A Week After Open Enrollment Ends, What’s Next? Phase 2!

One week ago was the end of open enrollment of the Affordable Care Act, and the subsequent announcement that over 1.2 million Californians had signed up for private health plans through Covered California (and over 7.1 million in marketplaces through the United States). Health and consumer advocates point out that the work continues on the Affordable Care Act in California, with “phase two” of health reform to ensure access to high quality coverage and healthcare for all Californians.

A recent report, “Mission Advanced but Not Accomplished: Four Years of Health Reform in California,” outlined the much needed work left be done to implement and improve the Affordable Care Act in our state:

1) Helping Californians who started applications prior to 3/31 to finish picking a plan by 4/15; and ongoing enrollment in Medi-Cal and Californians amidst life changes;

2) Improving the customer service experience, and tool to help select plans;

3) Extending coverage and help to the remaining uninsured;

4) Enforcing strong consumer protections to ensure timely access to care once in coverage;

5) Working for accountability and transparency for increased quality and reduced cost. 

ENROLLMENT: The work to sign Californians up for coverage has not ended: Thousands of Californians who started the process of signing up before the deadline have a grace period until April 15th to finish and pick a plan. Hundreds of thousands of other Californians have ongoing opportunities to enroll based on their income or change of life circumstance. California should be pro-active is getting people during job changes, moves, divorce, graduation, and other life moments when people often lose coverage.

California also needs to improve the customer service experience to make it easier to sign up, from reducing wait times at the call center and increasing the number of in-person enrollment counselors, to improving the website and plan selection tools on quality rating and searching for providers. These improvements are needed not just for the next open enrollment period, but even before, as new graduates and others have the opportunity to sign up for coverage in the next few months.

CONSUMER PROTECTIONS IN COVERAGE: Once Californians are insured, they need to have the security and consumer protections that the coverage is meaningful. It’s up to California regulators to be vigilant in their enforcement of consumer protections. Regulators need to ensure that networks have an adequate number of medical providers, and that patients can get the care they need when they need it. Health Access is the sponsor of several related bills including SB964(Hernandez), that would increase oversight over network adequacy of health plans. California legislators have the opportunities to close loopholes and increase oversight over insurers to ensure that consumers get the care they need, and the promise of the health reform law is fulfilled.

THE REMAINING UNINSURED: While the Affordable Care Act has already begun to dramatically reduce the number of uninsured, it’s up to state and county policymakers to finish the job, and take additional steps toward a more inclusive and more efficient health system. Counties need to maintain and extend their safety-net programs to the remaining uninsured. We are pleased to pursue a statewide solution, SB1005(Lara), legislation to extend the help the Affordable Care Act provides, but to all Californians, regardless of immigration status.

COST AND QUALITY: The Affordable Care Act provided new tools to help prevent illness and control cost. Partially as a result of the Act, health care costs has risen slower in the last four year than anytime in the last fifty, but there’s much more to do to make this trend sustainable. California policymakers and voters have options this year to make the health industry more transparent and accountable for the goal of reducing costs and improving quality.” Health Access supports specific legislative proposals on this subject, as well as pending November ballot measures to regulate health insurance rates and cap hospital charges.