SACRAMENTO, Calif. – Californians who must pay for their own
health insurance are getting their first detailed look at what health care
reform will truly offer. Covered California, the state run program that
oversees implementation of theAffordable Care Act, is releasing the standards
for benefit plans that will be made available to California citizens who do not
rely on employer provided insurance or Medi-Cal for health care coverage.
“The most important aspect of these benefits is they are
standardized and they are adjusted according to income to lower costs for those
with lower incomes,” said Peter V. Lee, Executive Director of Covered California.
“Standardization is a game changer. It lets consumers shop from one insurance
provider to the next, knowingthat the benefits are the same. This is about removing
barriers to care; about changing the focus of health insurance on prevention
and on taking care of the sick.”
“Covered California is leading the way for consumers to make
apples to apples comparisons when choosing health coverage,” said James Guest,
President and CEO of Consumers Union. “Not only can consumers no longer be
denied due to pre-existing conditions, they know there will be no surprises or
gimmicks, and the benefits are the same from one carrier to the next.”
Consumers have four levels of plans from which to choose –
Bronze, Silver, Gold and Platinum. Households earning less than 250 percent of
the federal poverty level can receive financial help if they enroll in a Silver
plan; the less income they earn, the more financial assistance they can receive.
For example, individuals earning between 150 to 250 percent of the federal poverty
level can expect to pay $20 to see their primary care physician, while those earning
100 to 150 percent would pay $4.
“California has clearly learned from our experience.
Massachusetts launched its health insurance exchange without standardizing
benefits, but changed course after recognizing that allowing consumers to make
apples-to-apples comparisons among plan options is critical to their ability to
make informed decisions about what health plan satisfies their needs and meets their
budget.” said Jean Yang, Executive Director of Massachusetts Health Connector.
To be eligible for financial support, consumers must
purchase plans from Covered California’s marketplace. The State of California
is leading the health care innovation process by requiring that all carriers
offer these same standard designs to all individuals and small businesses –
whether inside or outside of Covered California. While higher income
individuals choosing one of these plans would not be eligible for financial
help, they would be assured that the plan contains the same essential health
benefits offered, and the exact same benefit design so they can make true
comparisons.
Examples of benefits, their costs, and typical premium costs
are available on the newly launched Covered California website,
www.CoveredCA.com. The website will deliver up-to-date information for consumers,
and access to resources during the lead up to the open enrollment period this
fall for coverage that starts January 1, 2014. The website currently includes
seven fact sheets, in both English and Spanish, and additional fact sheets are
soon to be added, as well as translation of the material in 11 more languages.
Covered California also announced it has launched a social
media presence on Facebook, Twitter, YouTube and Google+.Critical next steps in
the launch of Covered California include the selection of insurance carriers
that will be allowed to participate in Covered California, and determination of
the plan pricing.
About Covered
California
California is the first state to create a health benefit
exchange following the passage of federal health care reform. Covered
California is charged with creating a new insurance marketplace that allows individuals
and small businesses to purchase competitively priced health plans using
federal tax subsidies and credits. Coverage starts in 2014.
Covered California is overseen by a five-member board
appointed by the Governor and Legislature; the California Health and Human
Services Secretary serves as an ex officio voting member and is its current
Chair.
For more information on Covered California, please visit www.CoveredCA.com.
