The 2020 changes that made California health insurance more accessible

Live in California? Don’t forget that your have an extended 2021 Open Enrollment Period in your state. California’s Open Enrollment Period through their state-run exchange, Covered California, runs from November 1, 2020 to January 31, 2021. Call (855) 772-2663 to enroll.

There are some important changes that happened in California that affect your health insurance. Here’s what you need to know for Open Enrollment in California. And for detailed information on how to enroll in Marketplace coverage, grab our free step-by-step guide here.

Expanded subsidy eligibility

California is the first state to offer extra financial assistance to middle-income enrollees who shop the Marketplace. Keep in mind that California is one of the states that runs its own Health Insurance Exchange, called Covered California. 

And now, even more people will be eligible for Obamacare cost savings in California through Covered California.

Increased income range for subsidies

Cost savings and subsidies are now available to middle-income folks. In other words, those with an annual income of between $50,000 - $75,000 for individuals and between $103,000 - $154,000 for a family of four will now qualify for subsidies. So what does this mean for you? Earned too much to be eligible for cost savings subsidies and tax credits for Obamacare in California in the past? This year may be different. 

Approximately 235,000 middle-income Californians who previously did not qualify for financial help because they exceeded federal income requirements will now be eligible for Obamacare subsidies. On average, each of these households can expect to see a savings of $172 per month off their premium rates. This translates to a savings of 23 percent on current premium rates.

New savings for those already qualifying for subsidies

Expanded subsidy eligibility also impacts those who already receive subsidies and other cost savings methods for their Obamacare coverage. An estimated 663,000 Covered California enrollees who currently receive some form of federal subsidy on their Affordable Care Act insurance will see even more savings. There will be a savings of approximately 5 percent a month on premiums for these enrollees.

An estimated 23,000 Covered California enrollees have annual household incomes below 138 percent of the Federal Poverty Line ($17,237 for an individual and $35,535 for a family of four). These folks will see some dramatic cost savings next year. Starting in 2020, this group will now pay just $1 per member per month for the benchmark insurance plan.

Not sure if you now qualify for new costs savings on an Affordable Care Act plan in California? The HealthSherpa Consumer Advocate Team can help. Feel free to reach out at (872) 228-2549.

Individual mandate

Starting in 2020, there will be an individual mandate in California. This means that in California, individuals who go without health insurance may have to pay a fine.

New penalties for going without coverage

The penalty fine for not having health insurance for a full year is whichever is higher: $695 per adult and $347.50 per child, per household OR 2.5% of annual household income above the state tax filing threshold.

You won’t have to pay the fine if you have a gap in coverage that’s less than three months, and you’ll only have to pay the full fine if you go without coverage for the whole year. If you have a gap in coverage that’s more than 3 months but less than a full year, you’ll just pay 1/12 of the fine for each month you didn’t have coverage - minus the 3 month exemption.

It is projected that 229,000 Californians will become newly covered by health insurance in 2020 as a result of the individual mandate. If you need help enrolling in a Covered California plan for 2020, HealthSherpa can assist. You can reach our Consumer Advocate Team at (872) 228-2549 to learn about your options.

How individual mandates keep costs down

The Affordable Care Act had originally implemented a national individual mandate for health insurance. This was overturned by the Republican-led Congress and went into effect in 2019, though. Individual mandates, however, are thought by many to be essential to having a functional, and cost-effective, health care system. Uninsured individuals pass on the biggest health care costs to taxpayers. And ensuring that all people, including young and healthy people, have health insurance creates a larger pool of people for a given insurance policy to cover. When you have a larger pool, and one with healthier people in it, health insurance rates go down. 

By reducing the number of uninsured people and increasing the number of people who are insured, insurance premiums go down as does medical debt assumed by taxpayers. This is why some states, like California starting in 2020, have implemented their own individual mandates. 

More choice

Starting with the 2020 Open Enrollment Period, there will be many more insurance choices offered on Covered California. All eleven health plans previously participating in Covered California in 2019 will return for 2020 Open Enrollment. In addition, Anthem Blue Cross Blue Shield will also be returning to the state. Now, 87 percent of Californians will be able to choose between three different insurance carriers. 

The return of Anthem Blue Cross Blue Shield to large swaths of California means many more options for those left looking for new coverage after the insurance company left the state in 2017. Now, the health insurer is expanding back into the Central Coast, Los Angeles County, parts of the Central Valley and the Inland Empire.

And as a result, Californians shopping for Obamacare on Covered California are about to get a lot more options for their coverage. And that means even more options for their care. 

We always recommended comparison shopping plans to see what’s best for you and your family. Please feel free to contact the HealthSherpa Consumer Advocate Team at (872) 228-2549 to start. 

Medi-Cal expansion for undocumented young adults

Another big change in California this year was the expansion of Medi-Cal, the state’s Medicaid program, to all undocumented adults under the age of 25.

California first made moves to expand Medi-Cal to undocumented Californians in 2016. And it was then that the state moved to expand Medi-Cal to all children under the age of 18, regardless of immigration status.

But starting January 1, 2020, this expansion went further, now including young adults. In 2020, all Californians may enroll in Medi-Cal and have coverage until they turn 26. It is the latest step by California Governor Gavin Newsom to work towards universal healthcare for all in the state, regardless of immigration status. 

Need help enrolling in Medi-Cal or not sure if you qualify? The HealthSherpa Consumer Advocate Team can advise. You can reach them at (872) 228-2549.