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Californians Must Have Health Insurance In 2020, Or Face Penalty

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A new state law requires Californians to have health insurance in 2020 or face a penalty on their state taxes. This follows the repeal of the individual mandate at the federal level, which took effect in 2019.

Speaker 1: 00:00 You don't hear too much about it in the headlines anymore, but covered California is still working to expand health coverage in the state. Open enrollment starts tomorrow and runs through January 31st some big changes in California's health insurance are rolling out next year and joining us to explain is the executive director of covered California Peter Lee and Peter. Welcome. Great to be with you. I suppose the biggest change is the new state individual mandate that requires Californians to have health insurance. Congress removed the federal individual mandate. Why did the state pick it up last year? Folks in Washington said, we don't need a penalty anymore. Don't need a requirement. It had been in place for five years. It had helped nudge people to do the right thing, shop and get insurance. California said, we actually think the affordable care act is working. Let's go back to what was working but also make it better is not only is it the law in California to have health insurance now and you'll pay a penalty if you don't, but there's more subsidies available and we're the first state in the nation to make financial help.

Speaker 1: 01:04 There for middle class folks, people that make more money and so in many ways more, and I think that's the bigger deal is that California said, let's not just protect the affordable care act. Let's go beyond it and make it work better. We're going to talk about those subsidies in a minute. Let me hang on to the individual mandate though. If the mandate means that if California and stone signup for insurance, they'll face a penalty as you said. What kind of penalty? Well, it depends on how much money you make, but if you're a family of four, you're going to pay at least $2,000 as a penalty if you're an individual at least $700 but if you make more money, the penalty literally could be up to $10,000 for a family of four. But you know, I say this often, the bigger penalty isn't writing a check to the franchise tax board, which is who you'd write the check to.

Speaker 1: 01:51 It's showing up in the emergency room and walking out with an $80,000 bill. It's going without insurance and deciding you don't get that checkup, that diagnosis cancer early. That's what people should avoid and people want health insurance if they find out how affordable it is because these do state subsidies, it's more affordable for a million Californians. People will want the coverage they can afford. Did the rollback of the federal mandate impact the rate of uninsured Californians? We absolutely think it did. Last year in 2019 we saw a major decline in people signing up new. During last years, open enrollment declined about 20% that's a big drop and we think that, you know the penalty was a nudge. It's not the reason anyone buys health insurance, but for many people it may be the reason they shop and realize that, Oh my God, I'm eligible for financial help. Instead of paying $800 I may only have to pay $200 and there's a subsidy to cover the rest.

Speaker 1: 02:49 That's what we want people to do is to go to [inaudible] dot com and find out if they're eligible for that financial help. Let's talk about that change. For middle income Californians, they may be eligible now for significant state subsidies on their health insurance. Tell us all about that. Well, so the California legislature and governors, some signed a law to provide over $500 million to provide financial help for about a million Californians. Many of them are getting help right now, uh, or eligible for federal help to lower their premiums. But the affordable care act had what we called a cliff, which is if you make more than 400% of the federal poverty level, which is about 50,000 for an individual or 75,000 for a family, you would get zero financial help. Now, healthcare in America is expensive. I've talked across the state to people who found that, boy, I made a little bit more than that.

Speaker 1: 03:41 $50,000 healthcare's not affordable for me. California is the first state in the nation to say, we're going to help people out than make more than 50,000 a year up to 75,000 years in individual, you might get hundreds of dollars to lower your healthcare costs and you can find out if you're eligible in two minutes, go into coverage. [inaudible] dot com all you need to have is your zip code, how much you earn, how big your family is. We can tell you in an instant if you're eligible for financial help and what health plans you can sign up for in your community and about how much could it bring your eye health insurance bill down. It's you. You might get a subsidy of $50 150 or $750 you don't know. It all depends, and we've actually had people who have enrolled in coverage already who have had, instead of paying $900 a month, we'll be paying $300 a month because the state subsidy will be over 600 you won't know until you check and we want to make sure California to get the word out.

Speaker 1: 04:37 Now's the time to start shopping. Now according to a recent study, more than 700,000 Californians who are eligible for Medicare apparently don't know it because they may not enroll in 2020 if someone goes to covered California, that portal, will it determine if if they are eligible for medical? Absolutely. I mean one of the things, we are the one stop shop to see if you're eligible for anything. If you're eligible for medical, we're gonna help you get enrolled. You can do it online if you're eligible for state or federal financial help to lower your private plan that you choose through us that's there to either way cover California's got your back. We are there with one purpose to help consumers to get affordable coverage and the legislature just expanded medical coverage for undocumented young adults. How does that work? So if you go to our website and you're younger than 26 and are not currently illegal resident, you're going to be eligible to enroll in medical.

Speaker 1: 05:32 We'll help those people find out how to sign up to work with their local County to get those benefits. Are rates under covered California? Are they going up much this year? So one of the things that happened this year is because California put in place that mandate that it's the law to have coverage. The health plan said, Hey, we're going to get a better risk, make people healthier people. That meant that on average premiums are going up less than 1% next year. That's the lowest we've had it in six years in the San Diego region. Basically premiums aren't going up at all. So if you aren't getting a subsidy, you're still going to see the benefits of having it be the law to have coverage because it's going to mean you aren't paying a 9% increase. Rather your premium should stay on average. Constant. You know, there's so much confusion at the national level about health insurance.

Speaker 1: 06:21 How confident are you that covered California can maintain its system of coverage despite what's going on nationally? Yeah, we're totally confident. Look, there's still chatter in Washington. There's still going to be court cases, but change to the national level will take years. People need to know that they sign up right now for covers. That will take effect in January, 2020 they'll have coverage for all of 2020 they'll get MediCalc, they've signed up for it. They'll get our coverage with federal and state subsidies for 2020 and going long beyond that, any changes that happened down the road are going to take a long time. And we live in a state that says, let's not just rest on our laurels. Let's not just protect the affordable care act bill, let's go beyond it. Which is what we're doing now by helping some undocumented folks, but hundreds of thousands of middle-class Californians getting financial help today.

Speaker 1: 07:12 Okay, so finally, how do people sign up? It's actually easy. The first thing go to covered ca.com and literally in two minutes, shop and compare. You can find out if you're eligible for financial help and what health plans you can choose. If you're confused, go online, put in your zip code and we can send you to local help in your community. There's thousands of certified insurance agents. They never charge a penny to you to provide their service. They can help you enroll, or you can call our 800 number. All of those are reliable. Fastest way to find them covered. ca.com and remember, if you sign up by December 15th which a lot of time you've got coverage effective January one you don't want to go a day into next year without having health insurance. I've been speaking with the executive director of covered California, Peter ley. Peter, thank you. Thanks for having me.

Speaker 2: 08:04 [inaudible].

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Maureen Cavanaugh and Jade Hindmon host KPBS Midday Edition, a daily radio news magazine keeping San Diego in the know on everything from politics to the arts.