Covered California Continues “Let’s Talk Health” Campaign With Record Financial Support Available As Its 12th Open Enrollment Continues
BAKERSFIELD, Calif. — Covered California continued its “Let’s Talk Health” campaign at the Beale Memorial Library today with the 2025 open-enrollment period underway.
Regardless of the results of the 2024 election, open enrollment is ongoing and coverage through Affordable Care Act marketplaces throughout the nation, including Covered California, is unaffected for 2025.
“Our doors are open, and now is the time for Californians to sign up for health insurance,” Covered California Executive Director Jessica Altman said. “The Patient Protection and Affordable Care Act remains the law of the land, and the election results do not affect the financial assistance available to enrollees through federal and enhanced state subsidies next year. The most financial assistance ever offered to Californians to help pay for health care coverage remains available for 2025.”
Covered California announced the first-year results of its first-in-the nation health plan accountability program, the Quality Transformation Initiative(QTI), today at its board meeting.
The QTI — aimed at improving health care outcomes and reducing disparities for members — was created with input from consumer advocates, health care providers and health insurance companies. It was developed in collaboration with the Department of Health Care Services and CalPERS.
The QTI establishes direct and substantial financial incentives (up to 1 percent of premium in the first year, rising to 4 percent of premium in future years) for all Covered California health insurance companies by requiring payments for failing to meet specified benchmarks for a focused, meaningful set of health-outcome measures. These equity-centered outcome measures include blood pressure and diabetes control, colorectal cancer screening and childhood immunizations.
However, that was actually only for the preliminary rate filings. In addition, at the time I only had access to California's on-exchange individual market enrollment data, so I had to guess at the off-exchange numbers.
The small group market was more frustrating: I only had enrollment data for about 1/3 of the carriers; the rest had redacted their enrollment information. This meant I couldn't even guess at a weighted average rate change.
via Covered California: (this is actually from nearly a month ago; somehow I missed it at the time):
SACRAMENTO, Calif. — Covered California announced its health plans and rates for the 2025 coverage year with a preliminary weighted average rate increase of 7.9 percent.
The rate change can be attributed to many factors, including a continued rise in health care use, increases in pharmacy expenditures, the rising cost of care, labor shortages and other issues affecting the health care industry.
Because of the robust financial help available to Covered California enrollees, many will see a small impact, if any, to their monthly cost. Covered California, with the support of Gov. Newsom and the California Legislature, has worked to reduce the impact of increased consumer costs in 2025 by providing more support for its state-enhanced cost-sharing reduction (CSR) program, which will eliminate deductibles and lower the cost of care for over a million Californians.
Covered California announced today that more than 158,000 Californians remained covered through the Medi-Cal to Covered California enrollment program over the past year.
Beginning in April 2023, following the end of the federal continuous coverage requirement put in place during the COVID-19 pandemic, Medi-Cal resumed its renewal process by redetermining eligibility for over 15 million of its members. In May 2023, Covered California and the Department of Health Care Services (DHCS), which administers California’s Medi-Cal program, launched the Medi-Cal to Covered California enrollment program.
Under the program, Covered California automatically enrolls individuals in one of its low-cost health plans when they lose Medi-Cal coverage and gain eligibility for financial help through Covered California. Through early June of 2024, the program has helped 158,100 Californians remain insured.
On Jan. 1, immigrants may qualify for Medi-Cal regardless of legal status
...Milagro and her husband are among the more than 700,000 immigrants ages 26-49 expected to newly qualify for full health insurance come Jan. 1. That’s when California takes the final step in opening up Medi-Cal, the state’s health care program for low-income residents, to everyone who meets eligibility requirements, regardless of their immigration status.
Good grief. I have no idea how I missed this legislation. I had read about and even written about it several times over the past several years, but I sort of lost track of it since the COVID pandemic hit.
Back in 2016, California passed a bill which extened eligibility for Medi-Cal (California's brand name for Medicaid) to around 170,000 undocumented children statewide...although this ultimately ended up resulting in around 250,000 children being added to the roles.
Covered California’s Health Plans and Rates for 2024: More Affordability Support and Consumer Choices Will Shield Many From Rate Increase
SACRAMENTO, Calif. — Covered California announced its health plans and rates for the 2024 coverage year with apreliminary weighted average rate increase of 9.6 percent.
The rate change can be attributed to many factors, including a continued rise in health care utilization following the pandemic, increases in pharmacy costs, and inflationary pressures in the health care industry, such as the rising cost of care, labor shortages and salary and wage increases.
In July, Covered California announced the preliminary weighted average 2024 premium rate changes for the ACA individual market. They still haven't released the final/approved rates, or the small group market average rate changes, but today they released the final rate changes for standalone dental plans:
SACRAMENTO, Calif. — Covered California announced that the statewide weighted average rate change for dental coverage in 2024 will be 4.31 percent. The rate increase is the first since 2020 and continues a trend of holding costs steady for consumers.
A few weeks ago I noted that, thanks to California Governor Gavin Newsom and the Democratically-controlled state legislature finally reaching a compromise agreement on how to allocate ~$330 million/year in revenue generated by the state's individual mandate penalty, around $83 million will be utilized to dramatically reduce out of pocket expenses for hundreds of thousands of ACA exchange enrollees.
