Act is a very simple one on paper: The Subsidy Cliff. People who enroll in ACA exchange policies are entitled to financial assistance on a sliding scale...but only if their household incomes fall between 100-400% of the Federal Povery Level. Those below the lower threshold (actually, below 138% FPL) are expected to enroll in Medicaid, but those over the upper threshold of 400% FPL (around $50,000/year for a single person, roughly $103,000/year for a family of four) are completely on their own.
Here's the current federal premium subsidy formula (the precise premium cap percentages change slightly from year to year...and the Trump Administration is even messing with that a bit, so I'm not sure what it'll be in 2020):
It turns out that this was only part of a marathon voting session yesterdayover the past few weeks. Either the state Senate, Assembly or both have also voted to pass threea bunch ofother healthcare-related bills (I've included simple descriptions of each):
BREAKING: California Assembly passes our #AB1246(@Limon) to align consumer protections for all Californians, including those in large group coverage. #Care4AllCA
Federal law generally bars illegal immigrants from being covered by Medicaid. But a little-known part of the state-federal health insurance program for the poor has long paid about $2 billion a year for emergency treatment for a group of patients who, according to hospitals, mostly comprise illegal immigrants.
The lion’s share goes to reimburse hospitals for delivering babies for women who show up in their emergency rooms, according to interviews with hospital officials and studies.
Covered California Announces Grants to Community-Based Organizations Across California in Preparation for 2020 and Beyond
Community-based organizations and clinics will receive a total of $6.3 million in grant funding to help people enroll in quality health care coverage.
The 105 organizations reflect California’s diversity and will target populations that are hard to reach, uninsured and eligible for financial help through Covered California.
Approximately 89 percent of Californians live within a 15-minute drive of these community-based organizations.
Covered California announced Friday that it intends to partner with 105 community-based organizations to educate consumers about their health care options, offer in-person enrollment and renewal assistance and provide ongoing support on how to get the best value from their health plan. The Navigator grants announced are part of Covered California’s ongoing commitment to support robust marketing and outreach, including working with trusted organizations throughout the state to help hard-to-reach people understand this new era of health care.
New Analysis Finds Leading State-Based Marketplaces Have Performed Well, and Highlights the Impact of the Federal Mandate Penalty Removal
The report examines the impact that federal and state actions have had on state-based marketplaces and the federally facilitated marketplace (FFM).
Cumulative premium increases in California, Massachusetts and Washington are less than half of the increases seen in FFM states, but 2019 premium increases spiked in California and Washington compared to Massachusetts, which continued its state-based penalty.
WASHINGTON D.C. — A new report highlights the benefits of state-based exchanges, particularly in the areas of controlling premium costs and attracting new enrollment. The report, which was produced by Covered California, the Massachusetts Health Connector and the Washington Health Benefit Exchange, found that premiums in these states were less than half of what consumers saw in the 39 states that relied on the federally facilitated marketplace (FFM) between 2014 and 2019.
On November 15th, 2014 we launched the HealthCare.gov portal for 33 states to enroll in SHOP Marketplaces. As of May 2015, approximately 85,000 Americans have 2015 coverage through SHOP Marketplaces with about 10,700 small employers participating in SHOP Marketplaces. These totals do not include employers that began coverage in 2014 and have not yet renewed their coverage through HealthCare.gov for 2015.
Last fall, I reported that thanks to the one-two punch of a) reinstating the ACA's individual mandate penalty at the state level and b) using the revenue generated from the mandate penalty to help fund a robust reinsurance program, the state of New Jersey had successfully lowered average unsubsidized premiums for 2019 individual market policies by a net swing of nearly 22 percentage points.
Covered California Plan Selections Remain Steady at 1.5 Million, but a Significant Drop in New Consumers Signals Need to Restore Penalty
Covered California finishes open enrollment with 1.5 million plan selections, which is virtually identical to 2018’s total, despite federal changes.
A key reason for the steady enrollment is that more people entered the renewal process for 2019 coverage after a strong enrollment period for 2018.
The federal removal of the individual mandate penalty appears to have had a substantial impact, leading to a decrease of 23.7 percent in new enrollment.
SACRAMENTO, Calif. — Covered California announced that more than 1.5 million consumers selected a health plan for 2019 coverage during the most recent open-enrollment period, a figure in line with last year’s total. There was a 7.5 percent increase in the number of existing consumers renewing their coverage and a 23.7 percent drop in the number of new consumers signing up for 2019.
If you encounter long hold times today and are unable to get through to our Customer Service Center on Jan. 15 to complete your enrollment, please contact our customer service center no later than 6:00 p.m. on Friday, Jan. 18 to complete your enrollment. At that time, you must let the representative know that you were unable to get through on Jan. 15.
Oddly, the message didn't include C4HCO's actual phone number: 855 752-6749
Gov. Newsom Urges Uninsured to Get Covered Before Midnight Deadline Tomorrow as Covered California Continues Promoting Enrollment
Consumers have through Jan. 15 to sign up and select a plan, through Covered California or directly with health plans, for Feb. 1 coverage.
Gov. Gavin Newsom promotes enrollment for the estimated 1.1 million uninsured Californians eligible to enroll in Covered California or Medi-Cal.
Covered California research shows that 82 percent of uninsured consumers surveyed, who are eligible for financial assistance, do not know that they qualify.
LOS ANGELES, Calif. — California Gov. Gavin Newsom on Monday urged Californians who need health insurance to enroll as Covered California continued promoting coverage statewide before the deadline to enroll on Jan. 15.
“Covered California is in the final two days of open enrollment. That means if you are without health insurance, you need to sign up by Tuesday, Jan. 15, to secure health coverage,” Newsom said.