California

Earlier this week, newly-sworn-in Governor Gavin Newsom announced several proposals for improvements to California's implementation of the Affordable Care Act along with some other important healthcare-related measures. The most important ACA-specific ones were:

  • Reinstating the individual mandate penalty at the state level, as New Jersey, the District of Columbia, Vermont and Massachusetts have (VT's doesn't kick in until next year, and MA simply reverted back to their own pre-ACA mandate penalty), and
  • Enhancing ACA subsidies and expanding them to those earning 400-600% of the Federal Poverty Level

Newsom didn't include any details on either proposal, but I assumed that the mandate would simply reinstate what it was under the ACA before being repealed by Congressional Republicans in December 2017 ($695 per person or 2.5% of household income), and that the expanded subsidies would simply take the existing ACA formula (which limits the cost of benchmark Silver plans to no more than 9.86% of household income and provides subsidies to cover the difference after that), and raise the cut-off point from 400% FPL to 600% FPL.

This Just In from Covered California...

California’s Open Enrollment for Individuals Ends Jan. 15; Consumers Have One Week to Sign Up for Health Care Coverage

  • Consumers have through Jan. 15 to sign up and select a plan through Covered California or directly with health plans for coverage that will begin on Feb. 1.
  • The final week of open enrollment comes on the heels of Gov. Newsom’s announcing sweeping proposals, including a new requirement for having coverage and expanded subsidies.
  • While open enrollment ended for much of the nation in December, California’s final deadline is about two weeks earlier than it was in previous years, when open enrollment ran through the end of the month.
  • More than 238,000 consumers had selected a plan through Dec. 31.

Some awesome news out of the Golden State today:

Gov. Gavin Newson announced sweeping proposals to tackle the state’s healthcare needs shortly after taking office on Monday, outlining a dramatic Medi-Cal expansion that would cover young undocumented adults, a requirement that all consumers in the state carry health insurance and increased subsidies for middle-class families to help those who need it.

...Newsom campaigned on a universal healthcare platform and has said the issue would be among his top priorities. His announcement on Monday stopped short of the single-payer system demanded by activists that would cover all residents’ healthcare costs, but was characterized as the first step down that path.

According to the article, Newsom, who just took office a few hours ago, already plans on rolling out his proposed state budget on Thursday, which is expected to include, among other things:

So, it's over, right? Well...not quite. The 2019 ACA Open Enrollment Period officially ended last night...but only in 43 states. In the remaining seven (+DC), Open Enrollment hasn't ended yet2019 ACA Open Enrollment is still ongoing for nearly 10% of the population!

  • In Massachusetts, open enrollment runs through Jan. 23rd, 2019 for coverage starting February 1st

ALSO...

This Just In...

FOR IMMEDIATE RELEASE
Dec. 15, 2018

Covered California Extends Deadline for Jan. 1 Coverage Until Friday, Dec. 21

  • Texas District Court’s ruling on the constitutionality of the Affordable Care Act has no impact on Covered California’s open enrollment period.
  • Covered California is extending today’s deadline to Friday, Dec 21, for consumers who want health care coverage that starts on Jan. 1, 2019.
  • Consumers who enroll after Dec. 21, and by Jan. 15, will have their coverage start on Feb. 1.
  • While open enrollment ends in 44 states on Saturday, California is one of seven health insurance marketplaces which will enroll consumers after Dec. 15, serving 25 percent of the U.S. population.
  • 58,000 consumers have signed up since Monday, including 17,000 on Friday.

"Open enrollment is full-steam ahead in California and continues in other states for several more weeks. No one in America should let this TX District Court ruling discourage them from enrolling in health coverage or be worried about using the coverage they have. This case will wind its way through the courts and I’m confident the Supreme Court will once again do the right thing and uphold the Affordable Care Act,"

--Peter Lee, executive director of Covered California

Pelosi Statement on District Judge Ruling in GOP Lawsuit Against Pre-Existing Condition Protections and the Affordable Care Act

“Tonight’s district court ruling exposes the monstrous endgame of Republicans’ all-out assault on people with pre-existing conditions and Americans’ access to affordable health care.

This just in...

Consumer Interest Surges as First Key Deadline Approaches for Covered California and the Individual Market

  • More than 150,000 new consumers selected a plan through Dec. 12.
  • Consumer interest is surging, with more than 28,000 consumers selecting a plan during the past three days.
  • Consumers must sign up by Dec. 15 in order to have their coverage start on Jan. 1, 2019. Open enrollment in California continues through Jan. 15.

SACRAMENTO, Calif. — Covered California announced today that 150,191 new consumers signed up for coverage through Dec. 12. Consumer interest is once again surging ahead of a key deadline, with more than 10,000 people signing up on Wednesday, and more than 28,000 selecting a plan within the past three days.

This just in...

Covered California’s Open Enrollment Is off to a Solid Start as the First Key Deadline Approaches

  • More than 90,500 new consumers selected a plan through Nov. 30.
  • While plan selections are ahead of the pace set in 2016, when Covered California also delayed its marketing until after Election Day, they are slightly behind the pace set during 2017.
  • Roughly 1.2 million Covered California enrollees have been renewed for 2019, similar to last year’s totals.
  • An estimated 1.1 million uninsured Californians are eligible to enroll in Covered California or Medi-Cal. New research shows that 82 percent of uninsured consumers surveyed, who are eligible for financial assistance, do not know that they qualify.
  • Consumers must sign up by Dec. 15 in order to have their health insurance start on Jan. 1, 2019. Open enrollment in California continues through Jan. 15.

Covered California, the largest state-based ACA exchange for the largest state in the country, actually launched their 2019 ACA Open Enrollment Period over three weeks ago, on October 15th.

They still haven't posted any 2019 enrollment numbers, which I find rather irritating, but they did just send out the following press release regarding a promotional bus tour they're doing which highlights a couple of interesting data points:

Covered California Launches Iconic Bus Tour to Promote Enrollment and Show How “Life Can Change in an Instant”

Yes, that's right...while the 2019 Open Enrollment Period doesn't start for the rest of the country until November 1st, the Golden State has decided to kick things off two weeks early (16 days early, technically): Covered California, the largest state-based ACA exchange, is officially open for business for 2019 enrollment as of today!

In addition, while you can't actually enroll for 2019 coverage in any other state until November 1st, in several states you can window shop to find out what your 2019 policy options and pricing will be, along with estimates about what sort of financial assistance you'll qualify for once you actually do go through the enrollment process.

The states which are already open for window shopping already include:

The official annual ACA Open Enrollment Period (OEP) starting and ending dates have jumped around a lot since the exchanges kicked off back on October 1, 2013.

For the first OEP, people were given 6 months since the technology and the process were brand new to everyone...and thank God they were given the technical mess that the federal exchange (HealthCare.Gov) as well as many of the state-based exchanges experienced at launch. Things were eventually worked out, but not only was that extra time in spring 2014 vitally important, many people still needed some extra time beyond that as well. The official deadline to enroll for 2014 coverage was March 31, but the HHS Dept. gave people who had started their application by then an extra 15-day "overtime" period to complete the process.

For the 2015 OEP, the official dates were from November 15 - February 15th, cutting the time period down to three months. This time there was a one-week "overtime" period tacked onto the end.

For 2016 and 2017, HHS settled on November 1st - January 31st, which seemed to make sense since it was easier to remember: November, December, January.

BREAKING: Governor @JerryBrownGov today signed several #Care4AllCA bills that protects patients and places greater accountability on health insurers now on Gov's desk:#SB910 & #SB1375 to ban/limit "junk" insurance;#AB2499 on MLR; and#AB2472 on a public option study.

— Health Access CA (@healthaccess) September 22, 2018

With the 2019 Open Enrollment Period rapidly approaching, I figured this might be a good time to remind everyone that while it starts on November 1st for most of the country, the largest state, California, is kicking things off 2 weeks early (17 days early, actually). Covered California is launching their 2019 ACA Open Enrollment Period on Monday, October 15th, 2018:

Open enrollment for 2019 coverage will begin October 15, 2018 in California, and continue until January 15, 2019

Nationwide, open enrollment for 2019 coverage is scheduled to run from November 1, 2018 to December 15, 2018 — the same schedule that was followed in late 2017 for 2018 coverage. But Covered California was one of only three state-run exchanges that opted in 2017 to keep open enrollment at three months in duration for 2018 coverage (the others were New York and DC).

And the state enacted legislation (A.B.156) in late 2017 that codifies a three-month open enrollment period going forward — California will not be switching to the November 1 – December 15 open enrollment window that other states will be using.

It's been awhile since I last updated my "ACA Protection Spreadsheet", which is an attempt to track a whole mess of bills designed to protect the Affordable Care Act from sabotage at the federal level by the Trump Administration and Congressional Republicans. My last update was over a month ago, when Hawaii's Governor signed a law which locks in several ACA protections, including:

  • Ensure that young adults can continue to remain on their parents’ health insurance plans until age 26
  • Prohibit insurers from using applicants’ gender to set premiums
  • Prohibit insurers from rejecting an application based on an applicant’s medical history, or imposing coverage exclusions based on pre-existing conditions.

Today, however, there were major developments regarding #ShortAssPlan restrictions (and a few other important patient protection bills) in three states: Two positive, one negative.

CALIFORNIA:

California's contains over 12% of the entire U.S. population, around 13% of total ACA exchange enrollment and nearly 16% of the total ACA individual market. As such, when they make any announcements about their ACA exchange policies (or in this case, 2019 premiums), it's a pretty big deal for the national averages.

Today, Covered California, the largest state-based ACA exchange, announced their proposed 2019 ACA premium changes:

Covered California Releases 2019 Individual Market Rates: Average Rate Change Will Be 8.7 Percent, With Federal Policies Raising Costs

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