CHA and Covered California are joining together to ask for hospitals’ continued assistance in ensuring that all patients understand the health coverage options available to them through the Covered California marketplace. In addition, Covered California has developed a toolkit for hospitals, offering ready-to-use information to share with patients. The attached letter contains links to a variety of toolkit resources, including an open enrollment fact sheet, as well as flyers on the financial assistance available through the Covered California marketplace and steps patients can take to apply for coverage. Covered California urges hospitals to consider other ways to promote open enrollment in their communities, such as through social media, by including information in community newsletters, participating in local press events or partnering to promote enrollment events.
California hospitals have played a vital role in communicating with patients about their Covered California health coverage options and will continue to lead the way in assisting patients with eligibility and information during the open enrollment period from Nov. 1 through Jan. 31.
Today, Covered California released final rates for the 2018 plan year, following its proposed 2018 rates for the individual market, released last July. The proposed rates included a statewide average rate change of 12.5 percent as well as a potential separate surcharge related to the lack of federal funding for cost-sharing reductions (CSRs). The surcharge averaged an additional 12.4 percent on Silver products, ranging from 8 to 27 percent across carriers. Covered California previously delayed the announcement of final rates, pending ongoing federal policy discussions and possible congressional action to fund CSRs. In the absence of a federal commitment to continue funding CSRs, Covered California plans will include the CSR surcharge on Silver-tier products for the upcoming year. Attached is a press release with more information about today’s announcement.
With 2018 open enrollment right around the corner, Covered California is gearing up for various open enrollment outreach activities, including a bus tour and mural art installation project called “Covered in Art.” The project will include murals painted on the exteriors of health facilities in various cities throughout the state. The goal is to create vibrant and permanent murals that bring the community together in support of health care and celebrate the importance of being “covered.” All murals will be painted professionally by local artists and will range from mid-sized to large-scale on building exteriors. The murals will be showcased with a public event at each mural site.
Hospitals or organizations interested in participating in the mural art project or providing an exterior wall for painting should contact Kelsey Caldwell at firstname.lastname@example.org or (916) 588-0485; or Patrick Dorsey at email@example.com or (909) 499-1972 by Friday, Sept. 29.
The California Department of Health Care Services (DHCS), in collaboration with Covered California and the California Department of Finance, last week issued an analysis outlining the impact the proposed Graham-Cassidy amendment would have on California. Calling the proposal “the most devastating of the three federal health care proposals… evaluated this year,” DHCS projects that California would lose $138.8 billion in federal funding from 2020 through 2027. Notably, the amendment would fundamentally change the federal-state partnership established by Medicaid 50 years ago by changing the program’s funding methodology to a per capita spending limit based on historical data.
DHCS’ most significant concerns include:
Shift in federal financing to per capita limit
Elimination of federal funding for expansion
Time-limited state block grant program
Elimination of enhanced funding for In-Home Supportive Services
One-year ban on Planned Parenthood participation in Medicaid
Elimination of hospital presumptive eligibility
Reduced levels of California’s provider fee on skilled-nursing and other long-term care facilities
According to DHCS, the amendment also concentrates the biggest cuts in states that expanded coverage, relying on federal promises of continued support. California, which saw the biggest reduction in its uninsured rate under the Affordable Care Act, would see the biggest cuts under Graham-Cassidy.
Covered California released a report this week about the critical role that marketing and outreach play in promoting a stable individual health insurance market and making coverage more affordable. The report, Marketing Matters: Lessons From California to Promote Stability and Lower Costs in the National and State Individual Insurance Markets, found that if the federally facilitated marketplace invested at a rate comparable to California — which devotes 1.4 percent of the marketplace’s total premiums to marketing and outreach — it would invest $480 million, which is more than 10 times what the federal government recently announced it would spend to promote enrollment for 2018.
According to the report, if the federally facilitated marketplace invested at this level over three years, it would likely result in 2.1 million more Americans enrolling or keeping their coverage, while decreasing premiums by an average of 3.2 percent, and generating a return on investment for the spending of about five to one.
Yesterday, Covered California for Small Business (CCSB) released its health plan choices and rates for the 2018 plan year. The weighted average rate change of 5.6 percent is less than last year and is slightly lower than the overall medical trend for small- and large-group business lines in California. CCSB will offer five plans in 2018, including two preferred provider organization plans with full provider networks from Blue Shield of California and Health Net; two health maintenance organization plans that are provider- and hospital-based from Kaiser Permanente and Sharp Health Plan; and Chinese Community Health Plan in San Francisco. CCSB will not offer Western Health Advantage in 2018, which will impact an estimated 350 consumers.
Currently, more than 35,000 individuals have insurance through CCSB, representing a growth of approximately 7,600 individuals for a 27 percent gain in membership over this time last year. CCSB also announced that next month it will launch enhanced web-based enrollment and renewal capabilities for customers, certified insurance agents and general agents.
At its meeting last week, the Covered California Board of Directors announced it would take three actions in an effort to stabilize the individual health insurance market and continue to provide consumers with choice and the lowest rates possible in the face of persistent national uncertainty. First, Covered California will wait until Sept. 30 to decide whether its health plans must add a cost-sharing reduction (CSR) surcharge to Silver-tier plans. In past years, the federal government reimbursed health insurance companies for those costs; that funding is now in question. If Congress and the President decide to fund CSRs by Sept. 30, rates for Silver-tier plans could move forward without the added CSR surcharge. If a decision is not made by Sept. 30, Covered California will implement its contingency plan in which the total premium would reflect the CSR surcharge for consumers with Silver-tier plans who receive subsidies.
However, Covered California reports that, in most cases, consumers would not see a “net” change in what they would pay since their premium tax credit would also increase. Last week, a report from the Congressional Budget Office found that ending the CSR reimbursements would raise premiums by about 20 percent in 2018 and 25 percent in 2020 and subsequent years. In addition, because the premium tax credit would rise along with the premiums, ending CSR reimbursements would increase the federal deficit by $194 billion over the next 10 years.
Today, Covered California released the attached proposed rates for the 2018 individual market, announcing that all 11 of its participating health insurance companies will return for the upcoming year. Covered California Executive Director Peter V. Lee said the average statewide rate change for 2018 will be a 12.5 percent increase, and noted that consumers can reduce that amount to less than a 3.3 percent increase if they shop for the best value and switch to the lowest-priced plan in the same metal tier. In addition, consumers will see federal subsidies rise, as they are tied to the price of the second-lowest-cost Silver plan. Those subsidies will help offset a significant portion of the rate change.
The rate change varies by health plan and region. Covered California notes that without the Affordable Care Act-mandated health insurance tax — a one-time increase of an average 2.8 percent — the average increase would have been less than 10 percent.