- Consumers have until the end of Friday, Dec. 22, to sign up for health coverage that begins on Jan. 1, 2018. Covered California’s open-enrollment period runs through Jan. 31, 2018.
- More than 220,000 new enrollees selected a plan through Dec. 15, which remains ahead of last year’s pace.
- Based on the first month’s enrollment, most consumers are paying less for their coverage in 2018.
- The impending removal of the individual mandate penalty, with other key actions, means significant uncertainty for 2019 — which could lead to collapsing individual markets in many states in the absence of strong federal stabilization policies.
SACRAMENTO, Calif. — Covered California updated its enrollment data on Wednesday and alerted consumers to a key deadline that is approaching. While the open-enrollment period has ended in most states, uninsured consumers in California have until midnight on Dec. 22 to sign up if they want their coverage to begin on Jan. 1, 2018.
“The time is now to ring in the New Year with a quality health plan that provides protection and peace of mind,” said Peter V. Lee, executive director of Covered California. “We have seen thousands of people signing up every day as we near this key deadline, and Covered California wants to make sure everyone knows that time is running out to get health coverage that starts on Jan. 1.”
The latest data shows that more than 220,000 new consumers signed up for coverage through Dec. 15, which is about 10 percent more than last year, when 199,000 consumers selected a plan during the same time period. In addition, approximately 1.2 million existing Covered California consumers have had their coverage renewed for 2018.
With the continued health care policy debate at the federal level, Covered California also noted that the individual market faces significant uncertainty in 2019. Three of the main causes of this uncertainty are:
- Repeal of the individual mandate penalty: Repeal will take effect in 2019, and could threaten the individual market in many states. Health insurance companies rely on certainty when setting their rates, and may decide to exit their markets in the face of an uncertain market caused by a shrinking pool of consumers who are less healthy.
- Lack of federal marketing: Health insurance needs to be sold, particularly to young and healthy individuals who are less likely to feel compelled to purchase coverage on their own. The federal administration significantly reduced the marketing and outreach budget for the current open-enrollment period, which could lead to fewer consumers enrolled, a less healthy risk mix and higher premiums for consumers.
- Recent executive order: The president’s executive order called for regulations that would allow the sale of “association health plans” or “short-term plans.” Depending on how these regulations are structured, these plans could skim healthier individuals off the individual market and leave consumers without comprehensive coverage. Not only would these consumers be enrolled in “Swiss cheese” policies that were common prior to the Affordable Care Act, those left in the exchanges would see higher premiums because of a less healthy consumer pool.
During its December board meeting, Covered California discussed several federal policies that could make a difference in stabilizing individual markets across the country and noted that now is the time for bipartisan efforts to protect consumers and lower premiums. These policies include:
- Reinsurance or high-risk pool: Implementing state-based risk stabilization programs such as reinsurance or invisible high-risk pools is the focus of bipartisan legislation proposed by senators Susan Collins and Bill Nelson. If appropriately structured and funded, it could reduce premiums by between 10 and 12 percent in 2019, while providing the certainty health carriers need to remain in markets. For a detailed look at some of the structural issues that such a program should include, click here: http://hbex.coveredca.com/data-research/library/State-Based_Invisible_High_Risk_Pools_or_Reinsurance-12-17-20%20(002)_final.pdf.
- Federal marketing commitment: Other bipartisan legislation proposed by senators Lamar Alexander and Patty Murray includes provisions that would require the federal government to spend $100 million annually to promote enrollment. While Covered California relies on its own funding to invest more than $100 million in marketing and outreach, federal proposals like this would inject stability into states that rely on the federally facilitated marketplace.
- Restore cost-sharing reduction (CSR) funding: While many states developed a workaround to compensate for the cancellation of reimbursement payments to carriers that provide low-cost services to low-income consumers, it is an imperfect solution that is less effective and actually costs the federal government more through increased tax credit spending. The Alexander-Murray proposal would restore this funding.
- Removing the health insurance tax: The removal of this tax, which is included in the Patient Protection and Affordable Care Act, would lead directly to lower premiums.
“President Trump today tweeted that removing the individual mandate penalty ‘means Obamacare is being repealed.’ With that announcement, we hope that Congress and the president can now turn their attention to bipartisan solutions needed to stabilize the individual insurance market across the nation,” Lee said. “While one provision of the Affordable Care Act will go away in 2019 — the tax penalty for not buying insurance — consumers can be confident that they will have access to the same quality, affordable health coverage from Covered California in 2018 and in the years to come.”
Lee added, “The lynchpin of the Affordable Care Act is financial help for millions of Americans and changing the rules so insurers must cover everybody. Those elements remain in place.”
Covered California also wants consumers to know that while the enrollment deadline for most states was Dec. 15, Californians will have through Jan. 31, 2018, to explore their options and select a plan that best fits their needs. While consumers can sign up for coverage in the month of January, if they wait until then, their coverage will not start until Feb. 1 or March 1.
A recent Covered California analysis found that the net monthly premiums for enrollees who receive financial help are on average 10 percent lower than what new and renewing consumers paid last year. The lower prices are a result of more financial help being available for consumers who qualify for assistance. The Affordable Care Act is designed to protect consumers by providing more premium tax credits when premiums rise.
“With the deadline of Friday, Dec. 22, to get coverage that starts Jan. 1, we want to make sure that consumers know about the increased financial help that is available to help bring health care coverage within reach,” Lee said.
Since 2014, more than 3 million people have purchased health insurance through Covered California, and nearly 4 million have enrolled in the state’s Medi-Cal program. Together, the gains have cut the rate of the uninsured in California from 17 percent in 2013 to a historic low of 6.8 percent as of June 2017.
Consumers interested in learning more about their coverage options should go to www.CoveredCA.com where they can get help to enroll. They can explore their options and find out if they qualify for financial help by using the Shop and Compare Tool. They can also get free and confidential enrollment assistance by visiting www.coveredca.com/find-help/ and searching among 800 storefronts statewide, or more than 17,000 certified enrollers who can assist consumers in understanding their choices and enrolling, including individuals who can assist in other languages. In addition, consumers can reach the Covered California service center by calling (800) 300-1506.
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 www.CoveredCA.com.
