California

New open enrollment “the biggest and most significant” since the 2014 startup, Peter Lee

COVERED CALIFORNIA JE VDA 10/24/19 FRESNO BEE OFFICES -- Peter V. Lee, executive director of Covered California, said $420 million in state funding will be used to provide subsidies for more middle class Californians.
COVERED CALIFORNIA JE VDA 10/24/19 FRESNO BEE OFFICES -- Peter V. Lee, executive director of Covered California, said $420 million in state funding will be used to provide subsidies for more middle class Californians. jesparza@vidaenelvalle.com

Peter V. Lee, executive director of Covered California, calls the new open enrollment “the biggest and most significant” since the 2014 startup of the Affordable Care Act.

And why he is calling it those two things? Because for the first time, the state is leading not just to defend the ACA but to go beyond it, Lee said.

Lee said the governor and legislature agree that is not only important to play defense when it comes to the ACA, but to work on improving it, which is reflected with the big new policy changes in California that will touch millions of people.

“They really are examples for the nation, because we as a state for the last six years have been an example of making the Affordable Care Act work,” Lee said, adding that now the state is working on how to build it up and making it better.

Lee said it was really a remarkable fast turnaround for the state legislature and Gov. Gavin Newsom who just took office in January, that in short, few months have things in place such as new available state subsidies are for consumers starting January 2020.

However, there is something that really worries Lee.

“I am actually worried that we won’t get the word out enough, because these are really big issues,” Lee said, adding that it is not just another open enrollment period, which already started on Oct. 15 and thanks to a new law, it extends through Jan. 31, 2020. However, consumers who wants to have health coverage starting Jan. 1, they need to sign up by Dec. 15.

One of the big changes, is what Lee calls “defend the Affordable Care Act by putting back into state law the requirement to have health insurance,” which was removed by the Trump Administration in 2019.

When the ACA was implemented, there was a mandate that if people didn’t carry health insurance, they would pay a penalty when filing their income taxes.

Lee explains that starting in 2020, those people who live in California and don’t get health insurance that they can afford, will pay a penalty to the State Franchise Tax Board which would administrate that penalty when they file their 2020 taxes in the spring of 2021. The penalty is based on the person’s income and the number of people in the household.

But more importantly, Lee wants to get the word out about the new state subsidies, adding that there is about a million Californians who will be eligible.

Even though the biggest number of people who would be eligible for state subsidies are people eligible now for federal subsidies, Lee said that about a quarter of a million Californians that make more than 400 percent of poverty and up to 600 percent of poverty – which is middle-class Californians with many of them living in the Central Valley – who were out of luck before, now will be eligible for state subsidies.

Lee said $420 million in state funding will be used to provide subsidies for more middle-class Californians.

For example, an individual making more than $50,000, or a couple making more than $70,000 or a family of four making more than $100,000 will now get financial help, Lee said.

“We are the only state in the nation that’s doing that, that is directly addressing the middle-class with subsidies,” Lee said, adding that by having the penalty and the subsidies, more people are going to be signing up for health care coverage.

Lee said areas like in the Central Valley will more competition for consumers to select health plans now that Anthem Blue Cross will be back at the state exchange to offer health plans in the Fresno, Kings Madera Counties or better known as Region 11 in the Central Valley.

Lee said is important for people to know about the importance of shopping for health plans to see how much they can save on health coverage.

Lee said that Covered California will be spending $110 million in marketing and starting this month consumer will start to watch television add as well as hear radio ads in English, Spanish, Korean, Vietnamese, etc. depending of where they live.

“We are getting the word out there everyway we can,” Lee said.

To learn more about coverage options visit: www.CoveredCA.com, or call Covered California at (800) 300-1506.

María G. Ortiz-Briones: 559-441-6782, @TuValleTuSalud

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