Yesterday, Covered California, which enrolls 1.4 million Californians, announced that all 11 health plans will continue to participate in 2018 and unveiled the rates for next year. Overall, California’s marketplace remains stable despite constant federal attacks on the health system.
The Guarantees of the ACA Continue in Face of Trump Attacks
Despite the Trump Administration’s attempts to sabotage and undermine the Affordable Care Act, California continues to have a stable individual market. All 11 insurers are staying in the marketplace and subsidies will continue to ensure that 86% of the 1.4 million in Covered California will not have to pay more than a percentage of their income for a silver plan. California is Exhibit A showing that President Trump and others aren’t telling the truth when they say Obamacare is failing. California is a clear example of ACA success in ensuring access and options for coverage. Unfortunately, the Trump Administration’s actions and attacks have directly led to higher premiums that would otherwise not be necessary.
In particular, we appreciate Covered California’s creativity in finding a way to hold health consumers harmless if President Trump follows through with his threats to withhold cost-sharing reduction (CSR) payments to health plans. Covered California has ensured that any additional rate increases resulting from the Trump Administration’s failure to fund CSR payments will only apply to those who receive subsidies, and increases in federal assistance will spare most consumers from the full impact of the premium increases. Covered California’s work-around means consumers who do not get subsidies will not see additional rate spikes because of the Trump Administration’s sabotage.
The impact of Anthem’s withdrawal from 16 regions is offset by Blue Shield, Health Net, and Oscar expanding into new regions. As a result, 96% of Covered California consumers will have at least 2 plan choices and 82% of consumers will have more than 3 plans to choose from.
Confronting the Cost of Care, Including Prescription Drugs:
Rate increases are never good for consumers and we must focus on reining in underlying health care costs, such as the ever increasing cost of prescription drugs. California legislators must pass a package of bills aimed at controlling prescription drug prices, including SB 17 (Hernandez), which would increase transparency in prescription drug pricing.
These preliminary rates must be reviewed by the California Department of Managed Health Care and the California Department of Insurance, and consumers can submit comments to state regulators during the 60-day public comment period. We urge California regulators to scrutinize these rates to ensure they are justified and reflect actual health care costs.
Options and Advice for Consumers:
With the defeat (for now) of ACA repeal in Congress, yesterday’s announcement should give California consumers confidence that they will continue to have options for affordable health coverage.
Consumers should take advantage of financial assistance to get affordable coverage. Regardless of the increase in premiums, the ACA guarantees that those who qualify for subsidies won’t pay more than a percentage of their income, based on a sliding scale, for a silver plan. Consumers will also be eligible for higher premium tax credits that will offset premium rate increases, protecting them from the rate hike. In addition, we urge consumers to actively shop and compare plans as this could limit rate increases to as little as 3 percent. Health consumers, regardless of pre-existing condition, can take control of their own health care by finding the plan and rate in their region that is best for them.