California consumer and health advocates hailed the current COVID-19 relief package that passed the Senate this weekend for its historic investments in health care coverage and accessibility and urged its final passage in the House of Representatives.
The package includes significant funding for vaccine distribution, direct income support to families, and aid to state and local governments that will assist in providing health and human services. Most notably, the federal bill provides historic financial assistance to help millions of Americans afford health coverage in the midst of this pandemic, ensuring that no American will pay more than 8.5% of their income on health care coverage.
This premium relief builds on the work already done in California, where the state has been investing in subsides for more people in Covered California since last year, above and beyond what the Affordable Care Act (ACA) provided.
As these state investments get supplanted with the federal assistance, advocates urge quick action for California policymakers to extend and repurpose the state subsidies to meet the additional affordability needs in our high cost-of-living state, including a reduction in cost-sharing and deductibles.
ON THE OVERALL PACKAGE
This federal package brings much-needed relief to Californians continuing to struggle with the current public health and economic crises. The major health investments will help our state get through the pandemic, with direct assistance to families to get and stay covered, necessary funds for an efficient and equitable vaccine distribution, and state and local aid to our health system that has been stretched to the brink.
The additional help to afford coverage, whether through COBRA or Covered California and other ACA marketplaces, is a literal lifesaver in this public health emergency. Keeping Californians covered in this crisis is crucial not just to provide care to patients with COVID-19 but for all the co-morbid conditions that make this virus so deadly.
ON THE NEW AFFORDABILITY ASSISTANCE
This new assistance, augmenting the help in the ACA insurance marketplaces like Covered California, is a long-sought victory in the work to strengthen the ACA and cover millions more Americans, and make care more affordable for millions more. Retroactive to the beginning of the year and through 2022, the bill stipulates that no one will spend more than 8.5% of their income on coverage.
Virtually everyone who gets a health plan through Covered California—around one and a half million Californians, up and down the income scale, and potentially hundreds of thousands more—will get new financial help, with new assistance totaling hundreds or even thousands of dollars. For low-income Californians, a new sliding scale will mean even lower costs, down to zero premiums for those at 150% of the poverty level or below. This new investment will eliminate all affordability cliffs in the individual health care market.
For so many workers that lost not just wages and jobs but their employer-based health benefits during this pandemic, this help is an urgently needed lifeline, and protection against the sticker shock that many experience when looking buy a health plan as an individual.
ON THE NEED FOR STATE ACTION ON SUBSIDIES
California’s investment in state-level subsides was the vanguard for this federal financing. Implemented in 2020 by Governor Newsom and the Californian Legislature, after years of advocacy by health and consumer groups, the state subsides helped many Californians afford care during the pandemic. This federal bill takes the next step to cap those premiums and make care even more affordable. These new federal resources will supplant the state’s existing efforts, but California is an expensive state and Californian’s will continue to struggle to pay for care – particularly out of pocket expenses. California policymakers should reinvest this money to fill ongoing affordability gaps, such as lowering cost-sharing and ever-increasing deductibles.