Think you can’t afford health insurance? Check out financial help at Covered California for 2024

If you were discouraged last year by the costs for health insurance, don’t let that experience keep you from shopping and comparing prices during this year’s open enrollment because there’s more financial help than ever, consumer advocates said Thursday.

More than 1.3 million Californians go uninsured, even though they’re eligible for subsidies through Covered California or no-cost coverage from Medi-Cal, Covered California Executive Director Jessica Altman reported.

“Right here in the Sacramento region are over 130,000 of those people who could have subsidies — who could have assistance, yet, are going without the peace of mind of coverage,” Altman said.

With the Tower Bridge as a backdrop Thursday morning, Altman and a diverse group of regional leaders urged Sacramento residents to sign up for a health insurance plan offered on the state marketplace during the 2024 open enrollment period, which runs through the end of January.

About 90% of those who found a health insurance policy through Covered California got help paying for it, Altman said.

In the past, some people found that Covered California’s original affordability help was not enough, consumer advocate Anthony Wright of Health Access California said.

There were no subsidies, for instance, for individuals who earned more than four times the poverty level, Wright said, and in California, that includes people making a little more than $50,000 a year. But since the cost of living here is so high, he said, $50,000 is not enough to necessarily make ends meet.

In other cases, coverage of hospital expenses did not kick in until after people paid a deductible, Wright said, meaning people would have to pony up $5,000 before insurers paid their share of the medical expenses.

The good news, though, is that has changed, Wright said. Thousands of people no longer have to pay thousands of dollars in deductibles before insurances plans cover their costs, he said, and other cost-sharing benefits have further reduced the financial burden on consumers.

Financial help expanded, eliminating deductibles for many Californians

“This is not the Affordable Care Act of a decade ago, or even five years ago,” Wright said. “As a matter of fact, we should even rename it. ... We should call the ACA, the Even More Affordable Care Act.”

Consumers will find that health insurance plans are sold in four levels of coverage on the exchange: bronze, silver, gold and platinum. As the metal tier rises in value, so does the portion of medical expenses that a health plan covers compared with what consumers are expected to pay in co-pays and deductibles.

“There is now a federal government guarantee that nobody buying insurance on their own has to pay more than 8% of their income to get a solid silver plan,” Wright said, “and those who make less pay even less on a sliding scale. This provides peace of mind for those looking for premium options and acts as a shield for the ever increasing cost of care.”

Most Covered California shoppers choose the middle-tier silver plans. Those plans cover 70% of all medical costs, while the consumer pays 30%. On average, platinum-level plans cover 90% of health care cost; and gold plans, 80%.

Those who don’t have access to an employer-sponsored plan will find insurance plans from brand-name companies such as Aetna, Anthem, Blue Shield or Health Net on the Covered California marketplace.

Two-thirds of Covered California’s consumers are eligible for comprehensive health coverage at a cost of $10 or less each month, the agency said, and nearly half could get a comprehensive silver-level plan for that price.

All plans must meet guidelines spelled out by the Patient Protection and Affordable Care Act. Enacted in 2010, the law paved the way for rights and protections that were unheard of just 14 years ago.

Open enrollment ends Jan. 31, 2024, consumer advocates stress

Insurers, for instance, must offer coverage to people with pre-existing conditions, and their plans must include free access to many preventive medical services. And, insurers cannot place lifetime or yearly dollar limits on what they will cover.

The ACA also paved the way for state-based exchanges, such as Covered California and a federal insurance marketplace that many other states use.

The open enrollment period, which began Nov. 1 and will run through Jan. 31, 2024, is the only time during the year when everyone is welcome to sign up for coverage in the next year. If consumers wait until this period is over, they will need a qualifying life event — such as a move to the state or the birth or adoption of a child — to be eligible for coverage.

Since Covered California’s first open-enrollment period in 2013, the state uninsured rate has fallen to 6.5% in 2022 from 17.2%. That’s is the largest percentage point drop for any state in the nation over this time period, according to federal data.

Want to know what costs look like for you or your family? Go to CoveredCA.com, Altman said, and enter four pieces of information: your income, your ZIP code, how many people in your household need coverage and their ages.

This Covered California gateway also lets users know if their household is eligible for free coverage through Medi-Cal. Starting in 2024, California legislators and Gov. Gavin Newsom have expanded Medi-Cal eligibility to all low-income Californians, regardless of immigration status.

“In Black and Brown communities of color, we are most likely to suffer from disease, sickness and ailments because of lack of information or lack of access to real health care,” Jay King, president of the California Black Chamber of Commerce, said. “Today, we are here to inform and encourage you to check out Covered California and take advantage of all of the opportunities and protections that they’ve offered.”