Napa's Health Insurance Guys: Covered California costs to rise, but subsidies available

Dear Readers: So many things are changing and happening!

For example ...

Open enrollment for individuals and families through Covered California begins Nov. 1 and goes through Jan. 31, 2024. For the approximately 1.6 million members, the average statewide increase for next year is 9.6%.

For our area, which includes Marin, Napa, Solano and Sonoma counties, the almost 57,000 members face a 6.5% increase. Executive Director Jessica Altman said "Nearly 90% of Covered California's enrollees receive financial help, with many paying $10 or less per month for their health insurance."

When we meet with prospective customers we emphasize (I mean really emphasize) that the subsidies through Covered California are based on household income. The amount must be accurate and any changes must reported quickly.

We don't have the numbers for 2024 yet, but the chart for 2023 (Federal Poverty Level) shows that a family of four earning less than $111,000 could qualify for a subsidy.

Something a little different

Gov. Newsom recently signed a bill that might help pave the way for universal healthcare in California. Senate Bill 770, authored by Sen. Scott Wiener (D-San Francisco) begins the process of obtaining a waiver that would allocate federal Medicaid and Medicare funds to possibly help fund a single-payer system for every resident. The state's health secretary has until June 1, 2024 to offer recommendations.

The California Nurses Association is against the bill because it doesn't go far enough to nail down a single-payer system which they have advocated for many years.

In support of the bill, Cindy Young of the California Alliance for Retired Americans said, "There are things seniors can't get or it's eating up our pension money to be able to pay for those things. Long term care is an absolute necessity."

This last struck us strange because long term care provisions in both the Affordable Care Act and the early form of Covered California went down in flames as simply too expensive. Projected costs of large scale long term care (LTC) are unknowable.

Speaking of LTC, one of our long-time readers of the Health Insurance Guys, in response to a column, asked about when he might have to pay a California tax to support statewide LTC.

We didn't have an answer then but we do have an updated timeline for California's Long Term Care Insurance Task Force. Similar to the Washington State plan involving a payroll tax for everyone who doesn't already have an LTC individual plan, the program would be in place for employees who need the benefits in the future.

The Task Force recommended a statewide comprehensive benefit and had an actuarial subcommittee prepare feedback for a Nov. 2 presentation to the group. The presentation of the Final Actuarial Report to the Task Force is Dec. 14, and to the legislature on Jan. 1.

By the way, this could also be the deadline for getting individual LTC. On Jan. 3, the legislature reconvenes and may or may not take it up.