Covered California premiums take double-digit jump in region; aid rises too
A nearly 11% jump in Covered California premiums in a region that includes Ventura County is driven partly by inflation and pressures created by the COVID-19 pandemic, said the leader of the health insurance system.
Open enrollment in the government-subsidized marketplace used by about 44,000 county residents began on Nov. 1 with an end-of-the-year deadline for people who want coverage beginning New Year’s Day. Premiums in a region that includes Ventura, Santa Barbara and San Luis Obispo counties are set to jump an average of 10.7%, or more than double last year’s increase.
“It’s a challenging year for (insurance) rates in general in California,” said Covered California Executive Director Jessica Altman. She said the increase is driven not only by rising medical care costs but also higher usage pushed by patients making up for care missed early in the pandemic as well as rising needs for mental health treatment.
Blue Shield’s premium rates across California also jumped higher than any other insurer in Covered California, Altman said. In the three-county central coast region, more than 80% of Covered California clients use Blue Shield.
But financial help for coverage has risen too, Altman said, asserting costs in the insurance program remain affordable. About 90% of the people in Covered California receive subsidies and the majority of people who receive assistance pay premiums of $10 or less a month, she said.
What is Covered California?
Covered California is the marketplace created by the Affordable Care Act, also known as Obamacare, and signed into law nearly 14 years ago. It is designed to provide insurance to people who can’t get affordable coverage through work and aren’t eligible for government insurance in Medicare and Medi-Cal.
Who gets subsidies?
A new cost-sharing program will reduce deductibles and out-of-pocket costs for about 650,000 people, Altman said. Eligibility for subsidies and the amount received is largely dependent on income and whether an employer offers insurance deemed affordable, meaning costs take up no more than 8.39% of household income.
People can get a rough estimate of how much help they would receive and their monthly premiums by using the marketplace’s shop and compare tool. The Kaiser Family Foundation also offers an online calculator of costs.
Does legal status affect eligibility?
Undocumented immigrants are not eligible for coverage in Covered California, but they may qualify for insurance through Medi-Cal.
What if I do nothing?
People already in the program who don’t take any action will be automatically renewed. People are required to report status changes including income, household size and home address.
California law also requires people carry health insurance, though exemptions are available. Minimum fines for being uninsured an entire year are $900 per adult and $450 for each child.
What if I have more questions?
People can call Covered California at 1-800-300-1506, use online chat tools or seek help from a free network of local insurance agents and enrollers. To apply, people need their Social Security number, federal tax information, employer and income data and, for non-citizens, immigration documents. They can apply online, by phone or in person.
Tom Kisken covers health care and other news for the Ventura County Star. Reach him at tom.kisken@vcstar.com or 805-437-0255.
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This article originally appeared on Ventura County Star: Ventura County insurance premiums for Covered California rise
