Californians will see some pretty big changes when they get ready to sign up or purchase health insurance this year.
Peter Lee, executive director of Covered California, the state’s health insurance marketplace, is optimistic that these changes will improve and build on how the Affordable Care Act started in this state. California has been credited with the most effective expansion of Medicaid in the country.
Covered California’s open enrollment period for 2020, which began Oct. 15, runs through Jan. 15. Once the enrollment period closes, people will not be able to sign up for coverage unless they qualify for a special enrollment due to a major life event such as job loss, having a baby or getting married.
About 122,624 people in Riverside and San Bernardino counties and 1.4 million statewide are enrolled in Covered California plans. Those who are eligible to receive healthcare from their employers are not eligible for Covered California plans.
Lee talked to the Southern California News Group about Covered California’s big changes this year and answered questions impacts on individuals and families in the Inland Empire and statewide:
Q: What’s the biggest change this year when it comes to enrolling for healthcare?
A: This open enrollment year is the biggest one since 2014 when the Affordable Care Act went into effect. There are significant changes coming that will touch almost a million Californians. This year, the Legislature in California brought back the requirement to purchase health insurance. So, a family of four that can afford to buy health insurance, but doesn’t do so, would be looking at a $2,000 penalty. A premium is considered unaffordable if it is more than 9% of your household income.
This might seem harsh, but it’s a win-win situation because you’re covered when you have an accident or a health condition, and premiums will be lower for everyone when more people get insurance. Plus, this year, 250,000 Californians will become eligible for state subsidies. Last year, the statewide average premium increase was 8.7%. And that was because fewer people enrolled after the federal government removed the requirement to purchase healthcare.
RELATED: Signing up for Covered California or Medi-Cal?: Here’s what you need to know
Q: How will these changes affect the cost of health insurance in 2020?
A: The penalty and subsidies combined have had a broader positive effect. We’ve seen health plans lowering their rates for 2020. The average premium rate increase for those who purchase their plans through Covered California in 2020 will be about 0.8%. For those in the Inland Empire, the increase will be about 0.1%, which is really low if you consider that premiums have gone up by 7% per year on average.
Q: Do consumers have any new options this year?
A: As a result of the penalty being brought back (in California), Anthem, which had left the market earlier, has returned. So, people in the Inland Empire had four plans to choose from last year. This year, they will have five plans to choose from. Competition helps consumers. They have more of a choice and the average person could save about 10% by switching to the lowest-cost plan.
Q: Who will benefit the most from state subsidies?
A: The only way to get these subsidies is to enroll through us (Covered California). This year about 235,000 middle-income Californians, who previously did not qualify for financial help because they exceeded federal income requirements, will be eligible to receive an average of $172 per household each month, which will help save an average of 23% of their current premiums. Many of these consumers, such as those who live in high-cost regions such as Southern California, will see significant savings.
More information: coveredca.com