California: CoveredCA announces 1.47 million QHPs; residents still have until 1/31 to #GetCovered!

This came out while I was in DC for the Families USA conference...

Covered California’s New Enrollment Surges Past Last Year’s Mark with More than a Week Before the Upcoming Jan. 31 Deadline

  • More than 318,000 consumers have newly enrolled during the current open-enrollment period, surpassing last year’s open enrollment total.
  • However, new research shows that many Californians – particularly the uninsured – are unaware of a new state law which requires people to have health insurance or face a penalty.
  • In addition, many Californians are unaware of the new financial help that is available for the first time this year, including first-in-the-nation assistance for middle-income consumers.
  • Open enrollment, which continues through Jan. 31, is the one time when people can sign up for health insurance in the individual market without needing a qualifying life event.

SACRAMENTO, Calif. — Covered California announced new enrollment data as it moved into the final week of open-enrollment and continued to reach out to consumers about the new state penalty and additional financial help that went into effect with the new year.

As of Wednesday, Jan. 22, more than 318,000 consumers had newly signed up for health insurance through Covered California during the current open-enrollment period, which surpassed last year’s total of 295,000.

The 318K figure is up 49,000 since January 4th. This puts Covered CA's total enrollment for 2020 at around 1,468,000 QHP selections through January 22nd.

For comparison, last year Covered California enrolled a grand total of 1,513,883 people by the final deadline. They're 3.0% shy of that as of this report, and will need to add at least another 46,000 more enrollees to beat that by January 31st...which is gonna be tough without a last-minute enrollment surge.

“With one week to go in open enrollment, Covered California has surpassed last year’s open enrollment total, but thousands are signing up every day and we’re not done yet,” said Covered California Executive Director Peter V. Lee. “Californians have until midnight on January 31st to sign up and not only avoid paying a penalty to the Franchise Tax Board but — for almost a million Californians — get new help from the state to lower their health care costs.”

The open-enrollment period runs through Jan. 31. It is the one time of the year when consumers can freely sign up for coverage without having to experience a qualifying life change. People who sign up by the deadline will have their coverage start on Feb. 1.

Having a health insurance plan in place this year is critical because of a new law that the state of California enacted that requires Californians to have coverage in 2020. Those who can afford coverage, but choose to go without it, could face a penalty when they file their taxes with the California Franchise Tax Board in 2021. The penalty can be more than $2,000 for a family of four.

“We do not want Californians to write a check to the Franchise Tax Board when they could get coverage that is way more affordable than they think,” Lee said. “This year there is new financial help that will help nearly one million people lower the cost of their coverage.”

A recent survey released by Covered California, Californians’ Understanding of the Mandate to Have Health Coverage and the Awareness of Financial Help,found that many people, particularly the uninsured, are unaware of the new penalty and additional financial help. Among the findings:

  • Many Californians do not know about the new penalty
    Many Californians reported being unaware of the new requirement to have health coverage in 2020 or face a penalty, including a majority of the uninsured (56 percent).
  • Many uninsured Californians are unaware that financial help is available
    Among the uninsured, 62 percent are unaware that Covered California offers financial help to help pay for health insurance. In addition, only 27 percent of the uninsured are aware that Californians can receive even more financial help than ever before for health coverage.

Confusion or unawareness of the reinstated mandate penalty makes complete sense since the federal mandate was zeroed out in late 2017, but the zeroing wasn't actually implemented until January 2019, and the penalty itself isn't actually charged until people file their taxes the following year...and the confusion in California specifically is compounded by the fact that they didn't reinstate the penalty until a year after it was zeroed out at the federal level.

On top of all of this is the insane Texas Fold'em lawsuit, which only exists because the federal penalty was zeroed out...something that almost every headline about the ACA mentions these days.

As a result, you have a whole lot of Californians who have no clue that the penalty is back at the state level or who aren't clear about whether it is or not.

As for unawareness of the expanded subsidies, I cautioned about that back in December. Imagine you're a self-employed individual earning between 400-600% FPL (let's call it around $60,000/year). Perhaps you did check out Covered California a few years ago and were disappointed to learn that you earn too much to qualify for financial assistance. What are the odds that you're going to pay attention to a TV commercial for CoveredCA this year touting financial help?

CoveredCA is running several ads (in both English and Spanish) during open enrollment. There's two of them which mention the expanded/enhanced subsidies:

The first one states that "new this year, almost a million people could receive additional help...more for those already getting it, and new help for many who haven't gotten it before."

The second, shorter ad simply says "new this year, almost a million people could receive additional help."

They're not bad ads, but they don't exactly grab you by the collar either. I'm thinking that a harder sell may be required to get the attention of the target audience--unless it specifically states that people earning between $50K - $75K (or $103K - $150K for a family of four) are eligible for assistance now (and also clarifies that it's potentially thousands of dollars), many will probably just tune out the whole thing.

My suspicion is that next year word of mouth will have spread quite a bit, but I'm not expecting a huge surge in additional enrollment between 400-600% FPL this year...and from the numbers at the top of this post it sounds like my suspicions are correct. It'll take some time for word to spread.

“The new state subsidies and the requirement to have coverage are the two biggest changes effecting individuals who do not have employer coverage since Covered California first opened our doors in 2014 and we want to make sure consumers know that health insurance could be more affordable than they think,” Lee said. “People need to take action by next Friday, so they do not get caught paying a significant penalty when they file their taxes a year from now.”

In addition to the new state penalty California also expanded the amount of financial help available to many consumers, including a first-in-the-nation program to help middle-income consumers afford coverage.

The new state subsidies could extend to an individual making up to $74,940 and a family of four with a household income of up to $154,500.

Right now, the average subsidy for eligible consumers earning less than 400 percent of the federal poverty level is $447 per month; the average state subsidy for eligible middle-income consumers is $469 per month.

Californians Can Still Enroll

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:

“Californians owe it to themselves to take a few minutes of their day to see whether they qualify for financial help from the federal government, the state, or both,” Lee said. “Visit and check out your options before the end of the month.”

About Covered California

Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit