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Memo to Washington: Lessons Learned From California’s Obamacare Rollout

Certainly, the rollout of Obamacare in the state has not been without its challenges, and yet — California has 12 percent of the nation’s population and nearly 25 percent of all sign-ups nationwide. In addition to the more than 800,000 people currently enrolled in California, another 877,000 Californians are likely to be eligible for Medi-Cal. That’s on top of another 652,000 people who transitioned to Medi-Cal from the Low Income Health Program (more on that in a minute). That’s well over 2 million people total.

How Covered California’s Outreach to Latinos Is Falling Short

For starters, Spanish-speaking counselors are hard to come by. More of them are needed to address concerns of Latinos, who are wary of the health insurance system. Some are hesitant to sign up because they’re afraid undocumented family members will be discovered and then deported. Others aren’t sure it’s worth the money.

People like Larissa Bobadilla are trying to convince them that it’s okay.

New Health Plan for the Poor and Elderly Raises Questions

An experiment in managing the health of older Californians is causing a lot of confusion among seniors. Letters have been hitting mailboxes around the state this week with information about the changes. It’s the second letter in a series of three — the first went out in January — and they have been inspiring a lot of calls to county health insurance counseling centers.

Medi-Cal Expansion Opens Doors to Care for Transgender Patients

Among those estimated to enroll in the expansion of Medi-Cal, some of those most likely to benefit are among the most stigmatized in health care — transgender patients. Darryl Avery, 48, is one of them. Avery was born female, but identifies as a man. Several years ago, he began his transition. He moved to San Francisco where he sought medical care, stable housing, culinary schooling, and eventually, sex reassignment surgery.

Covered California: The COBRA Glitch

Bond told me she had enrolled in a Covered California plan but didn’t understand where her subsidy was. When she had reviewed her options for Covered California, the “shop and compare” calculator indicated that she qualified for a subsidy — close to $300 — but when she actually enrolled, the subsidy was not applied.

And Bond definitely needs the coverage. In 2010, Bond was treated for non-Hodgkin lymphoma. While she’s cancer-free now, the aggressive chemotherapy damaged her immune system. She says she needs monthly infusions of antibodies to keep her healthy. The treatment is called IVIG, and it costs a small fortune — more than $8,000 a month, Bond said.

People With Canceled Health Insurance Policies Shifted to New Ones Without Permission

But this month, Kingma logged into his bank’s website and saw that his old insurer, Anthem Blue Cross, had deducted $587.40 from his account and had enrolled him in another of its insurance products for this year — he says without permission.

Hundreds of other consumers are caught in the same predicament, insurers acknowledge. And the California Department of Insurance said it is exploring whether any laws were broken when insurance companies withdrew money from consumers’ accounts for plans they didn’t select.

Covered California Health Plans to Include Children’s Dental Next Year

It was a big debate last summer. While children’s dental coverage is one of the Affordable Care Act’s 10 essential health benefits, the ACA gives states the flexibility to offer the coverage in a stand alone plan. Covered California first required insurers to include children’s dental, then told them to strip out the benefit, in favor of offering stand alone plans at an additional cost.

Now the data is in. Less than one-third of enrolled children on Covered California through 2013 also has dental coverage. Executive director Peter Lee says the additional cost appears to be on issue. “A lot of folks are low income,” he said. “They’re thinking additional coverage versus food on the table.”