Peter Lee, executive director of California health exchange Covered California, took some time today to field questions from Reddit users. Topics were wide ranging, and Mr. Lee answered the majority of questions put before him, including several follow up questions. Some highlights:
On Guaranteed Issue health insurance:
One of the BIG DEAL changes to health insurance that starts 1/1/14 is that health insurance companies need to accept everyone — regardless of health history or status — and they cannot charge differently based on health status. This means that many who have been denied coverage or priced out of coverage will now have guaranteed coverage. It also means that the millions who have employer-based coverage (which is not changed) now know that they will be able to get coverage in the future if they leave their job.
On California health coverage for those currently unsinsured, and the penalty for not having health insurance:
California has about 5 million uninsured; about 2.6 million will be eligible for finanical help to pick a private plan through CoveredCA — in addition 1.4 million will be eligible for expanded Medi-Cal. We want ALL of them to be enrolled, but know that we won’t get everyone…over the first few years, we think about 70% of those eligible will actually enroll. This means that a few years in we will still have a few million uninsured. All Californians who can afford coverage and do not buy it (meaning — the rest of us are insuring them) will pay a penalty to the the IRS. The penalty (for not having health insurance) starts small — $95 or 1% of income; growing in
On the California SHOP exchange:
Correct! The “SHOP” is the Small Employer Health Options Program — which is Covered California’s program to help small businesses both get access to federal tax subsidies (available to smaller businesses that have have lower income workers) AND provide a way for all small businesses (up to 50 people) to provide their employees the choice of plans usually only available to those who work in large businesses. The employer will be able to pick the “metal level” (how rich the coverage is) and then the employee can pick any plan. The employer only has to write one check to Covered California and can pick the amount of financial support to her/his employees.
We’re glad to see Mr. Lee step up to take questions in an open forum, and encourage this discourse to continue over the coming months. Information is at a premium these days- the more you know, the better off you will be during Open Enrollment, when it’s time to enroll in health benefits through the California health exchange, Covered California. As always, you can contact us at Quotebroker with any questions you may have on the ACA, Covered California, healthcare reform or healthcare in general.