February 20, 2019
Covered California enrollment dips 2% after ‘repeal and replace’ drama
SACRAMENTO--In California and across the nation, millions of Americans who do not receive health insurance through their employers are continuing to sign up for health plans through marketplaces created by the Affordable Care Act.

They are doing so in numbers roughly similar to years past, suggesting that sustained but failed efforts by congressional Republicans last year to overturn the law, and a successful repeal of the health law’s individual mandate, have not yet deterred many from buying health insurance.

About 1.5 million Californians signed up for insurance through the state marketplace Covered California during the three-month open enrollment period that ended Jan. 31, according to figures released by the agency Wednesday. That is a 2 percent dip compared to last year.

It was the fifth open enrollment period for the state exchange, and the first under President Trump.

California is one of 11 states plus the District of Columbia that run their own health insurance exchanges, which includes managing their own marketing budget and negotiating rates with health insurers, separate from the federal government, which operates the Healthcare.gov platform. In these 11 states plus D.C., enrollment for 2018 health plans remained virtually the same as last year, with just over 3 million people signing up for plans during open enrollment both years, according to data collected by the National Academy for State Health Policy, a nonprofit group of state health policymakers. The group obtained the data from the states and the Centers for Medicare and Medicaid Services.

In the five states that operate their own exchange but use the federal Healthcare.gov website to enroll people in plans, enrollment ticked up less than 1 percent, collectively, from 451,000 people to 455,000 people.

But for the 34 states that rely solely on Healthcare.gov, and were subject to a 90 percent, $90 million cut in advertising and promotion spending by the Trump administration, enrollment fell 5 percent compared to last year, from 8.8 million to 8.3 million people. It is down nearly 11 percent from 2016, when 9.3 million signed up for insurance through the federal exchange.

Other than Florida, California has by far the most residents signing up for health insurance on an exchange than any other state.

Aristeo Alvarez of San Jose recently renewed his Blue Shield PPO plan through Covered California for the fourth year in a row. Alvarez, who receives federal subsidies, pays $300 a month in premiums, 20 percent more than the $250 a month he was paying last year.

Alvarez, 42, works at a small jewelry and cell phone store in San Jose and drives part time for Uber. The store employs eight workers and does not provide health insurance. Prior to the Affordable Care Act, Alvarez bought a health plan on his own, but the subsidies he receives now help make insurance less expensive, he said.

“It’s good for people that work and can’t really afford the full cost of insurance,” Alvarez said.

The repeal of the individual mandate, included in the GOP tax bill passed late last year, takes effect in 2019. Health policy experts predict insurance premiums will rise more dramatically then as a result of some healthy people choosing to drop coverage if it is not required. That would make the remaining pool of customers, as a whole, sicker and costlier.

“While we’ve seen remarkable stability in 2018, 2019 looks very troubling,” said Peter Lee, executive director of Covered California. “The removal of federal penalty and other factors will mean premiums will go up 15 to 30 percent or more, depending on the state.”

These projected premium increases would apply to the roughly 6 million Americans, including 1 million in California, who earn too much to qualify for federal subsidies. For those receiving subsidies, the premium increases are expected to be less drastic because under the Affordable Care Act, if premium costs go up, financial assistance must also go up accordingly to offset the increase. (Source: San Francisco Chronicle)
Story Date: February 15, 2018
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