California

As I noted a month ago, as of January 1st, 2024, California extended Medicaid (Medi-Cal) eligibility to around 700,000 more undocumented residents:

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.

Because of this, I admit to scratching my head at first when I read this article from the Redwood City Pulse:

via Covered California:

SACRAMENTO, Calif. — With a key deadline coming up on Dec. 31, Covered California announced that 161,670 people have signed up for 2024 coverage as of Dec. 23 during this open enrollment, marking an 18 percent increase over the same period last year and the highest during this same period in four years.

Another 1,571,559 Californians have renewed their coverage so far.

That's 1,733,229 QHP selections to date. By comparison, last year the combined new+renewal enrollment in CA was 1,676,616 through 12/24, meaning the 2024 Open Enrollment Period is actually running more like 5.3% higher than last year on a per day basis:

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.

Then, in 2019, California's expansion of Medicaid to undocumented residents moved to the next phase: Around 100,000 more young undocumented adults aged 19 - 25 years old.

Originally posted 7/26/23; updated 11/02/23

via Covered California:

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 a preliminary 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.

via Covered California:

Los Angeles, Calif. — Covered California kicked off its 2024 open-enrollment period at the iconic Los Angeles State Historic Park and Roundhouse Bridge, a public space that serves some of the most vulnerable communities in the state, with roots that connect back to the early history of the city and region…

Covered California Executive Director Jessica Altman was joined by California Health and Human Services Secretary Dr. Mark Ghaly and Assemblymember Miguel Santiago of California’s 54th district to launch open enrollment. They highlighted how record financial help — through enhanced federal premium support and a new program in California that will reduce out-of-pocket costs for over 650,000 consumers — is bridging the gap between uninsured Californians and access to affordable coverage and quality care.

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.

Via Amy Lotven of Inside Health Policy:

Last month I posted an explainer about a situation in California which boiled down to a huge pot of extra revenue (~$330 million per year, give or take) being fought over between Governor Gavin Newsom and the Democratically-controlled State Legislature.

The bottom line is that this funding was intended to go towards reducing health insurance premiums for ACA exchange enrollees via Covered California as supplemental subsidies to be added on top of federal ACA tax credits...but the passage of the American Rescue Plan and the subsequent Inflation Reduction Act kind of made that moot, since the federal subsidies were made more generous than what the state subsidies would have been anyway.

As a result, Gov. Newsom decided that the extra revenue should go into the general state fund, while Democrats on the state legislature wanted to redirect it to eliminate deductibles and other types of cost sharing for ACA enrollees instead. This led to an impasse for the past several months:

This post has a long intro, but please bear with me...

Back in 2018, after the then-Republican controlled Congress zeroed out the ACA's federal "individual mandate penalty" (officially the "shared responsibility penalty"), I posted both a video and slideshow explainer about what this penalty was and why it was included in the ACA in the first place.

The very short and simplified version is this:

via Covered California:

Covered California Launches Statewide Push to Help Californians Stay Covered if They Lose Their Medi-Cal Eligibility

Covered California lanza una campaña estatal para ayudar a los californianos a permanecer cubiertos si pierden su elegibilidad para Medi-Cal

SACRAMENTO, Calif. — Covered California launched a virtual media tour on Wednesday to spread the word about the upcoming Medi-Cal to Covered California Enrollment Program and how it will help keep Californians covered.