California

A couple of weeks ago, Covered California reported that as of December 7th, over 486,000 residents were taking advantage of their newly-expanded & enhanced state ACA subsidies:

...More than 486,000 individuals have been determined eligible for the new state subsidy, including about 23,000 in the 400 to 600 percent range of the federal poverty level, which could extend to an individual making up to $74,940 and family of four with a household income of up to $154,500. Of those in this income range who have signed up through Covered California, 44 percent have been found eligible for the state financial assistance.

...If I'm following correctly, the total breakout is:

  • 777,000 = either 138 - 200% FPL or not eligible for any subsidies
  • 463,000 = 200 - 400% FPL; receiving both federal & state subsidies
  • 23,000 = 400-600% FPL; receiving state subsidies only

The press release also broke out the household average for the new/expanded subsidies:

This just in from Covered California:

Covered California Releases New Enrollment Data and Issues Reports on Five Years of Improving Affordability, Access and Accountability

  • Covered California announced that there are more than 230,000 new plan selections during the current open enrollment period – up approximately 16 percent over this time last year. More than 1.15 million people have also renewed their coverage.
  • In addition, more than 540,000 people will receive new state subsidies that will make quality health care coverage more affordable in 2020.
  • The agency also released two extensive reports that detail Covered California’s impacts on lowering costs and assuring quality care in its implementation of the Affordable Care Act.
  • Since 2013, California has reduced its uninsured rate by more than any other state in the nation has by expanding Medi-Cal, investing in marketing and outreach and keeping costs low for consumers.
  • California’s individual market consistently ranks among the healthiest in the nation, helping unsubsidized consumers save about $1,550 annually in 2018 on their premiums compared to consumers in the federal marketplace.
  • Covered California’s open-enrollment period runs through Jan. 31. Consumers must sign up before the end of Dec. 20 for their coverage to start on Jan. 1. California is one of 10 state marketplaces that are still open for business, representing 28 percent of Americans.

This just in from Covered California, CA's ACA exchange:

Due to high call volume and enrollment demand, @CoveredCA will extend the deadline for Jan. 1 coverage through midnight next Friday, Dec. 20. That means consumers have an extra 5 days to sign up for #ACA #healthcare coverage for all of 2020. Check rates.

— Covered California News (@CoveredCAnews) December 13, 2019

ALERT: The deadline to enroll in health insurance starting January 1 has been extended to midnight on December 20. Don't wait and get covered!

Moments ago, Covered California, the nation's largest state-based ACA exchange, released data via a media teleconference regarding the 2020 Open Enrollment Period.

In addition to being the largest ACA exchange after HealthCare.Gov, this info from Covered California is especially significant for the 2020 OEP due to their newly expanded/enhanced premium subsidies.

To recap: Under the ACA, financial subsidies are available to exchange enrollees earning between 100-400% of the Federal Poverty Level (FPL). That's between around $12,500 - $50,000/yr if you're a single adult, or between $25,000 - $100,000/yr for a family of four. Under the standard ACA formula, enrollees in that income range have their premiums capped at no more than around 2.0 - 9.8% of their income, on a sliding scale.

Unfortunately, this means that people earning more than 400% FPL are eligible for no financial assistance at all, a sudden drop-off known as the Subsidy Cliff.

Covered California and the Challenged Athletes Foundation Team Up to Promote Open Enrollment and the Dec. 15 Deadline for Coverage During All of 2020

  • While Covered California’s Open Enrollment period runs through Jan. 31, 2020, consumers must enroll by the end of Dec. 15 to have their coverage begin on Jan. 1.
  • Covered California is teaming up with the Challenged Athletes Foundation, to host a Holiday Boot Camp to promote the importance of health, fitness and the open enrollment period. 
  • The Boot Camp will be led by Paralympian, 2019 Parapan Gold Medalist and World Record Holder Scout Bassett and Nike Master Trainer Betina Gozo.
  • Californians who choose to go without coverage could face a penalty when they file their 2020 taxes.

Covered California continued its statewide open enrollment campaign by teaming up with the Challenged Athletes Foundation in San Diego for its Holiday Boot Camp on Tuesday. The event comes as Covered California alerts consumers about a critical upcoming deadline. Consumers must sign up by Dec. 15 if they want their coverage to start on Jan. 1.

A few weeks ago, I did a write-up about a concerning development at HealthCare.Gov: The growing push under the Trump Administration to not only partner with 3rd-party web brokers (which has been done since the first days of the ACA under the Obama Administration), but to actively promote those third-party brokers over HealthCare.Gov itself.

In and of itself, this wouldn't be too problematic as long as people are still ultimately enrolling in fully ACA-compliant policies and receiving ACA subsidies if they're eligible for them. Hell, one of these 3rd-party authorized web brokers even has a banner ad at the top of my website...which I only allow because this particular one only sells on-exchange ACA-compliant policies.

I have a different California-specific post coming later this afternoon, but I stumbled across a mildly interesting bit of data and figured this would be a good time to share it while I wait to be able to post that one.

As you may recall, while the ACA required that most individual market major medical healthcare policies sold have to comply with full ACA regulations, there were some exceptions to this. The biggest exception made was for major medical plans which had been continuously enrolled in since before the ACA was signed into law in March 2010.

These plans were grandfathered in, and so are appropriately called "Grandfathered Plans", and applied to perhaps 5 million people or so back in 2014, when ACA-compliance became mandatory for newly-sold policies.

California

IMPORTANT: As I've noted before, Covered California has arranged to expand and enhance their ACA premium subsidies beyond the official ACA formula starting with the 2020 Open Enrollment Period. Back in October, I posted a detailed analysis, complete with tables and graphs to explain just how much hundreds of thousands of Californians could save under the new, beefed-up subsidy structure.

However, Anthony Wright of Health Access California just called my attention to the fact that I made a major mistake in my analysis which impacted every one of the examples: I was basing them on the draft enhanced subsidy formula from back in May instead of the final version, which is considerably more generous at the upper end of the sliding scale than the draft version was!

In short:

  • The ACA formula caps premiums (for the benchmark Silver plan) at between 2 - 9.8% of household income but only if you earn between 100 - 400% of the Federal Poverty Level.
  • The draft California formula is a bit more generous from 100 - 400% FPL and also caps premiums between 9.9 - 25% of income between 400 - 600% FPL.
  • The final California formula is more generous yet: It's pretty much the same up to 400% FPL, but caps premiums between 9.8 - 18% of income between 400 - 600% FPL.

I've therefore gone back and re-calculated and re-written the entire blog post below with the updated, corrected subsidy formula. My apologies for the error!

----------

There's two important points for CA residents to keep in mind starting this Open Enrollment Period:

  • First: The individual mandate penalty has been reinstated for CA residents. If you don't have qualifying coverage or receive an exemption, you'll have to pay a financial penalty when you file your taxes in 2021, and...
  • Second: California has expanded and enhanced financial subsidies for ACA exchange enrollees:

Until now, only CoveredCA enrollees earning 138-400% of the Federal Poverty Line were eligible for ACA financial assistance. Starting in 2020, however, enrollees earning 400-600% FPL may be eligible as well (around $50K - $75K/year if you're single, or $100K - $150K for a family of four). In addition, those earning 200-400% FPL will see their ACA subsidies enhanced a bit.

 

I'm very pleased to see this.

I've made quite a bit of fuss about California expanding availability of ACA financial subsidies to those earning 400 - 600% of the Federal Poverty Line ($75K for a single person, $154K for a family of four). The subsidies aren't massive for most people, but for hundreds of thousands of Californians--especially older folks earning between 400 - 450% FPL--this is a huge savings. In addition, they're sweetening the subsidies somewhat for those already receiving ACA tax credits.

The only real concern I had about this is whether enough people in California know about it. Just like with reinstating the mandate penalty (which California has also done this year), expanding & enhancing ACA subsidies isn't gonna cause a spike in enrollment if no one knows they're available. A lot of people who might have checked into it in prior years isn't likely to bother taking another look if they don't know that the income cut-off threshold has gone up, and many others have never bothered trying in the first place because they "heard somewhere" that they won't qualify.

Pages

Advertisement