Obamacare

The Affordable Care Act takes full effect on January 1, 2014. Will California be ready?

RECENT POSTS

Brown on Health Coverage: “Right Thing to Do. But It Isn’t Free.”

Gov. Jerry Brown is sworn in as California governor for the fourth time. (Andrew Nixon/Capital Public Radio)

Gov. Jerry Brown is sworn in as California governor for the fourth time. (Andrew Nixon/Capital Public Radio)

Jerry Brown was sworn into his fourth term as governor of California Monday morning. In a wide-ranging inaugural address (that doubled as a State of the State address), he included some brief remarks about the Affordable Care Act.

Here’s the text of what he said:

Along with education, health and human services constitute a major part of what state government does. And in the past few years we have made massive commitments in this area, which will require increasing levels of spending, the full extent of which is not yet known. For example, two years ago California embraced the Affordable Care Act, dramatically increasing its health insurance coverage under the Medi-Cal program. The state will enroll 12.2 million people during this new budget year, a more than 50 percent increase.

Providing the security of health coverage to so many Californians who need it is the right thing to do. But it isn’t free. Although the federal government will temporarily foot much of the bill, new state costs – now and more so in the future – will run into the billions.

Before we take a deeper look at his statements about Medi-Cal, let’s go back a year ago to last year’s budget. Then, Brown’s budget proposal included an additional $670 million for Medi-Cal, at least in part because of the expected additional costs due the expansion of Medi-Cal under the Affordable Care Act. Perhaps more importantly, “The Medi-Cal caseload is expected to be approximately 24 percent of the state’s total population,” the governor said when he released last year’s budget.

Speed forward a year. Obamacare sign-ups surged in California during 2014 and outstripped all estimates. Specifically in Medi-Cal, it’s not 24 percent of the population that is covered by the program, it’s closer to 33 percent.

While the ACA  pays for 100 percent of the people who are newly eligible for Medi-Cal, many people who signed up in 2014 were already eligible before the ACA expansion. They just had not enrolled. With all the hoopla around the ACA, plenty of those previously-eligible people signed up. Many refer to this as the “woodwork” effect.

Estimates are of the 2.4 million people who signed up for Medi-Cal by Mar. 31, about 800,000 of them were previously eligible. The federal government funds those people at the non-expansion rate of 50 precent. That’s why in the May revision of his budget, Gov. Brown included an additional $1.2 billion to fund the caseload.

Brown closed his brief remarks about health with a remark about the state’s costs “in the future.” The federal government is funding 100 percent of the Medi-Cal expansion only through 2016. Come 2017, the match will start to drift down and ultimately end at 90 percent. Yes, this is still a generous federal outlay. But 10 percent of billions of dollars is a lot of money.

The governor is expected to release his budget proposal on Friday.

Health Law Mandate in Effect, Hits Employers Unevenly

(Getty Images)

Business owners who employ more low-wage workers, such as restaurants and retail, are likely to feel the employer mandate the most. (Getty Images)

By Emily Bazar, CHCF Center for Health Reporting

Remember those end-of-the world predictions from Nostradamus, the ancient Mayans and Pat Robertson that we somehow survived?

“If I’m a restaurant owner and don’t offer coverage to my employees now, my world will change a lot after Jan. 1 and it will change for the workers as well.”  

The “employer mandate” may be Obamacare’s version of that.

One of the most-feared aspects of the Affordable Care Act took effect Jan. 1 after some delay, and requires large businesses to provide health coverage to their employees or face financial penalties.

Despite the concerns surrounding the mandate, it won’t hit all businesses hard, nor will it provide coverage to all uninsured workers. Instead, just like the rest of Obamacare, its impacts will be felt unevenly, among some industries and employees more than others.

Think restaurants, retail and low-wage workers.

Q: My employer doesn’t offer health insurance. Will that change under Obamacare?

A: It all depends. Continue reading

Deciding Whether That Covered California Subsidy Is Worth the Hassle

Cecily Liu, 37, with her three children – Nolan Lin, 6 months, Fiona Lin, 3, and Larissa Lin, 5 at their house in Richmond, Calif. The self-employed accountant said signing up her family through Covered California was a hassle (Heidi de Marco/Kaiser Health News).

Cecily Liu, 37, with her son at their house in Richmond, Calif. The self-employed accountant said signing up her family through Covered California was a hassle. (Heidi de Marco/Kaiser Health News)

By Andrew Wang, Kaiser Health News

With the deadline looming to re-enroll in California’s insurance exchange, Kuei Lin Liu faced a tough question: Do I want to go through this all over again?

After a year of bureaucratic snags, data glitches and inexplicably dropped coverage, Liu wondered whether Covered California was worth the effort.

“I’m so frustrated right now,” she said. “I spent the last year trying to work out this mess.”

The 37-year-old Richmond resident first enrolled in the exchange last fall, when she left a senior accounting position at a big corporation and the benefits that came with it. With two daughters under 5 and a son due in May, Liu said going uninsured was not an option.

So Liu and her husband Qing Lin, a stay-at-home dad, signed up for a benefits-rich platinum plan from Blue Shield of California. With a projected income of about $90,000 from Liu’s tax preparation business, the family was eligible for a subsidy that covered a third of their nearly $1,600-a-month premium. Continue reading

Top 5 Stories on State of Health in 2014

President Obama took a victory lap on Apr. 1 as the first open enrollment of the Affordable Care Act came to a close and millions had signed up. A story about the ACA was in State of Health's top five posts this year. (Nicholas Kamm/AFP/Getty Images)

President Obama took a victory lap on Apr. 1 as the first open enrollment of the Affordable Care Act came to a close and millions had signed up. A story about the ACA was in State of Health’s top five posts this year. (Nicholas Kamm/AFP/Getty Images)

It’s been a big year in health: the launch of the Affordable Care Act, an ongoing Ebola epidemic and the first soda tax in the country, passed by Berkeley voters.

Here on State of Health, all those stories got plenty of attention from you, the readers. But the Top 5 might surprise you. We crunched the numbers and here are the posts that netted the most views this year.

1) What Philip Seymour Hoffman’s Tragic Death Teaches Us About Addiction

Philip Seymour Hoffman arrives for the Los Angeles premiere of 'The Hunger Games: Catching Fire' in Los Angeles, California, last November. Robyn Beck/AFP/Getty Images)

Philip Seymour Hoffman arrives for the Los Angeles premiere of ‘The Hunger Games: Catching Fire’ in Los Angeles, California, last November. Robyn Beck/AFP/Getty Images)

We all know the sad details. In February, Philip Seymour Hoffman died of a drug overdose. He had been an addict as a young man, but given up drugs and alcohol at 22. His relapse cost him his life. But what troubled me most after his death were the heartless social media attacks about his “selfishness” and “poor choices.” Continue reading

In Far-Northern California, People Have Just One Health Insurance Choice

Dennie Wright has a pile of medical bills for services his health insurance might not cover because it's out-of-state routine care. (Pauline Bartolone/Capital Public Radio)

Dennie Wright has a pile of medical bills for services his health insurance might not cover because it’s out-of-state routine care. (Pauline Bartolone/Capital Public Radio)

By Pauline Bartolone, Capital Public Radio

Dennie Wright lives in Indian Valley, a tiny alpine community at the northern end of the Sierra, 80 miles east of Chico and close to the Nevada state border.

“We’re back in the back country you might say. But it is a beautiful place to live, and that’s why we choose to live here,” says Wright.

Wright works in a grocery store as a meat cutter, and lives in a modest home overlooking a green pasture.

His zip code is one where Blue Shield stopped selling individual policies this year. Wright’s insurance agent told him he had only one insurance choice through the Covered California exchange. Continue reading

On California’s State Borders, People Struggle with Health Insurance Restrictions

Stacey and Kory Felker in their Quincy, California home. The Felkers live near the California-Nevada border, and recently learned that their individual insurance does not cover routine out-of-state care. (Pauline Bartolone/Capital Public Radio)

Stacey and Kory Felker in their home in Quincy, Calif. The Felkers live near the Nevada border and recently learned that their individual insurance does not cover routine out-of-state care. (Pauline Bartolone/Capital Public Radio)

By Pauline Bartolone, Capital Public Radio

For some people living along California’s state border, the closest or most convenient care is often out of reach.

Kory and Stacey Felker experienced this problem for the first time this year, after they signed up for individual insurance with Anthem Blue Cross.

The Felkers live in Quincy with their two kids. The small community rests in an alpine valley at 3,500 feet in the Sierra Nevada mountains, a couple of hours northwest of Lake Tahoe.

“Reno is the closest city,” says Stacey Felker. “That’s where we’ve always gone for health care.” Continue reading

Covered California Now At A Mall Near You

Sign outside a health insurance agency which seeks to lure customers on their way to the Sunvalley mall in Concord. (Marc Protenic/Health Markets)

Health Markets Insurance opened this storefront near the Sunvalley shopping center in Concord to capitalize on shoppers en route to the mall.  (Marc Protenic/Health Markets)

By April Dembosky

While shoppers flock to the malls to pick up the last neckties and Transformers on their Christmas lists, Covered California is trying to pitch them on an unconventional gift this holiday season: health insurance.

People headed to the mall for Christmas shopping see Covered California storefronts and think, “Oh my God, I have to do that.”

The state’s health insurance marketplace supported the development of more than 200 new storefronts at or near shopping centers across the state this year, each tasked with explaining the ins and outs of different health plans to holiday, and everyday, shoppers.

“Especially during this time of year, malls have incredible foot traffic,” says James Scullary, a Covered California spokesperson. “You may have someone who is running an errand or picking someone up who passes one of these facilities, and it passes in their mind: this is something they need to take care of.” Continue reading

Looking Ahead — and Back — at Obamacare in California

The second year of open enrollment for Covered California, the state’s health insurance marketplace, is underway. Scott Shafer of KQED’s Newsroom, spoke with State of Health editor Lisa Aliferis about how enrollment is going this year, including an upcoming Supreme Court challenge. They also looked back at the historic rollout of the Affordable Care Act.

Continue reading

Covered California Sign Ups Continue at Strong Pace

Peter Lee, executive director of Covered California. (Max Whitaker/Getty Images)

Peter Lee, executive director of Covered California. (Max Whitaker/Getty Images)

Just over 144,000 new people signed up for health insurance on the Covered California marketplace during the first month of open enrollment, officials said Wednesday.

Peter Lee, executive director of Covered California, noted that the state is now one-third of the way through open enrollment, which ends Feb. 15. At the same point last year, 110,000 people had picked a plan.

Lee said enrollment was going “remarkably smoothly” so far, although there have been “some small glitches along the way.”

Covered California is targeting 1.7 million enrollees for 2015, including renewing 1.2 million current customers and netting half a million new people. Continue reading

Tough Sell Getting Students Interested in Health Insurance

Screen Shot 2014-12-15 at 10.31.49 AM

Just three people attended a presentation on Covered California held recently at San Diego State University. (Nicholas McVicker/KPBS)

By Kenny Goldberg, KPBS

At a recent Covered California forum at San Diego State University, you could have heard a pin drop. There were only three students in the audience.

“I don’t think they realize that you’re healthy until you’re not. And that’s not the time to get coverage,” Jan Spencley, San Diegans for Healthcare Coverage.

Still, presenter Jan Spencley went through her entire PowerPoint routine.

Spencley directs the non-profit San Diegans for Healthcare Coverage. She told the students that without health insurance, one accident could saddle them with tens of thousands of dollars in medical bills.

And that would ruin their credit.

“You don’t get a phone on your own, you don’t get an apartment on your own, you don’t buy a car on your own if your credit’s messed up,” she told the students. Continue reading