Health & Medicine

California insurance enrollment will continue despite Texas Obamacare ruling

Would this interpretive dance inspire you to get health insurance? Watch it now

Covered California commissioned this dance to depict how unexpected life events can leave people thankful for medical coverage. It kicked off this year’s open enrollment with a performance on Thursday, Nov. 8, 2018.
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Covered California commissioned this dance to depict how unexpected life events can leave people thankful for medical coverage. It kicked off this year’s open enrollment with a performance on Thursday, Nov. 8, 2018.

Yes, a federal judge in Texas ruled Friday to strike down the Affordable Care Act, which created health insurance exchanges offering plans to people who aren’t covered through an employer.

Yes, consumers in about 40 states have until Saturday to sign up for coverage. Their states offer insurance through the federal marketplaces.

No, Californians need not worry about any of that in this enrollment period. Golden State residents have their own state-based health-insurance marketplace, and legislators have put in place a 12-week open enrollment period that doesn’t end until Jan. 15 every year.

“It’s still important for Californians to sign up by Dec. 15, if possible, in order for their coverage to start at the beginning of the new year,” said Anthony Wright, executive director of Health Access California. “However, we’re thankful we’re in California, where there is a one-month grace period. ... If they sign up during that period, their coverage will start later in February.”

Open enrollment will go on despite a ruling issued Friday by a federal judge in Texas, who struck down the Affordable Care Act. California Attorney General Xavier Becerra has been leading the defense in this case and denounced the ruling by U.S. District Judge Reed O’Connor in Fort Worth. 

“Today’s ruling is an assault on 133 million Americans with preexisting conditions, on the 20 million Americans who rely on the ACA for healthcare, and on America’s faithful progress toward affordable healthcare for all Americans,” said Attorney General Becerra in a news release emailed to The Bee. “The ACA has already survived more than 70 unsuccessful repeal attempts and withstood scrutiny in the Supreme Court. Today’s misguided ruling will not deter us: our coalition will continue to fight in court for the health and wellbeing of all Americans.”

Wright said he was not surprised by the ruling, and he urged consumers not to panic. Regardless of this ruling, he said, people should sign up for coverage. The judge did not block the continued operation of the ACA while a likely appeal is prepared.

The ACA marketplace offers health plans to people who can’t get coverage through an employer. About 1.2 million California residents have renewed their Covered California plans for 2019, the state-based exchange reported Thursday, and 150,191 new consumers have signed up during the current enrollment period.

Covered California has seen a surge of new enrollees this week as people rush to get coverage that will start Jan. 1. More than 10,000 of people enrolled Wednesday, with more than 28,000 in the first three days of the week. If consumers sign up for a plan after Dec. 15, their health coverage will start Feb. 1.

“The states that have maintained longer deadlines have also done other things like aggressive marketing campaigns,” Wright said. “There absolutely has been a quantitative difference in the level of enrollment for those (states) with their own exchanges that tend to do their own marketing and in many cases have set a longer open enrollment period versus the enrollment dates in the federal exchange.”

Wright’s Health Access worked closely with California Assemblymember Jim Wood, D-Santa Rosa, to permanently extend open enrollment for Covered California to 12 weeks, running from Oct. 15 to Jan. 15.

“One of the reasons we advocated for the deadline to go past Dec. 15 is we recognized that this is a time when people have lots of financial pressures,” Wright said. “We hoped it would make a difference for those folks who who may be feeling financially overwhelmed as they approach the holiday season and may want a chance to sign up at the beginning of the new year.”

Covered California reported it will spend about $40 million on advertising alone and will spend slightly more than $60 million on marketing and outreach as it tries to attract consumers who no longer will face a tax penalty in 2019 if they don’t maintain health insurance.

The Affordable Care Act includes the so-called individual mandate, requiring U.S. citizens to carry a basic level of health insurance. If they didn’t, they would have to pay a tax penalty. If everyone bought insurance, the logic was, insurers could afford to cover pre-existing conditions.

The Republican-controlled Congress voted to repeal the individual mandate in 2017, and that repeal goes into effect next year.

“Covered California continues to see strong interest, but we are seeing new enrollment that’s about 10 percent lower than last year, which we largely attribute to the removal of the individual mandate penalty,” said Covered California Executive Director Peter V. Lee.

Lee emphasizes in speeches and in advertisements that life can change in an instant, so people need to maintain insurance. His agency’s data show that more than 50,000 of its enrollees were either diagnosed with or treated for cancer in 2017 and 22,000 fractured, dislocated or sprained their arm or shoulder.

Enrollees pay an average of $5 a day for health insurance coverage, Lee said, and nine out of every 10 enrollees qualify for a subsidy from the federal government to help defray premiums, saving an average of 80 percent on the cost. To see whether you qualify, use the shop-and-compare tool at www.coveredca.com.

Wright recommends that even current Covered California enrollees use the tool to compare their current plan to new offerings since they may no longer have the best deal. Plans change every year, he said, and so do their costs.

“Health care insurance makes a good gift,” Wright said. “It gives a family not just health care but financial security and peace of mind. Coverage is about access to care, but it’s also about making sure you’re not one emergency away from financial ruin. That’s why it’s important for people to take a look at their options.”

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