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for.\u003c/p>\n\u003cp>\u003ca href=\"http://www.coveredca.com\" target=\"_blank\" rel=\"noopener\">Covered California\u003c/a>, the state’s Obamacare marketplace, is taking that mandate under the law seriously, and is now making a bold move to improve quality in a concrete way, and ultimately, ensure that California consumers get more value for their premium dollars.\u003c/p>\n\u003cp>In the next three-year contract that Covered California strikes with insurance companies, there will be a quality-focused stipulation: any hospital that doesn't meet certain targets for safety and quality can be excluded from the health plans sold through the marketplace.\u003c/p>\n\u003cp>“We’re saying ‘time’s up,’” said \u003ca href=\"https://www.bizjournals.com/sacramento/news/2015/05/22/covered-california-hires-chief-medical-officer.html\" target=\"_blank\" rel=\"noopener\">Lance Lang\u003c/a>, the chief medical officer for Covered California. “We’ve told health plans that by the end of 2019, we want networks to only include hospitals that have achieved that target.”\u003c/p>\n\u003cp>Lang says every hospital in California should be able to reach the quality targets, though some may need help identifying and fixing obstacles along the way. The chosen targets require hospitals to perform fewer unnecessary C-sections, reduce hospital-acquired infections, improve patient experience, and reduce excessive costs.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For example, C-sections. Hospitals get paid more to do them, and they usually take less time: 40 minutes for a scheduled procedure versus 24-hour on-call staffing for vaginal deliveries. Although C-sections are often medically prudent when the mother or fetus has a high risk of complication, many women who don’t need a C-section often get one anyway. Even in low-risk cases, some California hospitals are delivering 70 percent of those babies by C-section.\u003c/p>\n\u003cp>“That means that when a woman goes to a hospital, it’s the culture of the hospital that really determines whether or not she gets a cesarean section, not so much her own health,” said Lang.\u003c/p>\n\u003cp>Unnecessary C-sections create unnecessary risks: infection, hemorrhage, even death. Babies delivered by C-section are more likely to have complications and spend more time in the neonatal intensive care unit.\u003c/p>\n\u003cp>That’s not quality health care, said Lang, and that’s why Covered California is telling hospitals they need to reduce their C-section rates to 23.9 percent or lower, for low-risk births. \"Low risk\" is defined as a healthy, first-time mom carrying a single baby with its head down, all the way to full term (\u003ca href=\"https://www.nichd.nih.gov/news/resources/spotlight/102413-redefining-term\" target=\"_blank\" rel=\"noopener\">39 weeks gestation\u003c/a>).\u003c/p>\n\u003cp>Covered California is joined by \u003ca href=\"https://www.coveredca.com/medi-cal/\" target=\"_blank\" rel=\"noopener\">Medi-Cal\u003c/a>, the state health program for low-income residents, \u003ca href=\"https://www.calpers.ca.gov/\" target=\"_blank\" rel=\"noopener\">CalPERS\u003c/a>, the retirement program for state employees, and the \u003ca href=\"http://www.pbgh.org/\" target=\"_blank\" rel=\"noopener\">Pacific Business Group on Health\u003c/a>, which represents self-insured employers. Together, these groups pay for the health care of 16 million Californians, or 40 percent of the state, which gives them substantial leverage with hospitals.\u003c/p>\n\u003cp>But only Covered California is telling hospitals that if don’t play by the rules, they’ll be benched.\u003c/p>\n\u003cp>“It’s probably the boldest move we’ve seen in maternity care ever,” said Leah Binder, CEO of the \u003ca href=\"http://www.leapfroggroup.org/\" target=\"_blank\" rel=\"noopener\">Leapfrog Group\u003c/a>, a Washington, DC-based nonprofit that rates hospitals on quality.\u003c/p>\n\u003cp>Quality control for hospitals is a recent phenomenon, and still largely voluntary, she said.\u003c/p>\n\u003cp>“Back in the '80s and '90s, nobody ever thought that hospitals should have to report to anyone on how they were doing,” she said. “There’s never been a culture of accountability.”\u003c/p>\n\u003cp>Covered California’s move is nationally significant, Binder said, given the consequences for hospitals, and the agency’s reach – 1.4 million people buy coverage through the marketplace, and they shop among plans offered by 11 state-approved insurance companies.\u003c/p>\n\u003cp>Insurers and business groups across the country are already keeping an eye on California’s effort, she said, to see how they might band together to demand similar change from the hospitals in their regions.\u003c/p>\n\u003cp>“The Northeast Business Group on Health, which covers New York and Massachusetts and Connecticut, they will definitely be watching this to see what could be done,” Binder said.\u003c/p>\n\u003cp>Overall, California’s hospitals are on board with the goal. Of the 243 maternity hospitals in the state, 40 percent have already met the target, Lang said, and another 40 percent have taken advantage of coaching and consulting, to help educate the doctors on how they can adjust their practice, and to educate patients who request C-sections about the risks.\u003c/p>\n\u003cp>“While many may prefer that, when having the full information about the risk that they may be putting themselves and their babies in, they elect not to move in that direction,” said Julie Morath, CEO of the \u003ca href=\"http://www.hqinstitute.org/\" target=\"_blank\" rel=\"noopener\">Hospital Quality Institute\u003c/a>, a subsidiary of the \u003ca href=\"https://www.calhospital.org/\" target=\"_blank\" rel=\"noopener\">California Hospital Association\u003c/a>, both of which support the C-section reduction goals as “the right thing to do.”\u003c/p>\n\u003cp>The effort has raised some concerns among mothers who hear about the 23.9 percent target and worry about rationing.\u003c/p>\n\u003cp>“We don't just chase rates,” Morath said, in counter to that concern, “but rather look at what the clinical needs are and best respond to those. So if there is an indication for a cesarean section, the mother will receive a cesarean section.”\u003c/p>\n\u003cp>But the coaching, and the kind of system change and staffing levels that can be required to lower C-section rates, might be too costly for some hospitals. State data show there are about 40 hospitals that are still far off the target, including a cluster of hospitals in East Los Angeles that treat low-income, often uninsured, patients.\u003c/p>\n\u003cp>The target rate may not be fair for these hospitals, said Malini Nijagal, an OB/GYN at Zuckerberg San Francisco General Hospital. Her hospital’s C-section rate is already below the target, but she said it won’t be easy for others with more diverse patients.\u003c/p>\n\u003cp>“So if you have somebody who is on methamphetamines and is homeless and has not gotten any prenatal care, her chance of a C-section is way higher than someone who is not all those things,” she said. “And so the problem is, how do you adjust for the patient population of a hospital?”\u003c/p>\n\u003cp>At Memorial Hospital of Gardena, the C-section rate is 45.2 percent. At East Los Angeles Doctors Hospital, the rate is 48.1 percent, according to publicly-available state data listed on \u003ca href=\"http://calhospitalcompare.org/\" target=\"_blank\" rel=\"noopener\">CalHospital Compare\u003c/a> and \u003ca href=\"https://www.kqed.org/stateofhealth/358760/yelp-adds-c-section-rates-and-childbirth-data-to-reviews-of-california-hospitals\" target=\"_blank\" rel=\"noopener\">Yelp\u003c/a>.\u003c/p>\n\u003cp>Both hospitals are working diligently to lower the rates, according to Amie Boersma, director for communications for \u003ca href=\"http://avantihospitals.com/\" target=\"_blank\" rel=\"noopener\">Avanti Hospitals\u003c/a>, which owns both hospitals.\u003c/p>\n\u003cp>She said the hospitals will meet the 23.9 percent benchmark and are committed to doing so for the sake of their patients. Being excluded from Covered California health plan networks, she added, would make it even more difficult for those patients to get care. They would either have to pay \"out-of-network\" fees to be seen there, or they would have to travel farther to another facility that was still in the network.\u003c/p>\n\u003cp>“We are in under-served, economically challenged urban neighborhoods and it is vitally important that we continue to provide appropriate, high-quality care for our communities,” Boersma said.\u003c/p>\n\u003cp>Health plans can request exceptions to Covered California’s contract rules, in order to keep non-complying hospitals in their networks, as long as they document their reasoning.\u003c/p>\n\u003cp>“That is flexibility that we asked for to ensure that we maintain adequate access to providers,” said Charles Bacchi, CEO of the \u003ca href=\"http://www.calhealthplans.org/\" target=\"_blank\" rel=\"noopener\">California Association of Health Plans\u003c/a>, a trade group for insurers. “Any major changes to health plan networks must be filed with regulators, and health plans have to ensure that patients continue to receive services in a timely manner.”\u003c/p>\n\u003cp>So far, the prospect of exclusion, plus the coaching and education, have functioned as an effective motivator. By the 2020 deadline, Covered California’s Dr. Lang believes all hospitals will either have met the target or be on their way. While the consequences are real, and while it may take some awkward conversations to get there, he said the ultimate goal is to get hospitals to deliver better, safer care to patients.\u003c/p>\n\u003cp>“It's a quality improvement project,” Lang said, “but with a deadline.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>CORRECTION: An earlier version of this story incorrectly listed the quality-care targets hospitals would have to meet to be included in Covered California insurance plans. \u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Covered California, the state's insurance marketplace, has been actively focused on cost control for years. Now the agency is demanding more on quality measures such as C-section rates and hospital-acquired infections. ","status":"publish","parent":0,"modified":1534298703,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":35,"wordCount":1464},"headData":{"title":"A New Message for California Hospitals: Shape Up, or Get Kicked Out of Obamacare Networks | KQED","description":"Covered California, the state's insurance marketplace, has been actively focused on cost control for years. Now the agency is demanding more on quality measures such as C-section rates and hospital-acquired infections. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"A New Message for California Hospitals: Shape Up, or Get Kicked Out of Obamacare Networks","datePublished":"2018-03-26T16:45:17.000Z","dateModified":"2018-08-15T02:05:03.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"362982 https://ww2.kqed.org/stateofhealth/?p=362982","disqusUrl":"https://ww2.kqed.org/stateofhealth/2018/03/26/a-new-message-for-california-hospitals-shape-up-or-get-kicked-out-of-obamacare-networks/","disqusTitle":"A New Message for California Hospitals: Shape Up, or Get Kicked Out of Obamacare Networks","audioUrl":"https://www.kqed.org/.stream/anon/radio/tcr/2018/03/DemboskyHospitalQuality.mp3","audioTrackLength":214,"path":"/stateofhealth/362982/a-new-message-for-california-hospitals-shape-up-or-get-kicked-out-of-obamacare-networks","parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>While most of the recent debate around health care has been around cost -- especially the predictions about skyrocketing Obamacare premiums -- there are 100 pages in the Affordable Care Act devoted solely to improving the \u003ca href=\"https://www.kff.org/health-reform/fact-sheet/summary-of-the-affordable-care-act/\" target=\"_blank\" rel=\"noopener\">\u003cem>quality \u003c/em>of the health care\u003c/a> Americans are paying so much for.\u003c/p>\n\u003cp>\u003ca href=\"http://www.coveredca.com\" target=\"_blank\" rel=\"noopener\">Covered California\u003c/a>, the state’s Obamacare marketplace, is taking that mandate under the law seriously, and is now making a bold move to improve quality in a concrete way, and ultimately, ensure that California consumers get more value for their premium dollars.\u003c/p>\n\u003cp>In the next three-year contract that Covered California strikes with insurance companies, there will be a quality-focused stipulation: any hospital that doesn't meet certain targets for safety and quality can be excluded from the health plans sold through the marketplace.\u003c/p>\n\u003cp>“We’re saying ‘time’s up,’” said \u003ca href=\"https://www.bizjournals.com/sacramento/news/2015/05/22/covered-california-hires-chief-medical-officer.html\" target=\"_blank\" rel=\"noopener\">Lance Lang\u003c/a>, the chief medical officer for Covered California. “We’ve told health plans that by the end of 2019, we want networks to only include hospitals that have achieved that target.”\u003c/p>\n\u003cp>Lang says every hospital in California should be able to reach the quality targets, though some may need help identifying and fixing obstacles along the way. The chosen targets require hospitals to perform fewer unnecessary C-sections, reduce hospital-acquired infections, improve patient experience, and reduce excessive costs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For example, C-sections. Hospitals get paid more to do them, and they usually take less time: 40 minutes for a scheduled procedure versus 24-hour on-call staffing for vaginal deliveries. Although C-sections are often medically prudent when the mother or fetus has a high risk of complication, many women who don’t need a C-section often get one anyway. Even in low-risk cases, some California hospitals are delivering 70 percent of those babies by C-section.\u003c/p>\n\u003cp>“That means that when a woman goes to a hospital, it’s the culture of the hospital that really determines whether or not she gets a cesarean section, not so much her own health,” said Lang.\u003c/p>\n\u003cp>Unnecessary C-sections create unnecessary risks: infection, hemorrhage, even death. Babies delivered by C-section are more likely to have complications and spend more time in the neonatal intensive care unit.\u003c/p>\n\u003cp>That’s not quality health care, said Lang, and that’s why Covered California is telling hospitals they need to reduce their C-section rates to 23.9 percent or lower, for low-risk births. \"Low risk\" is defined as a healthy, first-time mom carrying a single baby with its head down, all the way to full term (\u003ca href=\"https://www.nichd.nih.gov/news/resources/spotlight/102413-redefining-term\" target=\"_blank\" rel=\"noopener\">39 weeks gestation\u003c/a>).\u003c/p>\n\u003cp>Covered California is joined by \u003ca href=\"https://www.coveredca.com/medi-cal/\" target=\"_blank\" rel=\"noopener\">Medi-Cal\u003c/a>, the state health program for low-income residents, \u003ca href=\"https://www.calpers.ca.gov/\" target=\"_blank\" rel=\"noopener\">CalPERS\u003c/a>, the retirement program for state employees, and the \u003ca href=\"http://www.pbgh.org/\" target=\"_blank\" rel=\"noopener\">Pacific Business Group on Health\u003c/a>, which represents self-insured employers. Together, these groups pay for the health care of 16 million Californians, or 40 percent of the state, which gives them substantial leverage with hospitals.\u003c/p>\n\u003cp>But only Covered California is telling hospitals that if don’t play by the rules, they’ll be benched.\u003c/p>\n\u003cp>“It’s probably the boldest move we’ve seen in maternity care ever,” said Leah Binder, CEO of the \u003ca href=\"http://www.leapfroggroup.org/\" target=\"_blank\" rel=\"noopener\">Leapfrog Group\u003c/a>, a Washington, DC-based nonprofit that rates hospitals on quality.\u003c/p>\n\u003cp>Quality control for hospitals is a recent phenomenon, and still largely voluntary, she said.\u003c/p>\n\u003cp>“Back in the '80s and '90s, nobody ever thought that hospitals should have to report to anyone on how they were doing,” she said. “There’s never been a culture of accountability.”\u003c/p>\n\u003cp>Covered California’s move is nationally significant, Binder said, given the consequences for hospitals, and the agency’s reach – 1.4 million people buy coverage through the marketplace, and they shop among plans offered by 11 state-approved insurance companies.\u003c/p>\n\u003cp>Insurers and business groups across the country are already keeping an eye on California’s effort, she said, to see how they might band together to demand similar change from the hospitals in their regions.\u003c/p>\n\u003cp>“The Northeast Business Group on Health, which covers New York and Massachusetts and Connecticut, they will definitely be watching this to see what could be done,” Binder said.\u003c/p>\n\u003cp>Overall, California’s hospitals are on board with the goal. Of the 243 maternity hospitals in the state, 40 percent have already met the target, Lang said, and another 40 percent have taken advantage of coaching and consulting, to help educate the doctors on how they can adjust their practice, and to educate patients who request C-sections about the risks.\u003c/p>\n\u003cp>“While many may prefer that, when having the full information about the risk that they may be putting themselves and their babies in, they elect not to move in that direction,” said Julie Morath, CEO of the \u003ca href=\"http://www.hqinstitute.org/\" target=\"_blank\" rel=\"noopener\">Hospital Quality Institute\u003c/a>, a subsidiary of the \u003ca href=\"https://www.calhospital.org/\" target=\"_blank\" rel=\"noopener\">California Hospital Association\u003c/a>, both of which support the C-section reduction goals as “the right thing to do.”\u003c/p>\n\u003cp>The effort has raised some concerns among mothers who hear about the 23.9 percent target and worry about rationing.\u003c/p>\n\u003cp>“We don't just chase rates,” Morath said, in counter to that concern, “but rather look at what the clinical needs are and best respond to those. So if there is an indication for a cesarean section, the mother will receive a cesarean section.”\u003c/p>\n\u003cp>But the coaching, and the kind of system change and staffing levels that can be required to lower C-section rates, might be too costly for some hospitals. State data show there are about 40 hospitals that are still far off the target, including a cluster of hospitals in East Los Angeles that treat low-income, often uninsured, patients.\u003c/p>\n\u003cp>The target rate may not be fair for these hospitals, said Malini Nijagal, an OB/GYN at Zuckerberg San Francisco General Hospital. Her hospital’s C-section rate is already below the target, but she said it won’t be easy for others with more diverse patients.\u003c/p>\n\u003cp>“So if you have somebody who is on methamphetamines and is homeless and has not gotten any prenatal care, her chance of a C-section is way higher than someone who is not all those things,” she said. “And so the problem is, how do you adjust for the patient population of a hospital?”\u003c/p>\n\u003cp>At Memorial Hospital of Gardena, the C-section rate is 45.2 percent. At East Los Angeles Doctors Hospital, the rate is 48.1 percent, according to publicly-available state data listed on \u003ca href=\"http://calhospitalcompare.org/\" target=\"_blank\" rel=\"noopener\">CalHospital Compare\u003c/a> and \u003ca href=\"https://www.kqed.org/stateofhealth/358760/yelp-adds-c-section-rates-and-childbirth-data-to-reviews-of-california-hospitals\" target=\"_blank\" rel=\"noopener\">Yelp\u003c/a>.\u003c/p>\n\u003cp>Both hospitals are working diligently to lower the rates, according to Amie Boersma, director for communications for \u003ca href=\"http://avantihospitals.com/\" target=\"_blank\" rel=\"noopener\">Avanti Hospitals\u003c/a>, which owns both hospitals.\u003c/p>\n\u003cp>She said the hospitals will meet the 23.9 percent benchmark and are committed to doing so for the sake of their patients. Being excluded from Covered California health plan networks, she added, would make it even more difficult for those patients to get care. They would either have to pay \"out-of-network\" fees to be seen there, or they would have to travel farther to another facility that was still in the network.\u003c/p>\n\u003cp>“We are in under-served, economically challenged urban neighborhoods and it is vitally important that we continue to provide appropriate, high-quality care for our communities,” Boersma said.\u003c/p>\n\u003cp>Health plans can request exceptions to Covered California’s contract rules, in order to keep non-complying hospitals in their networks, as long as they document their reasoning.\u003c/p>\n\u003cp>“That is flexibility that we asked for to ensure that we maintain adequate access to providers,” said Charles Bacchi, CEO of the \u003ca href=\"http://www.calhealthplans.org/\" target=\"_blank\" rel=\"noopener\">California Association of Health Plans\u003c/a>, a trade group for insurers. “Any major changes to health plan networks must be filed with regulators, and health plans have to ensure that patients continue to receive services in a timely manner.”\u003c/p>\n\u003cp>So far, the prospect of exclusion, plus the coaching and education, have functioned as an effective motivator. By the 2020 deadline, Covered California’s Dr. Lang believes all hospitals will either have met the target or be on their way. While the consequences are real, and while it may take some awkward conversations to get there, he said the ultimate goal is to get hospitals to deliver better, safer care to patients.\u003c/p>\n\u003cp>“It's a quality improvement project,” Lang said, “but with a deadline.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>CORRECTION: An earlier version of this story incorrectly listed the quality-care targets hospitals would have to meet to be included in Covered California insurance plans. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/362982/a-new-message-for-california-hospitals-shape-up-or-get-kicked-out-of-obamacare-networks","authors":["3205"],"categories":["stateofhealth_11","stateofhealth_15","stateofhealth_14","stateofhealth_13"],"tags":["stateofhealth_38","stateofhealth_3138","stateofhealth_368","stateofhealth_2808","stateofhealth_3231","stateofhealth_2519","stateofhealth_365"],"featImg":"stateofhealth_363029","label":"stateofhealth"},"stateofhealth_362576":{"type":"posts","id":"stateofhealth_362576","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"362576","score":null,"sort":[1517442197000]},"guestAuthors":[],"slug":"a-rush-to-get-health-insurance-for-2018-before-california-deadline","title":"A Rush to Get Health Insurance for 2018, Before California Deadline","publishDate":1517442197,"format":"audio","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cspan style=\"font-weight: 400\">The open enrollment period to get insurance through \u003ca href=\"https://www.coveredca.com/\" target=\"_blank\" rel=\"noopener\">Covered California\u003c/a> closes at midnight tonight. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Agents like Monica Tracht are feeling the looming deadline. \u003c/span>Tracht is a certified insurance agent for Covered California, based in San Francisco. She's spent recent nights fielding calls, at home, even past 10 p.m. At her office, she's booked back-to-back appointments, between which she accommodates walk-ins.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">San Francisco insurance brokers like Tracht are logging extra hours to sign up new enrollees for Covered California in 2018. These enrollment numbers, which \u003ca href=\"https://coveredcanews.blogspot.com/2018/01/covered-california-announces-continued.html\" target=\"_blank\" rel=\"noopener\">surpass last year's numbers\u003c/a>, are strong — despite actions by President Trump and Congressional Republicans that have weakened the Affordable Care Act (ACA). \u003c/span>\u003c/p>\n\u003cp>Tracht runs a \u003ca href=\"http://storefronts.coveredca.com/agent-signage/\" target=\"_blank\" rel=\"noopener\">Covered California \"Storefront,\"\u003c/a> a permanent location open to walk-in traffic with Covered California signage. The \"Storefront\" designation also means her office is prominently listed on the health care exchange website. Tracht says that's how most of her clients find her.\u003c/p>\n\u003cp>\"I'd advertised in a local magazine in Spanish,\" Tracht said, \"A couple people came because of the magazine.\" But Tracht realized she could save her advertising money, because Covered California was promoting the health care coverage for her. \"They're everywhere,\" she said. \"The TV, the radio, the newspapers.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>While the Trump Administration cut advertising budgets for the ACA, Covered California officials boosted their own marketing budget, to more than $100 million.\u003c/p>\n\u003cfigure id=\"attachment_362588\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-362588 size-medium\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2018/01/RS29076_mon2-qut-800x600.jpg\" alt=\"Monica Tracht used to advertise her health insurance business in a local, Spanish language magazine. But she's found she no longer needs to. Her clients find her through Covered California's own marketing efforts.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2018/01/RS29076_mon2-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/RS29076_mon2-qut-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/RS29076_mon2-qut-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/RS29076_mon2-qut-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/RS29076_mon2-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/RS29076_mon2-qut-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/RS29076_mon2-qut-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/RS29076_mon2-qut-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/RS29076_mon2-qut-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Monica Tracht used to advertise her health insurance business in a local, Spanish language magazine. But she's found she no longer needs to. Her clients find her through Covered California's own marketing efforts. \u003ccite>(Laura Klivans/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Marie Crinnion had an appointment with Tracht the day before the deadline. Crinnion is currently enrolled in\u003cspan style=\"font-weight: 400\"> \u003ca href=\"https://www.medi-cal.ca.gov/\" target=\"_blank\" rel=\"noopener\">Medi-Cal,\u003c/a> a government insurance program for low-income people, but thinks she will no longer qualify this year because her income will increase. Crinnion's mother died recently and now, Crinnion will collect rent from a property she inherited. \u003c/span>\u003c/p>\n\u003cp>\"I looked online for an actual person to be able to talk to, because my insurance situation is changing and it’s a little complicated,\" Crinnion said. \"I wanted to be able to explain it to a live person and get advice.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Crinnion wants to avoid a lapse in coverage because she has chronic immune problems and is partially blind. After going over her options with Tracht for a half hour, she learned her income will be too high this year to qualify for any insurance subsidies offered through Covered California. Crinnion felt she'd get a better deal by shopping outside of the Covered California exchange. She was especially interested in some of the individual plans offered by a local organization, \u003ca href=\"https://www.cchphealthplan.com/\" target=\"_blank\" rel=\"noopener\">Chinese Community Health Plan\u003c/a>. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In many other states, where consumers are using the federally-run marketplace, enrollment ended on Dec. 15. The Trump Administration shortened the enrollment period on the federal exchange from three months to six weeks. \u003c/span>\u003c/p>\n\u003cp>But all states will be affected by another new change to the ACA -- the Congressional tax bill, which removed the penalty for not having health insurance, starting in 2019.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Tracht said some consumers were a bit confused about the different deadlines, but said no one had questions about whether the penalty was still in effect. It is for 2018. \u003c/span>\u003c/p>\n\u003cp>Covered California officials are trying to accommodate last-minute sign-ups. Although the official deadline is January 31st, if consumers have started an application before midnight, but are struggling to complete it, they \"will be allowed to finish the process on Thursday or Friday with a certified enroller,\" according to James Scullary, a spokesman for Covered California.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>People who complete applications by February 2 will have coverage beginning on March 1.\u003c/p>\n\n","blocks":[],"excerpt":"Midnight on January 31 is the cutoff for enrolling in a Covered California plan this year.","status":"publish","parent":0,"modified":1517448156,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":637},"headData":{"title":"A Rush to Get Health Insurance for 2018, Before California Deadline | KQED","description":"Midnight on January 31 is the cutoff for enrolling in a Covered California plan this year.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"A Rush to Get Health Insurance for 2018, Before California Deadline","datePublished":"2018-01-31T23:43:17.000Z","dateModified":"2018-02-01T01:22:36.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"362576 https://ww2.kqed.org/stateofhealth/?p=362576","disqusUrl":"https://ww2.kqed.org/stateofhealth/2018/01/31/a-rush-to-get-health-insurance-for-2018-before-california-deadline/","disqusTitle":"A Rush to Get Health Insurance for 2018, Before California Deadline","audioUrl":"https://www.kqed.org/.stream/anon/radio/tcr/2018/01/CoveredCADeadlineKlivans.mp3","path":"/stateofhealth/362576/a-rush-to-get-health-insurance-for-2018-before-california-deadline","audioDuration":null,"audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-weight: 400\">The open enrollment period to get insurance through \u003ca href=\"https://www.coveredca.com/\" target=\"_blank\" rel=\"noopener\">Covered California\u003c/a> closes at midnight tonight. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Agents like Monica Tracht are feeling the looming deadline. \u003c/span>Tracht is a certified insurance agent for Covered California, based in San Francisco. She's spent recent nights fielding calls, at home, even past 10 p.m. At her office, she's booked back-to-back appointments, between which she accommodates walk-ins.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">San Francisco insurance brokers like Tracht are logging extra hours to sign up new enrollees for Covered California in 2018. These enrollment numbers, which \u003ca href=\"https://coveredcanews.blogspot.com/2018/01/covered-california-announces-continued.html\" target=\"_blank\" rel=\"noopener\">surpass last year's numbers\u003c/a>, are strong — despite actions by President Trump and Congressional Republicans that have weakened the Affordable Care Act (ACA). \u003c/span>\u003c/p>\n\u003cp>Tracht runs a \u003ca href=\"http://storefronts.coveredca.com/agent-signage/\" target=\"_blank\" rel=\"noopener\">Covered California \"Storefront,\"\u003c/a> a permanent location open to walk-in traffic with Covered California signage. The \"Storefront\" designation also means her office is prominently listed on the health care exchange website. Tracht says that's how most of her clients find her.\u003c/p>\n\u003cp>\"I'd advertised in a local magazine in Spanish,\" Tracht said, \"A couple people came because of the magazine.\" But Tracht realized she could save her advertising money, because Covered California was promoting the health care coverage for her. \"They're everywhere,\" she said. \"The TV, the radio, the newspapers.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>While the Trump Administration cut advertising budgets for the ACA, Covered California officials boosted their own marketing budget, to more than $100 million.\u003c/p>\n\u003cfigure id=\"attachment_362588\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-362588 size-medium\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2018/01/RS29076_mon2-qut-800x600.jpg\" alt=\"Monica Tracht used to advertise her health insurance business in a local, Spanish language magazine. But she's found she no longer needs to. Her clients find her through Covered California's own marketing efforts.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2018/01/RS29076_mon2-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/RS29076_mon2-qut-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/RS29076_mon2-qut-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/RS29076_mon2-qut-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/RS29076_mon2-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/RS29076_mon2-qut-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/RS29076_mon2-qut-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/RS29076_mon2-qut-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/RS29076_mon2-qut-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Monica Tracht used to advertise her health insurance business in a local, Spanish language magazine. But she's found she no longer needs to. Her clients find her through Covered California's own marketing efforts. \u003ccite>(Laura Klivans/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Marie Crinnion had an appointment with Tracht the day before the deadline. Crinnion is currently enrolled in\u003cspan style=\"font-weight: 400\"> \u003ca href=\"https://www.medi-cal.ca.gov/\" target=\"_blank\" rel=\"noopener\">Medi-Cal,\u003c/a> a government insurance program for low-income people, but thinks she will no longer qualify this year because her income will increase. Crinnion's mother died recently and now, Crinnion will collect rent from a property she inherited. \u003c/span>\u003c/p>\n\u003cp>\"I looked online for an actual person to be able to talk to, because my insurance situation is changing and it’s a little complicated,\" Crinnion said. \"I wanted to be able to explain it to a live person and get advice.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Crinnion wants to avoid a lapse in coverage because she has chronic immune problems and is partially blind. After going over her options with Tracht for a half hour, she learned her income will be too high this year to qualify for any insurance subsidies offered through Covered California. Crinnion felt she'd get a better deal by shopping outside of the Covered California exchange. She was especially interested in some of the individual plans offered by a local organization, \u003ca href=\"https://www.cchphealthplan.com/\" target=\"_blank\" rel=\"noopener\">Chinese Community Health Plan\u003c/a>. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In many other states, where consumers are using the federally-run marketplace, enrollment ended on Dec. 15. The Trump Administration shortened the enrollment period on the federal exchange from three months to six weeks. \u003c/span>\u003c/p>\n\u003cp>But all states will be affected by another new change to the ACA -- the Congressional tax bill, which removed the penalty for not having health insurance, starting in 2019.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Tracht said some consumers were a bit confused about the different deadlines, but said no one had questions about whether the penalty was still in effect. It is for 2018. \u003c/span>\u003c/p>\n\u003cp>Covered California officials are trying to accommodate last-minute sign-ups. Although the official deadline is January 31st, if consumers have started an application before midnight, but are struggling to complete it, they \"will be allowed to finish the process on Thursday or Friday with a certified enroller,\" according to James Scullary, a spokesman for Covered California.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>People who complete applications by February 2 will have coverage beginning on March 1.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/362576/a-rush-to-get-health-insurance-for-2018-before-california-deadline","authors":["8648"],"categories":["stateofhealth_2442","stateofhealth_15","stateofhealth_14","stateofhealth_1"],"tags":["stateofhealth_368","stateofhealth_2808","stateofhealth_2519","stateofhealth_3217"],"featImg":"stateofhealth_362589","label":"stateofhealth"},"stateofhealth_362498":{"type":"posts","id":"stateofhealth_362498","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"362498","score":null,"sort":[1517027336000]},"guestAuthors":[],"slug":"despite-ongoing-threats-to-the-affordable-care-act-the-head-of-covered-california-says-its-here-for-the-long-haul","title":"Head of Covered California: State Exchange ‘Here for the Long Haul’","publishDate":1517027336,"format":"audio","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cspan style=\"font-weight: 400\">Californians have until Jan. 31 to buy a health plan through the state’s health exchange, \u003ca href=\"http://www.coveredca.com/%E2%80%8E\" target=\"_blank\" rel=\"noopener\">Covered California\u003c/a>.\u003c/span>\u003c/p>\n\u003cp>Despite ongoing uncertainty around the Affordable Care Act (ACA) on a national level, the state's insurance marketplace, Covered California, is recording higher enrollment numbers this year when compared to the same time last year. The instability around the ACA is due to several factors, including Republican attempts to repeal and replace the bill, a shortened, six-week enrollment period in other states (California decided to keep the standard three-month enrollment), and the recent passage in Congress of a \u003ca href=\"https://www.npr.org/2017/12/15/571258698/chart-how-the-new-version-of-the-republican-tax-bill-would-affect-you\" target=\"_blank\" rel=\"noopener\">tax reform bill\u003c/a>, which removed the law's penalty for people who failed to buy health coverage. That coverage \"mandate\" is still in effect this year, but will expire starting in 2019.\u003c/p>\n\u003cp>KQED spoke to Covered California's executive director, Peter V. Lee, who emphasized that despite these challenges, his program remains solid.\u003c/p>\n\u003cp>\u003cem>This interview has been edited for brevity and clarity.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Can people still sign up for health insurance through Covered California? \u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>Peter V. Lee:\u003c/strong> We're in the very end of open enrollment. Many people are confused because in much of the country open enrollment ended Dec. 15. We’re open through Jan. 31 -- the end of the month. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Anyone that doesn't have insurance should come to our website and check it out. \u003c/span>Three-quarters of those eligible don't know (that they're eligible).\u003c/p>\n\u003cp>Click on “\u003ca href=\"https://www.coveredca.com/find-help/\" target=\"_blank\" rel=\"noopener\">find help near me\u003c/a>,” and you can find a local insurance agent. They're always going to be free. We have people that speak Cantonese, Spanish, and they all speak insurance.\u003c/p>\n\u003cp>\u003cstrong>Right, it feels like another language. You released numbers this past Monday showing how many people enrolled for the very first time, and those numbers are up from this time last year. Why do you think that is?\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>Lee:\u003c/strong> This last year has been sort of crazy -- a lot of roller-coaster effects. We've done everything we can to have things be stable for consumers. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">One of the reasons we've seen more people sign up is it's cheaper for many people. About 1.1 million of California consumers get financial help, which lowers their premiums. For them, their health care costs went \u003cem>down\u003c/em> 10 percent. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">For those for whom it's not cheaper, which means they don't get a subsidy, it may be on average 10 percent more expensive than last year.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">We're out there pounding the pavement, we're running ads, we're getting the word out through social media, through radio and through TV. People are getting the word out. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">This is the fifth year for open enrollment, and at this point we've become a pretty well-known brand in California. People are used to hearing about us and they come back.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>What percentage of people on Covered California get subsidies?\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>Lee:\u003c/strong> There's two numbers. First, the individual market has about 2.5 million people. Half of them buy direct from their health plans. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">You can only get a subsidy if you buy from us. So at Covered California about 85 percent of the people that sign up with us get a subsidy. \u003c/span>\u003c/p>\n\u003cp>\u003cstrong>You released a report on Jan. 18 predicting that individual insurance markets in all states would see rate hikes in 2019 between 16 and 30 percent. And you called it a \"roller coaster for consumers.\" How will that impact California in 2019?\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>Lee:\u003c/strong> First, that projection is for next year. I want to be really clear that for Californians shopping now that get subsidies, their rates went \u003cem>down\u003c/em> in 2018. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But nationally there's removal of the tax penalty [for not buying insurance]. Projections are that some healthier people will drop out of buying insurance. On average, that would increase premiums in California probably eigh,t percent on top of underlying health care costs. So we might see premiums go up next year by 15 percent in California. In other states, it could go up 30 percent or more. \u003c/span>\u003c/p>\n\u003cp>\u003cstrong>What is your plan for keeping Covered California afloat in the future?\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>Lee:\u003c/strong> Number one: Covered California is totally afloat. The worst case is, and this is bad, there might be a few hundred thousand fewer Californians with health insurance. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The penalty being there, or not being there, isn't the glue that holds the Affordable Care Act together. We're here for the long haul and we operate like a business. We've got hundreds of millions of dollars in reserves. We use zero state funds, and zero federal funds. So we're a going proposition. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The issue for 2019 is what this means for people that get no subsidies. They will be saying, “Holy mother of God, I got a 15 percent rate increase!\"\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>What would you like to add?\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>Lee:\u003c/strong> This last year, there were interminable attempts to repeal and replace [the Affordable Care Act]. Didn't happen.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\"> One of the things that I am most surprised by is how much the health care debate has changed from six years ago before the Affordable Care Act. People took for granted that we could be in a world where, if you had diabetes or asthma or cancer, you could be denied getting health care forever. No one wants to go back to those days. That's a huge change.\u003c/span>\u003c/p>\n\n","blocks":[],"excerpt":"Covered California Executive Director Peter V. Lee says premiums are down for people with subsidies and enrollment is up.","status":"publish","parent":0,"modified":1517088030,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":29,"wordCount":907},"headData":{"title":"Head of Covered California: State Exchange ‘Here for the Long Haul’ | KQED","description":"Covered California Executive Director Peter V. Lee says premiums are down for people with subsidies and enrollment is up.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Head of Covered California: State Exchange ‘Here for the Long Haul’","datePublished":"2018-01-27T04:28:56.000Z","dateModified":"2018-01-27T21:20:30.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"362498 https://ww2.kqed.org/stateofhealth/?p=362498","disqusUrl":"https://ww2.kqed.org/stateofhealth/2018/01/26/despite-ongoing-threats-to-the-affordable-care-act-the-head-of-covered-california-says-its-here-for-the-long-haul/","disqusTitle":"Head of Covered California: State Exchange ‘Here for the Long Haul’","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/2018/01/2wayKlivansCoveredCASignups.mp3","path":"/stateofhealth/362498/despite-ongoing-threats-to-the-affordable-care-act-the-head-of-covered-california-says-its-here-for-the-long-haul","audioDuration":null,"audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-weight: 400\">Californians have until Jan. 31 to buy a health plan through the state’s health exchange, \u003ca href=\"http://www.coveredca.com/%E2%80%8E\" target=\"_blank\" rel=\"noopener\">Covered California\u003c/a>.\u003c/span>\u003c/p>\n\u003cp>Despite ongoing uncertainty around the Affordable Care Act (ACA) on a national level, the state's insurance marketplace, Covered California, is recording higher enrollment numbers this year when compared to the same time last year. The instability around the ACA is due to several factors, including Republican attempts to repeal and replace the bill, a shortened, six-week enrollment period in other states (California decided to keep the standard three-month enrollment), and the recent passage in Congress of a \u003ca href=\"https://www.npr.org/2017/12/15/571258698/chart-how-the-new-version-of-the-republican-tax-bill-would-affect-you\" target=\"_blank\" rel=\"noopener\">tax reform bill\u003c/a>, which removed the law's penalty for people who failed to buy health coverage. That coverage \"mandate\" is still in effect this year, but will expire starting in 2019.\u003c/p>\n\u003cp>KQED spoke to Covered California's executive director, Peter V. Lee, who emphasized that despite these challenges, his program remains solid.\u003c/p>\n\u003cp>\u003cem>This interview has been edited for brevity and clarity.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Can people still sign up for health insurance through Covered California? \u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>Peter V. Lee:\u003c/strong> We're in the very end of open enrollment. Many people are confused because in much of the country open enrollment ended Dec. 15. We’re open through Jan. 31 -- the end of the month. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Anyone that doesn't have insurance should come to our website and check it out. \u003c/span>Three-quarters of those eligible don't know (that they're eligible).\u003c/p>\n\u003cp>Click on “\u003ca href=\"https://www.coveredca.com/find-help/\" target=\"_blank\" rel=\"noopener\">find help near me\u003c/a>,” and you can find a local insurance agent. They're always going to be free. We have people that speak Cantonese, Spanish, and they all speak insurance.\u003c/p>\n\u003cp>\u003cstrong>Right, it feels like another language. You released numbers this past Monday showing how many people enrolled for the very first time, and those numbers are up from this time last year. Why do you think that is?\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>Lee:\u003c/strong> This last year has been sort of crazy -- a lot of roller-coaster effects. We've done everything we can to have things be stable for consumers. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">One of the reasons we've seen more people sign up is it's cheaper for many people. About 1.1 million of California consumers get financial help, which lowers their premiums. For them, their health care costs went \u003cem>down\u003c/em> 10 percent. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">For those for whom it's not cheaper, which means they don't get a subsidy, it may be on average 10 percent more expensive than last year.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">We're out there pounding the pavement, we're running ads, we're getting the word out through social media, through radio and through TV. People are getting the word out. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">This is the fifth year for open enrollment, and at this point we've become a pretty well-known brand in California. People are used to hearing about us and they come back.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>What percentage of people on Covered California get subsidies?\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>Lee:\u003c/strong> There's two numbers. First, the individual market has about 2.5 million people. Half of them buy direct from their health plans. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">You can only get a subsidy if you buy from us. So at Covered California about 85 percent of the people that sign up with us get a subsidy. \u003c/span>\u003c/p>\n\u003cp>\u003cstrong>You released a report on Jan. 18 predicting that individual insurance markets in all states would see rate hikes in 2019 between 16 and 30 percent. And you called it a \"roller coaster for consumers.\" How will that impact California in 2019?\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>Lee:\u003c/strong> First, that projection is for next year. I want to be really clear that for Californians shopping now that get subsidies, their rates went \u003cem>down\u003c/em> in 2018. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But nationally there's removal of the tax penalty [for not buying insurance]. Projections are that some healthier people will drop out of buying insurance. On average, that would increase premiums in California probably eigh,t percent on top of underlying health care costs. So we might see premiums go up next year by 15 percent in California. In other states, it could go up 30 percent or more. \u003c/span>\u003c/p>\n\u003cp>\u003cstrong>What is your plan for keeping Covered California afloat in the future?\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>Lee:\u003c/strong> Number one: Covered California is totally afloat. The worst case is, and this is bad, there might be a few hundred thousand fewer Californians with health insurance. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The penalty being there, or not being there, isn't the glue that holds the Affordable Care Act together. We're here for the long haul and we operate like a business. We've got hundreds of millions of dollars in reserves. We use zero state funds, and zero federal funds. So we're a going proposition. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The issue for 2019 is what this means for people that get no subsidies. They will be saying, “Holy mother of God, I got a 15 percent rate increase!\"\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>What would you like to add?\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003cstrong>Lee:\u003c/strong> This last year, there were interminable attempts to repeal and replace [the Affordable Care Act]. Didn't happen.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\"> One of the things that I am most surprised by is how much the health care debate has changed from six years ago before the Affordable Care Act. People took for granted that we could be in a world where, if you had diabetes or asthma or cancer, you could be denied getting health care forever. No one wants to go back to those days. That's a huge change.\u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/362498/despite-ongoing-threats-to-the-affordable-care-act-the-head-of-covered-california-says-its-here-for-the-long-haul","authors":["8648"],"categories":["stateofhealth_11","stateofhealth_2442","stateofhealth_15","stateofhealth_14","stateofhealth_1"],"tags":["stateofhealth_38","stateofhealth_368","stateofhealth_2808","stateofhealth_2519","stateofhealth_3210"],"featImg":"stateofhealth_16356","label":"stateofhealth"},"stateofhealth_361837":{"type":"posts","id":"stateofhealth_361837","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"361837","score":null,"sort":[1509414698000]},"guestAuthors":[],"slug":"human-psychology-makes-health-insurance-a-hard-sell-especially-for-latino-consumers","title":"Human Psychology Makes Health Insurance a Hard Sell – Especially for Latino Consumers","publishDate":1509414698,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>The way human brains are wired, it just doesn’t make sense to us to buy something now that we may not need for years in the future.\u003c/p>\n\u003cp>“Health insurance has to be the toughest thing on earth to sell,” said \u003ca href=\"http://www.ogilvy.com/ogilvy-mather-board/christopher-graves/\" target=\"_blank\" rel=\"noopener\">Christopher Graves\u003c/a>, president and founder of Ogilvy’s Behavioral Science Center. “Especially if you're trying to sell it to somebody who's young, healthy and has not had some catastrophe health-wise.\u003c/p>\n\u003cp>That would be most Latinos in California, \u003ca href=\"https://ww2.kqed.org/stateofhealth/2014/02/17/missteps-in-covered-californias-marketing-campaign-to-latinos/\" target=\"_blank\" rel=\"noopener\">a primary target\u003c/a> of the marketing and outreach strategy for \u003ca href=\"https://www.coveredca.com/\" target=\"_blank\" rel=\"noopener\">Covered California\u003c/a>, the state’s insurance marketplace. The more healthy Latinos sign up for insurance, the more their premiums help balance the costs of caring for older, sicker Californians.\u003c/p>\n\u003cp>Latinos represent 38 percent of the marketplace’s potential customer base but about 30 percent of people who actually enroll, so Covered California sees marketing to the demographic as a good return on investment for the whole exchange.\u003c/p>\n\u003cp>But the Trump administration has made the already difficult task, of selling a product people don’t want to think about, even harder. Federal health officials slashed the national budget for marketing around the Affordable Care Act.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s over for Obamacare,” President Trump has been saying since his campaign. “Let Obamacare implode.”\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=FAJfWfzKSxs\u003c/p>\n\u003cp>But California controls its own marketing budget and plans to invest $111 million to counteract the negative press from the feds. It will also spend 30 percent of its media buy on Spanish-language ads. But in terms of the creative message, California is on the defensive.\u003c/p>\n\u003cp>“Even if they're hearing you know the Affordable Care Act is going away, we're saying ‘No, no, not yet, not yet,' ” said Lizelda Lopez, who helps direct Latino outreach for Covered California as the agency’s deputy director of communications. “We're still here.”\u003c/p>\n\u003cp>That’s the mantra for this year, she said: “We are open for business. We are here. Financial assistance is still available. Open enrollment is Nov. 1 to Jan. 31. We are here.”\u003c/p>\n\u003cp>Such simple messages may work for people who already bought coverage in previous years and just need to renew their plan, said Carlos Santiago, chief strategist at \u003ca href=\"http://santiagosolutionsgroup.com/\" target=\"_blank\" rel=\"noopener\">Santiago Solutions Group\u003c/a>, a research consulting firm. But they could be too simple for new customers.\u003c/p>\n\u003cp>“To convince someone that was uninsured to get it for the first time? Obviously that message is not going to work,” Santiago said. “Especially not this year.”\u003c/p>\n\u003cp>Plus, the belief that illness won’t happen to you -- Santiago said this is especially entrenched in Latino culture.\u003c/p>\n\u003cp>“Latinos are extremely, extremely positive and overly optimistic,” he said, one reason Latinos have higher rates of going uninsured.\u003c/p>\n\u003cp>“We don't need to worry so much about today. Things will be OK,” he said. “And obviously when it comes to insurance, that's not exactly what it's all about.\"\u003c/p>\n\u003cp>On that front, Covered California has some more dramatic ads featuring ambulances and overturned bicycles, or a scene of a \u003ca href=\"https://vimeopro.com/coveredcanews/instant-tv/video/239171245\" target=\"_blank\" rel=\"noopener\">ladder falling backward\u003c/a>. It also plans to push a series of videos on social media. Its market research shows Latina women are very active video sharers, Lopez said.\u003c/p>\n\u003cp>“Mi nombre es Guadalupe,” says a young woman in\u003ca href=\"https://player.vimeo.com/video/215252751/?autoplay=1\" target=\"_blank\" rel=\"noopener\"> one video\u003c/a>, as she shows pictures from her wedding day and talks about suddenly finding out she needed a heart transplant.\u003c/p>\n\u003cp>Without her health plan from Covered California, she said she never would have been able to afford the cost of surgery: $1.5 million.\u003c/p>\n\u003cp>This kind of personal story, which other Latinas can relate to, is good, Santiago said. But Latinos don’t respond to fear, he added, so if the message is too scary, it could backfire.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It’s a tug of war,” said Christopher Graves. “That trade-off is, people stop taking action. They basically become paralyzed by how overwhelming it is. There needs to be a balance.”\u003c/p>\n\n","blocks":[],"excerpt":"Covered California is doubling down on Obamacare marketing to counteract negative press from the Trump administration.","status":"publish","parent":0,"modified":1509493760,"stats":{"hasAudio":false,"hasVideo":true,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":21,"wordCount":695},"headData":{"title":"Human Psychology Makes Health Insurance a Hard Sell – Especially for Latino Consumers | KQED","description":"Covered California is doubling down on Obamacare marketing to counteract negative press from the Trump administration.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Human Psychology Makes Health Insurance a Hard Sell – Especially for Latino Consumers","datePublished":"2017-10-31T01:51:38.000Z","dateModified":"2017-10-31T23:49:20.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"361837 https://ww2.kqed.org/stateofhealth/?p=361837","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/10/30/human-psychology-makes-health-insurance-a-hard-sell-especially-for-latino-consumers/","disqusTitle":"Human Psychology Makes Health Insurance a Hard Sell – Especially for Latino Consumers","path":"/stateofhealth/361837/human-psychology-makes-health-insurance-a-hard-sell-especially-for-latino-consumers","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The way human brains are wired, it just doesn’t make sense to us to buy something now that we may not need for years in the future.\u003c/p>\n\u003cp>“Health insurance has to be the toughest thing on earth to sell,” said \u003ca href=\"http://www.ogilvy.com/ogilvy-mather-board/christopher-graves/\" target=\"_blank\" rel=\"noopener\">Christopher Graves\u003c/a>, president and founder of Ogilvy’s Behavioral Science Center. “Especially if you're trying to sell it to somebody who's young, healthy and has not had some catastrophe health-wise.\u003c/p>\n\u003cp>That would be most Latinos in California, \u003ca href=\"https://ww2.kqed.org/stateofhealth/2014/02/17/missteps-in-covered-californias-marketing-campaign-to-latinos/\" target=\"_blank\" rel=\"noopener\">a primary target\u003c/a> of the marketing and outreach strategy for \u003ca href=\"https://www.coveredca.com/\" target=\"_blank\" rel=\"noopener\">Covered California\u003c/a>, the state’s insurance marketplace. The more healthy Latinos sign up for insurance, the more their premiums help balance the costs of caring for older, sicker Californians.\u003c/p>\n\u003cp>Latinos represent 38 percent of the marketplace’s potential customer base but about 30 percent of people who actually enroll, so Covered California sees marketing to the demographic as a good return on investment for the whole exchange.\u003c/p>\n\u003cp>But the Trump administration has made the already difficult task, of selling a product people don’t want to think about, even harder. Federal health officials slashed the national budget for marketing around the Affordable Care Act.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s over for Obamacare,” President Trump has been saying since his campaign. “Let Obamacare implode.”\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/FAJfWfzKSxs'\n title='//www.youtube.com/embed/FAJfWfzKSxs'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>But California controls its own marketing budget and plans to invest $111 million to counteract the negative press from the feds. It will also spend 30 percent of its media buy on Spanish-language ads. But in terms of the creative message, California is on the defensive.\u003c/p>\n\u003cp>“Even if they're hearing you know the Affordable Care Act is going away, we're saying ‘No, no, not yet, not yet,' ” said Lizelda Lopez, who helps direct Latino outreach for Covered California as the agency’s deputy director of communications. “We're still here.”\u003c/p>\n\u003cp>That’s the mantra for this year, she said: “We are open for business. We are here. Financial assistance is still available. Open enrollment is Nov. 1 to Jan. 31. We are here.”\u003c/p>\n\u003cp>Such simple messages may work for people who already bought coverage in previous years and just need to renew their plan, said Carlos Santiago, chief strategist at \u003ca href=\"http://santiagosolutionsgroup.com/\" target=\"_blank\" rel=\"noopener\">Santiago Solutions Group\u003c/a>, a research consulting firm. But they could be too simple for new customers.\u003c/p>\n\u003cp>“To convince someone that was uninsured to get it for the first time? Obviously that message is not going to work,” Santiago said. “Especially not this year.”\u003c/p>\n\u003cp>Plus, the belief that illness won’t happen to you -- Santiago said this is especially entrenched in Latino culture.\u003c/p>\n\u003cp>“Latinos are extremely, extremely positive and overly optimistic,” he said, one reason Latinos have higher rates of going uninsured.\u003c/p>\n\u003cp>“We don't need to worry so much about today. Things will be OK,” he said. “And obviously when it comes to insurance, that's not exactly what it's all about.\"\u003c/p>\n\u003cp>On that front, Covered California has some more dramatic ads featuring ambulances and overturned bicycles, or a scene of a \u003ca href=\"https://vimeopro.com/coveredcanews/instant-tv/video/239171245\" target=\"_blank\" rel=\"noopener\">ladder falling backward\u003c/a>. It also plans to push a series of videos on social media. Its market research shows Latina women are very active video sharers, Lopez said.\u003c/p>\n\u003cp>“Mi nombre es Guadalupe,” says a young woman in\u003ca href=\"https://player.vimeo.com/video/215252751/?autoplay=1\" target=\"_blank\" rel=\"noopener\"> one video\u003c/a>, as she shows pictures from her wedding day and talks about suddenly finding out she needed a heart transplant.\u003c/p>\n\u003cp>Without her health plan from Covered California, she said she never would have been able to afford the cost of surgery: $1.5 million.\u003c/p>\n\u003cp>This kind of personal story, which other Latinas can relate to, is good, Santiago said. But Latinos don’t respond to fear, he added, so if the message is too scary, it could backfire.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It’s a tug of war,” said Christopher Graves. “That trade-off is, people stop taking action. They basically become paralyzed by how overwhelming it is. There needs to be a balance.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/361837/human-psychology-makes-health-insurance-a-hard-sell-especially-for-latino-consumers","authors":["3205"],"categories":["stateofhealth_15","stateofhealth_14"],"tags":["stateofhealth_38","stateofhealth_368","stateofhealth_3192","stateofhealth_3191","stateofhealth_2519","stateofhealth_365"],"featImg":"stateofhealth_361838","label":"stateofhealth"},"stateofhealth_361137":{"type":"posts","id":"stateofhealth_361137","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"361137","score":null,"sort":[1506114368000]},"guestAuthors":[],"slug":"a-tale-of-two-states-california-loses-and-texas-wins-under-gop-health-plan","title":"A Tale of Two States: California Loses and Texas Wins Under GOP Health Plan","publishDate":1506114368,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>California stands to lose billions in health care funding under the GOP’s latest plan to repeal and replace the Affordable Care Act, resulting in millions of Californians losing coverage.\u003c/p>\n\u003cp>The Graham-Cassidy legislation under discussion in the Senate would redistribute the funds now used to pay for the Affordable Care Act, effectively taking money from states that embraced all aspects of the law, like California, and redistributing it to other states, that didn't, like Texas.\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">“For a state like California or a Massachusetts or a New York, exactly the states that might be most motivated to at least try to preserve the ACA coverage gains - those are the states that would face the deepest cuts to their federal resources,” said Aviva Aron-Dine, senior fellow at the \u003ca href=\"https://www.cbpp.org/\">Center on Budget and Policy Priorities\u003c/a>.\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">The bill's Republican authors say redistributing the health funds is about fairness, and will give states more \"flexibility\" to redesign their own health systems.\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">But health officials in California predict dire consequences if the measure were to pass.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Simply stated, this proposal is the most devastating of the three federal health care proposals that we have evaluated this year,” top officials from the state Department of Health Care Services wrote in \u003ca href=\"https://californiahealthline.files.wordpress.com/2017/09/graham_cassidy_impact_memo_dhcs_092217.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">an analysis\u003c/a> released Friday. “If this amendment is adopted and becomes law, California will be faced with tens of billions of dollars in new costs [and] will require difficult decisions regarding the populations and benefits we choose to cover and how much we pay providers and plans for the services they provide.”\u003c/p>\n\u003cp> \u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">By 2026, California would lose $85.7 billion in federal funds, and by 2027 it would lose $138.8 billion, according to the analysis. That could cause 6.7 million Californians to lose insurance coverage, according to \u003ca href=\"http://laborcenter.berkeley.edu/the-gops-last-ditch-effort-to-repeal-the-affordable-care-act-is-the-worst-one-yet-for-california/\">estimates\u003c/a> from the The UC Berkeley Labor Center.\u003c/p>\n\u003cp>A lot of those people are entrepreneurs or their employees. Under the Affordable Care Act in California, half a million self-employed entrepreneurs -- and a million employees who work for small businesses -- got health coverage because of the ACA, either through the expansion of Medi-Cal, or through a subsidized personal insurance plan on the state exchange, Covered California.\u003c/p>\n\u003cp>\"It would be very difficult for entrepreneurs and self employed folks to access some level of coverage,\" said Mark Herbert, California director for the \u003ca href=\"http://www.smallbusinessmajority.org/states/california\" target=\"_blank\" rel=\"noopener noreferrer\">Small Business Majority\u003c/a>. \"So it would be massively destabilizing to the ability of small employers to attract talent.\"\u003c/p>\n\u003cp>Beyond that, there would be damaging ripple effects, Herbert added: \"There's no way that you can remove those sorts of dollars out of our local communities and not see some sort of economic impact on small businesses.\"\u003c/p>\n\u003cp>Under the Graham-Cassidy bill’s redistribution formula, several states that shunned the Affordable Care Act would get more money, according to a \u003ca href=\"http://avalere.com/expertise/life-sciences/insights/graham-cassidy-heller-johnson-bill-would-reduce-federal-funding-to-sta\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> by health consulting firm Avalare.\u003c/p>\n\u003cp>Texas will get a windfall of $35 billion in health funding over the next ten years, more than any other state. State officials would get to decide how they want to spend that money. But advocates and analysts say more money for Texas doesn't necessarily guarantee an improved health care system.\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">“Regardless of the size of the block grant, there's just no assurance that it would translate into good coverage, or coverage that's as affordable as what we have today,” said Stacey Pogue with the \u003ca href=\"http://bettertexasblog.org/2017/09/harmful-medicaid-cutaca-repeal-bill-resurfaces-senate/\" target=\"_blank\" rel=\"noopener noreferrer\">Center for Public Policy Priorities \u003c/a>in Austin.\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">Texas already has the highest number of uninsured folks, and Pogue says the state just doesn't have the infrastructure in place to expand coverage to more people. It didn't expand Medicaid in 2014, which was optional under the ACA, and the state didn't set up its own exchange, like California did with \"Covered California.\" Texans who wanted subsidized insurance plans had to use the federal exchange, healthcare.gov, which meant Texas had less flexibility when it came to regulating insurers.\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">“There's no planning and no thought put into, 'How would we create affordable coverage for low-income Texans?\" Pogue said, \"Unlike the 31 states that have expanded Medicaid, have done some central planning. And Texas would be starting from scratch.”\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">It would also take a lot of political will to make sure the state is actually expanding health care, Pogue added, and that motivation has been lacking among state lawmakers for years. In order to get the block grant, states would need to create a workable health infrastructure by 2020. For comparison, it took Massachusetts four years to set up its pre-Obamacare statewide insurance market.\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">“We are very concerned,” said Stacy Wilson, president of the Children's Hospital Association of Texas.\u003c/p>\n\u003cp>Wilson said this pot of money from Cassidy-Graham wouldn't solve chronic problems with Medicaid, 70 percent of which covers children. Wilson explained that's because the federal government would pay a fixed amount per person, under a per capita cap. That formula locks in how much the state gets per Medicaid enrollee, no matter how much treatment those enrollees need.\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">“We have very low per-capita costs already, and we get locked into that forever,” Wilson said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">A conservative policy group in Texas, \u003ca href=\"https://www.texaspolicy.com/press_release/detail/tppf-statement-on-graham-cassidy-health-care-bill\" target=\"_blank\" rel=\"noopener noreferrer\">The Texas Public Policy Foundation\u003c/a>, is also not happy about the bill, but their concern is that it doesn't go far enough to repeal Obamacare.\u003c/p>\n\n","blocks":[],"excerpt":"The Graham-Cassidy bill to repeal and replace the Affordable Care Act redistributes money from states that worked hard to implement Obamacare and gives it to states that refused Obamacare funding. ","status":"publish","parent":0,"modified":1506126021,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":11,"wordCount":915},"headData":{"title":"A Tale of Two States: California Loses and Texas Wins Under GOP Health Plan | KQED","description":"The Graham-Cassidy bill to repeal and replace the Affordable Care Act redistributes money from states that worked hard to implement Obamacare and gives it to states that refused Obamacare funding. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"A Tale of Two States: California Loses and Texas Wins Under GOP Health Plan","datePublished":"2017-09-22T21:06:08.000Z","dateModified":"2017-09-23T00:20:21.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"361137 https://ww2.kqed.org/stateofhealth/?p=361137","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/09/22/a-tale-of-two-states-california-loses-and-texas-wins-under-gop-health-plan/","disqusTitle":"A Tale of Two States: California Loses and Texas Wins Under GOP Health Plan","nprByline":"\u003cstrong>April Dembosky\u003c/strong>, KQED and \u003cstrong>Ashley Lopez\u003c/strong>, KUT","path":"/stateofhealth/361137/a-tale-of-two-states-california-loses-and-texas-wins-under-gop-health-plan","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>California stands to lose billions in health care funding under the GOP’s latest plan to repeal and replace the Affordable Care Act, resulting in millions of Californians losing coverage.\u003c/p>\n\u003cp>The Graham-Cassidy legislation under discussion in the Senate would redistribute the funds now used to pay for the Affordable Care Act, effectively taking money from states that embraced all aspects of the law, like California, and redistributing it to other states, that didn't, like Texas.\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">“For a state like California or a Massachusetts or a New York, exactly the states that might be most motivated to at least try to preserve the ACA coverage gains - those are the states that would face the deepest cuts to their federal resources,” said Aviva Aron-Dine, senior fellow at the \u003ca href=\"https://www.cbpp.org/\">Center on Budget and Policy Priorities\u003c/a>.\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">The bill's Republican authors say redistributing the health funds is about fairness, and will give states more \"flexibility\" to redesign their own health systems.\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">But health officials in California predict dire consequences if the measure were to pass.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Simply stated, this proposal is the most devastating of the three federal health care proposals that we have evaluated this year,” top officials from the state Department of Health Care Services wrote in \u003ca href=\"https://californiahealthline.files.wordpress.com/2017/09/graham_cassidy_impact_memo_dhcs_092217.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">an analysis\u003c/a> released Friday. “If this amendment is adopted and becomes law, California will be faced with tens of billions of dollars in new costs [and] will require difficult decisions regarding the populations and benefits we choose to cover and how much we pay providers and plans for the services they provide.”\u003c/p>\n\u003cp> \u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">By 2026, California would lose $85.7 billion in federal funds, and by 2027 it would lose $138.8 billion, according to the analysis. That could cause 6.7 million Californians to lose insurance coverage, according to \u003ca href=\"http://laborcenter.berkeley.edu/the-gops-last-ditch-effort-to-repeal-the-affordable-care-act-is-the-worst-one-yet-for-california/\">estimates\u003c/a> from the The UC Berkeley Labor Center.\u003c/p>\n\u003cp>A lot of those people are entrepreneurs or their employees. Under the Affordable Care Act in California, half a million self-employed entrepreneurs -- and a million employees who work for small businesses -- got health coverage because of the ACA, either through the expansion of Medi-Cal, or through a subsidized personal insurance plan on the state exchange, Covered California.\u003c/p>\n\u003cp>\"It would be very difficult for entrepreneurs and self employed folks to access some level of coverage,\" said Mark Herbert, California director for the \u003ca href=\"http://www.smallbusinessmajority.org/states/california\" target=\"_blank\" rel=\"noopener noreferrer\">Small Business Majority\u003c/a>. \"So it would be massively destabilizing to the ability of small employers to attract talent.\"\u003c/p>\n\u003cp>Beyond that, there would be damaging ripple effects, Herbert added: \"There's no way that you can remove those sorts of dollars out of our local communities and not see some sort of economic impact on small businesses.\"\u003c/p>\n\u003cp>Under the Graham-Cassidy bill’s redistribution formula, several states that shunned the Affordable Care Act would get more money, according to a \u003ca href=\"http://avalere.com/expertise/life-sciences/insights/graham-cassidy-heller-johnson-bill-would-reduce-federal-funding-to-sta\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> by health consulting firm Avalare.\u003c/p>\n\u003cp>Texas will get a windfall of $35 billion in health funding over the next ten years, more than any other state. State officials would get to decide how they want to spend that money. But advocates and analysts say more money for Texas doesn't necessarily guarantee an improved health care system.\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">“Regardless of the size of the block grant, there's just no assurance that it would translate into good coverage, or coverage that's as affordable as what we have today,” said Stacey Pogue with the \u003ca href=\"http://bettertexasblog.org/2017/09/harmful-medicaid-cutaca-repeal-bill-resurfaces-senate/\" target=\"_blank\" rel=\"noopener noreferrer\">Center for Public Policy Priorities \u003c/a>in Austin.\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">Texas already has the highest number of uninsured folks, and Pogue says the state just doesn't have the infrastructure in place to expand coverage to more people. It didn't expand Medicaid in 2014, which was optional under the ACA, and the state didn't set up its own exchange, like California did with \"Covered California.\" Texans who wanted subsidized insurance plans had to use the federal exchange, healthcare.gov, which meant Texas had less flexibility when it came to regulating insurers.\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">“There's no planning and no thought put into, 'How would we create affordable coverage for low-income Texans?\" Pogue said, \"Unlike the 31 states that have expanded Medicaid, have done some central planning. And Texas would be starting from scratch.”\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">It would also take a lot of political will to make sure the state is actually expanding health care, Pogue added, and that motivation has been lacking among state lawmakers for years. In order to get the block grant, states would need to create a workable health infrastructure by 2020. For comparison, it took Massachusetts four years to set up its pre-Obamacare statewide insurance market.\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">“We are very concerned,” said Stacy Wilson, president of the Children's Hospital Association of Texas.\u003c/p>\n\u003cp>Wilson said this pot of money from Cassidy-Graham wouldn't solve chronic problems with Medicaid, 70 percent of which covers children. Wilson explained that's because the federal government would pay a fixed amount per person, under a per capita cap. That formula locks in how much the state gets per Medicaid enrollee, no matter how much treatment those enrollees need.\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">“We have very low per-capita costs already, and we get locked into that forever,” Wilson said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp style=\"font-style: inherit;font-weight: inherit\">A conservative policy group in Texas, \u003ca href=\"https://www.texaspolicy.com/press_release/detail/tppf-statement-on-graham-cassidy-health-care-bill\" target=\"_blank\" rel=\"noopener noreferrer\">The Texas Public Policy Foundation\u003c/a>, is also not happy about the bill, but their concern is that it doesn't go far enough to repeal Obamacare.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/361137/a-tale-of-two-states-california-loses-and-texas-wins-under-gop-health-plan","authors":["byline_stateofhealth_361137"],"categories":["stateofhealth_2442","stateofhealth_15","stateofhealth_14","stateofhealth_1"],"tags":["stateofhealth_294","stateofhealth_368","stateofhealth_2808","stateofhealth_3169","stateofhealth_2519","stateofhealth_365","stateofhealth_3105"],"featImg":"stateofhealth_361149","label":"stateofhealth"},"stateofhealth_360850":{"type":"posts","id":"stateofhealth_360850","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"360850","score":null,"sort":[1503078231000]},"guestAuthors":[],"slug":"amid-uncertainty-over-health-care-covered-california-appeals-to-insurers-bottom-lines","title":"Amid Uncertainty Over Health Care, Covered California Appeals to Insurers' Bottom Lines","publishDate":1503078231,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>With ongoing uncertainty around the Affordable Care Act (ACA), the board that oversees California's health care marketplace took action to stabilize the exchange on Thursday. Their goal was to convince insurance companies to continue offering health plans through \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Covered California\u003c/a>.\u003c/p>\n\u003cp>Covered California Executive Director Peter V. Lee praised California's overall success as a health care marketplace, but cautioned that the exchange faces significant challenges.\u003c/p>\n\u003cp>\"We think this open enrollment’s going to be the most challenging since year one,\" Lee said. \"We’re dealing with the most federal uncertainty we’ve ever had.\"\u003c/p>\n\u003cp>Lee is referring to Congress's attempts to repeal the ACA, and the Trump administration's threats not to pay subsidies to insurance companies, as required under the health care law.\u003c/p>\n\u003cp>In the meeting, the board unanimously adopted two new resolutions they believe will maintain market stability. \u003ca href=\"http://board.coveredca.com/meetings/2017/08-17/2017-2019%20QHP%20Issuer%20Contract%20Amendment%20Resolution%20(2017-36).pdf\" target=\"_blank\" rel=\"noopener noreferrer\">The first\u003c/a> updates contracts between Covered California and insurance companies, allowing insurers who lose money in 2018 to increase profit margins in the following three years in order to recoup losses. Alternatively, if companies make unforeseen profits because of national uncertainty, those profits would go to reducing premiums in the future.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In an email, a spokesperson for Blue Shield of California, one of the exchange's providers, said the company \"supports Covered California’s program to address the pricing uncertainty and will participate to add stability in the market.\"\u003c/p>\n\u003cp>\u003ca href=\"http://board.coveredca.com/meetings/2017/08-17/Fiscal%20Year%202017-18%20Budget%20Revision%20(Resolution%202017-37).pdf\" target=\"_blank\" rel=\"noopener noreferrer\">The second resolution\u003c/a> increases Covered California's marketing and outreach budget by over $5 million. Marketing helps convince consumers, especially healthy ones, to sign up for plans. A mix of healthy and sick participants allows health care marketplaces to maintain lower premiums.\u003c/p>\n\u003cp>Finally, the board announced it would delay a decision about whether to further increase 2018 premiums until Sept. 30.\u003c/p>\n\u003cp>[contextly_sidebar id=\"QtimBtKZJz3HyH4ttMNqWM3dVsZyKIDx\"]\u003c/p>\n\u003cp>Those increases could be necessary to make up for the insurance companies' financial losses, if the federal government withholds subsidies designed to decrease costs for low-income consumers.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The board hopes that by the end of September it will better understand what will happen to the Affordable Care Act and how that will impact California.\u003c/p>\n\n","blocks":[],"excerpt":"Covered California's board introduces two resolutions and delays a decision about rate increases.","status":"publish","parent":0,"modified":1503091746,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":13,"wordCount":364},"headData":{"title":"Amid Uncertainty Over Health Care, Covered California Appeals to Insurers' Bottom Lines | KQED","description":"Covered California's board introduces two resolutions and delays a decision about rate increases.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Amid Uncertainty Over Health Care, Covered California Appeals to Insurers' Bottom Lines","datePublished":"2017-08-18T17:43:51.000Z","dateModified":"2017-08-18T21:29:06.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"360850 https://ww2.kqed.org/stateofhealth/?p=360850","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/08/18/amid-uncertainty-over-health-care-covered-california-appeals-to-insurers-bottom-lines/","disqusTitle":"Amid Uncertainty Over Health Care, Covered California Appeals to Insurers' Bottom Lines","path":"/stateofhealth/360850/amid-uncertainty-over-health-care-covered-california-appeals-to-insurers-bottom-lines","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>With ongoing uncertainty around the Affordable Care Act (ACA), the board that oversees California's health care marketplace took action to stabilize the exchange on Thursday. Their goal was to convince insurance companies to continue offering health plans through \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Covered California\u003c/a>.\u003c/p>\n\u003cp>Covered California Executive Director Peter V. Lee praised California's overall success as a health care marketplace, but cautioned that the exchange faces significant challenges.\u003c/p>\n\u003cp>\"We think this open enrollment’s going to be the most challenging since year one,\" Lee said. \"We’re dealing with the most federal uncertainty we’ve ever had.\"\u003c/p>\n\u003cp>Lee is referring to Congress's attempts to repeal the ACA, and the Trump administration's threats not to pay subsidies to insurance companies, as required under the health care law.\u003c/p>\n\u003cp>In the meeting, the board unanimously adopted two new resolutions they believe will maintain market stability. \u003ca href=\"http://board.coveredca.com/meetings/2017/08-17/2017-2019%20QHP%20Issuer%20Contract%20Amendment%20Resolution%20(2017-36).pdf\" target=\"_blank\" rel=\"noopener noreferrer\">The first\u003c/a> updates contracts between Covered California and insurance companies, allowing insurers who lose money in 2018 to increase profit margins in the following three years in order to recoup losses. Alternatively, if companies make unforeseen profits because of national uncertainty, those profits would go to reducing premiums in the future.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In an email, a spokesperson for Blue Shield of California, one of the exchange's providers, said the company \"supports Covered California’s program to address the pricing uncertainty and will participate to add stability in the market.\"\u003c/p>\n\u003cp>\u003ca href=\"http://board.coveredca.com/meetings/2017/08-17/Fiscal%20Year%202017-18%20Budget%20Revision%20(Resolution%202017-37).pdf\" target=\"_blank\" rel=\"noopener noreferrer\">The second resolution\u003c/a> increases Covered California's marketing and outreach budget by over $5 million. Marketing helps convince consumers, especially healthy ones, to sign up for plans. A mix of healthy and sick participants allows health care marketplaces to maintain lower premiums.\u003c/p>\n\u003cp>Finally, the board announced it would delay a decision about whether to further increase 2018 premiums until Sept. 30.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Those increases could be necessary to make up for the insurance companies' financial losses, if the federal government withholds subsidies designed to decrease costs for low-income consumers.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The board hopes that by the end of September it will better understand what will happen to the Affordable Care Act and how that will impact California.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/360850/amid-uncertainty-over-health-care-covered-california-appeals-to-insurers-bottom-lines","authors":["8648"],"categories":["stateofhealth_2442","stateofhealth_14","stateofhealth_1"],"tags":["stateofhealth_294","stateofhealth_38","stateofhealth_368","stateofhealth_2808","stateofhealth_2519"],"featImg":"stateofhealth_16356","label":"stateofhealth"},"stateofhealth_360417":{"type":"posts","id":"stateofhealth_360417","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"360417","score":null,"sort":[1501719537000]},"guestAuthors":[],"slug":"feinstein-deeply-concerned-with-anthem-rollback-of-coverage","title":"Feinstein 'Deeply Concerned' With Anthem Rollback of Coverage","publishDate":1501719537,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>California Senator Diane Feinstein said Wednesday that she was \"deeply concerned\" by Anthem Blue Cross’s decision to reduce individual health plan coverage for some 150,000 Californians.\u003c/p>\n\u003cp>\"I’m unhappy, at first blush, and at second blush, I don’t understand it,\" she said in an interview with KQED.\u003c/p>\n\u003cp>Anthem said it will withdraw from 16 of the 19 California regions it covers. This means \u003ca href=\"https://ww2.kqed.org/stateofhealth/2017/08/01/health-premiums-go-up-12-5-in-2018-and-anthem-exits-much-of-california/\" target=\"_blank\" rel=\"noopener noreferrer\">more than half of Californians\u003c/a> with an Anthem plan through the individual market -- or 153,000 people -- will have to find a new option.\u003c/p>\n\u003cp>In an email to KQED, Anthem Blue Cross representatives said the shrinking individual market and changes in federal guidance were the reasons behind its decision to cover fewer Californians this year. These changes will not impact Californians with Anthem plans through Medicare, Medi-Cal and their employer, or plans purchased before March 2010 -- which are grandfathered in.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Anthem representatives also said they'd \"continue to advocate solutions that will stabilize the market to allow us to return to a more robust presence in the future.\"\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Feinstein said the change came as a surprise and she's puzzled by the insurer opting out of the large California market. \"I'm really surprised to see this and deeply concerned.\"\u003c/p>\n\u003cp>Anthem's announcement came as Covered California -- the state's health care marketplace -- on Tuesday released the 11 participating \u003ca href=\"http://www.coveredca.com/news/PDFs/CoveredCA_2018_Plans_and_Rates_8-1-2017.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">health insurers and its 2018 rates\u003c/a>.\u003c/p>\n\u003cp>Covered California said the average health premium would increase 12.5 percent next year -- but could double if the federal government stops providing key cost-sharing subsidies that help low-income consumers. Covered California said it needs to finalize rates by Aug. 31.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lawmakers in Congress have temporarily abandoned their efforts to repeal and replace the Affordable Care Act, or Obamacare, despite President Trump's urging them to keep working on legislation.\u003c/p>\n\n","blocks":[],"excerpt":"Sen. Feinstein said the change came as a surprise and she's puzzled by the insurer opting out of the large California market. ","status":"publish","parent":0,"modified":1501781657,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":10,"wordCount":324},"headData":{"title":"Feinstein 'Deeply Concerned' With Anthem Rollback of Coverage | KQED","description":"Sen. Feinstein said the change came as a surprise and she's puzzled by the insurer opting out of the large California market. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Feinstein 'Deeply Concerned' With Anthem Rollback of Coverage","datePublished":"2017-08-03T00:18:57.000Z","dateModified":"2017-08-03T17:34:17.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"360417 https://ww2.kqed.org/stateofhealth/?p=360417","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/08/02/feinstein-deeply-concerned-with-anthem-rollback-of-coverage/","disqusTitle":"Feinstein 'Deeply Concerned' With Anthem Rollback of Coverage","path":"/stateofhealth/360417/feinstein-deeply-concerned-with-anthem-rollback-of-coverage","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>California Senator Diane Feinstein said Wednesday that she was \"deeply concerned\" by Anthem Blue Cross’s decision to reduce individual health plan coverage for some 150,000 Californians.\u003c/p>\n\u003cp>\"I’m unhappy, at first blush, and at second blush, I don’t understand it,\" she said in an interview with KQED.\u003c/p>\n\u003cp>Anthem said it will withdraw from 16 of the 19 California regions it covers. This means \u003ca href=\"https://ww2.kqed.org/stateofhealth/2017/08/01/health-premiums-go-up-12-5-in-2018-and-anthem-exits-much-of-california/\" target=\"_blank\" rel=\"noopener noreferrer\">more than half of Californians\u003c/a> with an Anthem plan through the individual market -- or 153,000 people -- will have to find a new option.\u003c/p>\n\u003cp>In an email to KQED, Anthem Blue Cross representatives said the shrinking individual market and changes in federal guidance were the reasons behind its decision to cover fewer Californians this year. These changes will not impact Californians with Anthem plans through Medicare, Medi-Cal and their employer, or plans purchased before March 2010 -- which are grandfathered in.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Anthem representatives also said they'd \"continue to advocate solutions that will stabilize the market to allow us to return to a more robust presence in the future.\"\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Feinstein said the change came as a surprise and she's puzzled by the insurer opting out of the large California market. \"I'm really surprised to see this and deeply concerned.\"\u003c/p>\n\u003cp>Anthem's announcement came as Covered California -- the state's health care marketplace -- on Tuesday released the 11 participating \u003ca href=\"http://www.coveredca.com/news/PDFs/CoveredCA_2018_Plans_and_Rates_8-1-2017.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">health insurers and its 2018 rates\u003c/a>.\u003c/p>\n\u003cp>Covered California said the average health premium would increase 12.5 percent next year -- but could double if the federal government stops providing key cost-sharing subsidies that help low-income consumers. Covered California said it needs to finalize rates by Aug. 31.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lawmakers in Congress have temporarily abandoned their efforts to repeal and replace the Affordable Care Act, or Obamacare, despite President Trump's urging them to keep working on legislation.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/360417/feinstein-deeply-concerned-with-anthem-rollback-of-coverage","authors":["8648"],"categories":["stateofhealth_1"],"tags":["stateofhealth_2698","stateofhealth_368","stateofhealth_3144","stateofhealth_28","stateofhealth_2865"],"featImg":"stateofhealth_360435","label":"stateofhealth"},"stateofhealth_360160":{"type":"posts","id":"stateofhealth_360160","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"360160","score":null,"sort":[1501633399000]},"guestAuthors":[],"slug":"health-premiums-go-up-12-5-in-2018-and-anthem-exits-much-of-california","title":"Health Premiums Go Up 12.5% in 2018, and Anthem Exits Much of California","publishDate":1501633399,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>More than half of the Californians who have an individual health insurance policy from Anthem Blue Cross will have to shop for a new plan next year.\u003c/p>\n\u003cp>The company is pulling out of the individual market in all but three regions of the state, abandoning 153,000 of its customers. Of those, 30,000 will be left with just one plan on offer through Covered California.\u003c/p>\n\u003cp>But the former Anthem customers who do have a choice of plans will be able to find reasonable alternatives.\u003c/p>\n\u003cp>“In a number of areas where consumers in Anthem will now be forced to shop, they will find much more cost-competitive options,” said Peter Lee, executive director of Covered California.\u003c/p>\n\u003cp>Statewide, premium rates will go up an average 12.5 percent in 2018 in the state’s Affordable Care Act marketplace. But in San Francisco, the average premium increase will be just 6.6 percent. In Fresno, Kings, and Madera counties, the average increase will be 4.7 percent.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Anthem customers can keep their plan if they live in the far rural northern part of the state, parts of the Central Valley, and Santa Clara County. But in areas where Anthem is one of only two plans offered for sale – like Modoc, Lassen, and Siskiyou counties in the far north – customers will pay as much as 54 percent more for their Anthem plan. The alternative, Blue Shield, will charge up to 24 percent more next year.\u003c/p>\n\u003cp>In a statement, Anthem said its price increases and partial departure from the market are due largely to federal changes and uncertainty around the future of the Affordable Care Act.\u003c/p>\n\u003cp>“Planning and pricing for ACA-compliant health plans has become increasingly difficult,” it said, because of “continual changes in federal operations, rules and guidance.”\u003c/p>\n\u003cp>The overall lack of predictability “simply does not provide a sustainable path forward to providing affordable plan choices for all California consumers,” the company said.\u003c/p>\n\u003cp>Uncertainty also affected the prices the remaining marketplace insurers plan to charge next year. Of the overall 12.5 percent average increase, 3 percent is due to uncertainty alone, Lee said.\u003c/p>\n\u003cp>Lee warned that some plans will see an additional 12 percent surcharge, on top of the 12.5 percent average increase, if President Trump makes good on his threat to stop so-called \"Cost-Sharing Reduction\" payments to insurers. These CSR payments help insurers provide discounts on co-pays and deductibles for low-income consumers, as they are required to do by the Affordable Care Act.\u003c/p>\n\u003cp>But even if the Trump administration withdraws the money, and insurers add the surcharge to premiums, Lee says most Californians won’t feel it, because the federal subsidy will also go up in kind, covering most of the premium increase.\u003c/p>\n\u003cp>“We do not want to implement this workaround,” Lee said. “It will cause unnecessary confusion, and ultimately cost the federal government billions of dollars more than they would have spent by [just] making the CSR payments directly to health plans.”\u003c/p>\n\u003cp>Covered California submitted \u003ca href=\"http://www.coveredca.com/news/pdfs/CoveredCA_CL_2018_Rates-HHSLetter.pdf\">a letter\u003c/a> to federal health officials, saying there's an urgent need to get clarity on the future of the cost-sharing reduction payments. California will have to decide by the end of August whether to add the surcharge to monthly premiums or not. After that, it cannot make changes to \u003ca href=\"http://www.coveredca.com/news/PDFs/CoveredCA_2018_Plans_and_Rates_8-1-2017.pdf\">2018 rates\u003c/a>.\u003c/p>\n\u003cp>\"I'm expecting to be dealing with a lot of angry and frustrated consumers as we head into 2018 open enrollment,\" said Jonathan Greer, a health insurance broker with Rockridge Health Benefits in Oakland. \"Unfortunately, many consumers will experience sticker shock this year, especially if the Trump Administration stops making the cost-sharing payments.\"\u003c/p>\n\u003cp>Insurers are also worried that the federal government will make changes to the Affordable Care Act in the middle of next year, after rates are locked in. In addition to the CSR payments, they are concerned the IRS will stop enforcing the individual mandate, the ACA's requirement that almost all Americans buy insurance. The mandate helps balance insurance \"risk pools\" by ensuring young, healthy people also buy policies, to help cover the costs of care for the sick.\u003c/p>\n\u003cp>Covered California had to fend off requests for premium increases well beyond the 12.5 percent average because of these fears.\u003c/p>\n\u003cp>“One of the things that many of the health plans said to us is ‘What if policies change mid-year? Our actuaries are saying, ‘Be really conservative and bump rates a boatload,’” Peter Lee said, recalling the tensions underlying the negotiations. “We said, ‘Take a deep breath. Before you bump up rates a boatload, instead, what can we do to help you plan over the long term?’”\u003c/p>\n\u003cp>The agency convinced insurers to keep the increases in check by drafting a plan that would allow them to make up for any 2018 losses in subsequent years. This backup plan, which still has to be approved by state regulators, wouldn’t cost the state money, Lee said. But it would allow insurers to shift costs internally so they could replenish the coffers in later years.\u003c/p>\n\u003cp>But Lee predicts the state probably won’t have to implement the backup plan. By keeping increases relatively low this year, more people will sign up for health plans, which will give insurers the stability they need to keep prices low in 2019 and beyond.\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"Uncertainty around the Affordable Care Act is pushing rates higher in California and has Anthem scaling back coverage.","status":"publish","parent":0,"modified":1501635400,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":922},"headData":{"title":"Health Premiums Go Up 12.5% in 2018, and Anthem Exits Much of California | KQED","description":"Uncertainty around the Affordable Care Act is pushing rates higher in California and has Anthem scaling back coverage.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Health Premiums Go Up 12.5% in 2018, and Anthem Exits Much of California","datePublished":"2017-08-02T00:23:19.000Z","dateModified":"2017-08-02T00:56:40.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"360160 https://ww2.kqed.org/stateofhealth/?p=360160","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/08/01/health-premiums-go-up-12-5-in-2018-and-anthem-exits-much-of-california/","disqusTitle":"Health Premiums Go Up 12.5% in 2018, and Anthem Exits Much of California","path":"/stateofhealth/360160/health-premiums-go-up-12-5-in-2018-and-anthem-exits-much-of-california","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>More than half of the Californians who have an individual health insurance policy from Anthem Blue Cross will have to shop for a new plan next year.\u003c/p>\n\u003cp>The company is pulling out of the individual market in all but three regions of the state, abandoning 153,000 of its customers. Of those, 30,000 will be left with just one plan on offer through Covered California.\u003c/p>\n\u003cp>But the former Anthem customers who do have a choice of plans will be able to find reasonable alternatives.\u003c/p>\n\u003cp>“In a number of areas where consumers in Anthem will now be forced to shop, they will find much more cost-competitive options,” said Peter Lee, executive director of Covered California.\u003c/p>\n\u003cp>Statewide, premium rates will go up an average 12.5 percent in 2018 in the state’s Affordable Care Act marketplace. But in San Francisco, the average premium increase will be just 6.6 percent. In Fresno, Kings, and Madera counties, the average increase will be 4.7 percent.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Anthem customers can keep their plan if they live in the far rural northern part of the state, parts of the Central Valley, and Santa Clara County. But in areas where Anthem is one of only two plans offered for sale – like Modoc, Lassen, and Siskiyou counties in the far north – customers will pay as much as 54 percent more for their Anthem plan. The alternative, Blue Shield, will charge up to 24 percent more next year.\u003c/p>\n\u003cp>In a statement, Anthem said its price increases and partial departure from the market are due largely to federal changes and uncertainty around the future of the Affordable Care Act.\u003c/p>\n\u003cp>“Planning and pricing for ACA-compliant health plans has become increasingly difficult,” it said, because of “continual changes in federal operations, rules and guidance.”\u003c/p>\n\u003cp>The overall lack of predictability “simply does not provide a sustainable path forward to providing affordable plan choices for all California consumers,” the company said.\u003c/p>\n\u003cp>Uncertainty also affected the prices the remaining marketplace insurers plan to charge next year. Of the overall 12.5 percent average increase, 3 percent is due to uncertainty alone, Lee said.\u003c/p>\n\u003cp>Lee warned that some plans will see an additional 12 percent surcharge, on top of the 12.5 percent average increase, if President Trump makes good on his threat to stop so-called \"Cost-Sharing Reduction\" payments to insurers. These CSR payments help insurers provide discounts on co-pays and deductibles for low-income consumers, as they are required to do by the Affordable Care Act.\u003c/p>\n\u003cp>But even if the Trump administration withdraws the money, and insurers add the surcharge to premiums, Lee says most Californians won’t feel it, because the federal subsidy will also go up in kind, covering most of the premium increase.\u003c/p>\n\u003cp>“We do not want to implement this workaround,” Lee said. “It will cause unnecessary confusion, and ultimately cost the federal government billions of dollars more than they would have spent by [just] making the CSR payments directly to health plans.”\u003c/p>\n\u003cp>Covered California submitted \u003ca href=\"http://www.coveredca.com/news/pdfs/CoveredCA_CL_2018_Rates-HHSLetter.pdf\">a letter\u003c/a> to federal health officials, saying there's an urgent need to get clarity on the future of the cost-sharing reduction payments. California will have to decide by the end of August whether to add the surcharge to monthly premiums or not. After that, it cannot make changes to \u003ca href=\"http://www.coveredca.com/news/PDFs/CoveredCA_2018_Plans_and_Rates_8-1-2017.pdf\">2018 rates\u003c/a>.\u003c/p>\n\u003cp>\"I'm expecting to be dealing with a lot of angry and frustrated consumers as we head into 2018 open enrollment,\" said Jonathan Greer, a health insurance broker with Rockridge Health Benefits in Oakland. \"Unfortunately, many consumers will experience sticker shock this year, especially if the Trump Administration stops making the cost-sharing payments.\"\u003c/p>\n\u003cp>Insurers are also worried that the federal government will make changes to the Affordable Care Act in the middle of next year, after rates are locked in. In addition to the CSR payments, they are concerned the IRS will stop enforcing the individual mandate, the ACA's requirement that almost all Americans buy insurance. The mandate helps balance insurance \"risk pools\" by ensuring young, healthy people also buy policies, to help cover the costs of care for the sick.\u003c/p>\n\u003cp>Covered California had to fend off requests for premium increases well beyond the 12.5 percent average because of these fears.\u003c/p>\n\u003cp>“One of the things that many of the health plans said to us is ‘What if policies change mid-year? Our actuaries are saying, ‘Be really conservative and bump rates a boatload,’” Peter Lee said, recalling the tensions underlying the negotiations. “We said, ‘Take a deep breath. Before you bump up rates a boatload, instead, what can we do to help you plan over the long term?’”\u003c/p>\n\u003cp>The agency convinced insurers to keep the increases in check by drafting a plan that would allow them to make up for any 2018 losses in subsequent years. This backup plan, which still has to be approved by state regulators, wouldn’t cost the state money, Lee said. But it would allow insurers to shift costs internally so they could replenish the coffers in later years.\u003c/p>\n\u003cp>But Lee predicts the state probably won’t have to implement the backup plan. By keeping increases relatively low this year, more people will sign up for health plans, which will give insurers the stability they need to keep prices low in 2019 and beyond.\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/360160/health-premiums-go-up-12-5-in-2018-and-anthem-exits-much-of-california","authors":["3205"],"categories":["stateofhealth_15","stateofhealth_14"],"tags":["stateofhealth_38","stateofhealth_368","stateofhealth_2808","stateofhealth_28","stateofhealth_2519","stateofhealth_365","stateofhealth_3143"],"featImg":"stateofhealth_360144","label":"stateofhealth"},"stateofhealth_360142":{"type":"posts","id":"stateofhealth_360142","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"360142","score":null,"sort":[1501624963000]},"guestAuthors":[],"slug":"covered-california-expects-12-5-average-rate-rise-in-2018","title":"Covered California Announces 2018 Rate Hikes, and an Anthem Exit","publishDate":1501624963,"format":"standard","headTitle":"California Healthline | State of Health | KQED News","labelTerm":{"term":3036,"site":"stateofhealth"},"content":"\u003cp>Covered California said Tuesday that premiums on its health insurance plans would rise by an average of 12.5 percent statewide next year, amid continuing uncertainty over the future of the Affordable Care Act.\u003c/p>\n\u003cp>The state’s Obamacare exchange also said one of its largest insurers, Anthem Blue Cross, would pull out of the exchange and the overall individual market in 16 of the 19 regions it currently serves, forcing 153,000 consumers to find new health plans.\u003c/p>\n\u003cp>The rate increases apply to people who purchase their own coverage in the individual market, not the majority of Americans who get their health insurance through work or government programs such as Medicare and Medicaid.\u003c/p>\n\u003cp>The expected 2018 rate increase is down from 2017’s average rise of 13.2 percent, and it includes a one-time increase averaging 2.8 percentage points because of the end of a “holiday” that gave health plans a break from the tax they are required to pay under the Affordable Care Act.\u003c/p>\n\u003cp>Without that one-time hit, Covered California said, the average 2018 premium increase would be lower than 10 percent. And the exchange said consumers could face increases as low as 3.3 percent if they shop for the best-priced plan at the same level of coverage they already have.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The expected California premium increases are dwarfed by some of the rates proposed in other states. In Iowa, for example, the sole carrier remaining on the exchange — Medica — has proposed a \u003ca href=\"http://www.desmoinesregister.com/story/news/health/2017/07/31/iowa-insurance-premiums-could-spike-moref-obamacare-funding-cut/526363001/\">43 percent increase \u003c/a>for next year, and it has said it would propose another increase of 12 to 20 percent on top of that if President Donald Trump decides to eliminate an important subsidy that helps some consumers reduce the cost of doctor visits, hospital stays and other medical services.\u003c/p>\n\u003cp>Blue Cross-Blue Shield of Georgia, the only insurer covering all counties in that state, is proposing a \u003ca href=\"http://www.myajc.com/news/state--regional-govt--politics/citing-uncertainty-blue-cross-seeks-big-rate-increases-georgia/hEVvZdpt6ODVmbtNokL12H/\">40.6 percent increase\u003c/a>, in large part because of the uncertainty surrounding these so-called \u003ca href=\"http://www.sacbee.com/news/local/health-and-medicine/ask-emily/article2581624.html\">cost-sharing subsidies\u003c/a>.\u003c/p>\n\u003cp>Some states, however, will see more moderate rate hikes next year than in California. In \u003ca href=\"http://www.bnd.com/news/article164506387.html\">Minnesota\u003c/a>, which has been hit in the past with large increases, some consumers could see their premiums shrink by as much as 15 percent, while others could pay 11 percent more. In Pennsylvania, premiums on exchange-based plans are expected to rise by a relatively tame \u003ca href=\"http://www.npr.org/sections/health-shots/2017/07/19/538099050/uncertainty-over-obamacare-leaves-next-years-rates-in-limbo\">9 percent on average \u003c/a>if the cost-sharing subsidies continue, and by 20 percent if they don’t.\u003c/p>\n\u003cp>Covered California’s calculation of the average statewide premium increase assumes the federal government will continue to fund the subsidies — which may not be a safe assumption.\u003c/p>\n\u003cp>The exchange said there could be an additional charge averaging 12.4 percent on silver plans — the second-least-expensive type of policy among the exchange’s \u003ca href=\"http://www.coveredca.com/individuals-and-families/getting-covered/coverage-basics/coverage-levels/\">four tiers\u003c/a> — if the administration under Trump decides not to continue funding them. The subsidies, paid directly to insurers, help reduce what some consumers pay out of their own pockets for medical expenses, such as physician visits, prescription drugs and hospital stays.\u003c/p>\n\u003cp>An announcement on whether the Trump administration will continue paying for them, at least for another month, was expected as early as this week. So far, Trump has let the subsidies continue on a month-to-month basis. But after Senate efforts to pass a repeal of the Affordable Care Act failed last week, he suggested in a tweet that he might pull the plug on them.\u003c/p>\n\u003cp>“We’ve prepared these rates in the midst of great uncertainty,” said Peter Lee, Covered California’s executive director. “We are doing our best to protect consumers. We hope to get clarity from the federal government before we make a decision by the end of August” on whether to tack on the silver plan surcharge to offset the loss of the federal subsidies, he said.\u003c/p>\n\u003cp>Lee said the exchange hoped not to do that, because “it will cause unnecessary confusion and ultimately cost the fed government billions of dollars more.”\u003c/p>\n\u003cp>Many Covered California consumers would not pay more out-of-pocket even if the cost of their health plans were to rise sharply, because the extra expense would be covered by federal tax credits intended to keep premiums affordable for consumers. Those subsidies, not directly threatened by Trump, are separate from the ones that help consumers with their out-of-pocket costs.\u003c/p>\n\u003cp>About 650,000 Covered California enrollees, or nearly half the exchange’s total enrollment, benefit from the cost-sharing reductions.\u003c/p>\n\u003cp>Those reduced rates are available only to Covered California enrollees who choose silver-level plans and whose annual income falls between 139 percent and 250 percent of the federal poverty level — about $34,200 to $61,500 for a family of four.\u003c/p>\n\u003cp>The exchange can’t wait too long before determining which rates consumers will face in 2018. State regulators need at least 60 days to review the rates, and Covered California and health plans also need to time to prepare for open enrollment, which begins Nov. 1.\u003c/p>\n\u003cp>Current enrollees will have the option to start renewing their plans sometime in October, said Covered California spokeswoman Lizelda Lopez.\u003c/p>\n\u003cp>Covered California also plans to create a new silver plan to be sold on the exchange for individuals and families who make too much money to qualify for tax credits and cost-sharing reductions. The surcharge will not be applied to that plan.\u003c/p>\n\u003cp>Covered California started offering plans in 2014. In the following two years, the agency successfully negotiated 4 percent average premium increases, far below the double-digit rate hikes that were the norm before the federal health law. That streak ended this year when rates shot up.\u003c/p>\n\u003cp>All of the rates are subject to state regulatory review and public comment. But neither of the state’s insurance regulators, the Department of Managed Health Care and Insurance Commissioner Dave Jones, has the authority to block the hikes.\u003c/p>\n\u003cp>The expansion of coverage under the Affordable Care Act has driven the percentage of uninsured Californians to a record low. The proportion of Californians lacking health insurance was 7.1 percent last year, down from 17 percent in 2013, before the coverage-expanding provisions of Obamacare began, federal data show.\u003c/p>\n\u003cp>The expansion of Medi-Cal, the state’s Medicaid program for lower-income residents, accounts for a significant part of that reduction. About 3.8 million Californians became eligible for Medi-Cal coverage under the Affordable Care Act. Total enrollment is 13.5 million, or about a third of the state’s population.\u003c/p>\n\u003cp>\u003cem>Chad Terhune contributed to this report.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"The figure could be higher if President Trump ends an important consumer subsidy, which he has threatened to do. Anthem Blue Cross also says it won't offer individual coverage in large parts of the state next year. ","status":"publish","parent":0,"modified":1501635243,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":1124},"headData":{"title":"Covered California Announces 2018 Rate Hikes, and an Anthem Exit | KQED","description":"The figure could be higher if President Trump ends an important consumer subsidy, which he has threatened to do. Anthem Blue Cross also says it won't offer individual coverage in large parts of the state next year. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Covered California Announces 2018 Rate Hikes, and an Anthem Exit","datePublished":"2017-08-01T22:02:43.000Z","dateModified":"2017-08-02T00:54:03.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"360142 https://ww2.kqed.org/stateofhealth/?p=360142","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/08/01/covered-california-expects-12-5-average-rate-rise-in-2018/","disqusTitle":"Covered California Announces 2018 Rate Hikes, and an Anthem Exit","nprByline":"Emily Bazar and Pauline Bartolone","path":"/stateofhealth/360142/covered-california-expects-12-5-average-rate-rise-in-2018","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Covered California said Tuesday that premiums on its health insurance plans would rise by an average of 12.5 percent statewide next year, amid continuing uncertainty over the future of the Affordable Care Act.\u003c/p>\n\u003cp>The state’s Obamacare exchange also said one of its largest insurers, Anthem Blue Cross, would pull out of the exchange and the overall individual market in 16 of the 19 regions it currently serves, forcing 153,000 consumers to find new health plans.\u003c/p>\n\u003cp>The rate increases apply to people who purchase their own coverage in the individual market, not the majority of Americans who get their health insurance through work or government programs such as Medicare and Medicaid.\u003c/p>\n\u003cp>The expected 2018 rate increase is down from 2017’s average rise of 13.2 percent, and it includes a one-time increase averaging 2.8 percentage points because of the end of a “holiday” that gave health plans a break from the tax they are required to pay under the Affordable Care Act.\u003c/p>\n\u003cp>Without that one-time hit, Covered California said, the average 2018 premium increase would be lower than 10 percent. And the exchange said consumers could face increases as low as 3.3 percent if they shop for the best-priced plan at the same level of coverage they already have.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The expected California premium increases are dwarfed by some of the rates proposed in other states. In Iowa, for example, the sole carrier remaining on the exchange — Medica — has proposed a \u003ca href=\"http://www.desmoinesregister.com/story/news/health/2017/07/31/iowa-insurance-premiums-could-spike-moref-obamacare-funding-cut/526363001/\">43 percent increase \u003c/a>for next year, and it has said it would propose another increase of 12 to 20 percent on top of that if President Donald Trump decides to eliminate an important subsidy that helps some consumers reduce the cost of doctor visits, hospital stays and other medical services.\u003c/p>\n\u003cp>Blue Cross-Blue Shield of Georgia, the only insurer covering all counties in that state, is proposing a \u003ca href=\"http://www.myajc.com/news/state--regional-govt--politics/citing-uncertainty-blue-cross-seeks-big-rate-increases-georgia/hEVvZdpt6ODVmbtNokL12H/\">40.6 percent increase\u003c/a>, in large part because of the uncertainty surrounding these so-called \u003ca href=\"http://www.sacbee.com/news/local/health-and-medicine/ask-emily/article2581624.html\">cost-sharing subsidies\u003c/a>.\u003c/p>\n\u003cp>Some states, however, will see more moderate rate hikes next year than in California. In \u003ca href=\"http://www.bnd.com/news/article164506387.html\">Minnesota\u003c/a>, which has been hit in the past with large increases, some consumers could see their premiums shrink by as much as 15 percent, while others could pay 11 percent more. In Pennsylvania, premiums on exchange-based plans are expected to rise by a relatively tame \u003ca href=\"http://www.npr.org/sections/health-shots/2017/07/19/538099050/uncertainty-over-obamacare-leaves-next-years-rates-in-limbo\">9 percent on average \u003c/a>if the cost-sharing subsidies continue, and by 20 percent if they don’t.\u003c/p>\n\u003cp>Covered California’s calculation of the average statewide premium increase assumes the federal government will continue to fund the subsidies — which may not be a safe assumption.\u003c/p>\n\u003cp>The exchange said there could be an additional charge averaging 12.4 percent on silver plans — the second-least-expensive type of policy among the exchange’s \u003ca href=\"http://www.coveredca.com/individuals-and-families/getting-covered/coverage-basics/coverage-levels/\">four tiers\u003c/a> — if the administration under Trump decides not to continue funding them. The subsidies, paid directly to insurers, help reduce what some consumers pay out of their own pockets for medical expenses, such as physician visits, prescription drugs and hospital stays.\u003c/p>\n\u003cp>An announcement on whether the Trump administration will continue paying for them, at least for another month, was expected as early as this week. So far, Trump has let the subsidies continue on a month-to-month basis. But after Senate efforts to pass a repeal of the Affordable Care Act failed last week, he suggested in a tweet that he might pull the plug on them.\u003c/p>\n\u003cp>“We’ve prepared these rates in the midst of great uncertainty,” said Peter Lee, Covered California’s executive director. “We are doing our best to protect consumers. We hope to get clarity from the federal government before we make a decision by the end of August” on whether to tack on the silver plan surcharge to offset the loss of the federal subsidies, he said.\u003c/p>\n\u003cp>Lee said the exchange hoped not to do that, because “it will cause unnecessary confusion and ultimately cost the fed government billions of dollars more.”\u003c/p>\n\u003cp>Many Covered California consumers would not pay more out-of-pocket even if the cost of their health plans were to rise sharply, because the extra expense would be covered by federal tax credits intended to keep premiums affordable for consumers. Those subsidies, not directly threatened by Trump, are separate from the ones that help consumers with their out-of-pocket costs.\u003c/p>\n\u003cp>About 650,000 Covered California enrollees, or nearly half the exchange’s total enrollment, benefit from the cost-sharing reductions.\u003c/p>\n\u003cp>Those reduced rates are available only to Covered California enrollees who choose silver-level plans and whose annual income falls between 139 percent and 250 percent of the federal poverty level — about $34,200 to $61,500 for a family of four.\u003c/p>\n\u003cp>The exchange can’t wait too long before determining which rates consumers will face in 2018. State regulators need at least 60 days to review the rates, and Covered California and health plans also need to time to prepare for open enrollment, which begins Nov. 1.\u003c/p>\n\u003cp>Current enrollees will have the option to start renewing their plans sometime in October, said Covered California spokeswoman Lizelda Lopez.\u003c/p>\n\u003cp>Covered California also plans to create a new silver plan to be sold on the exchange for individuals and families who make too much money to qualify for tax credits and cost-sharing reductions. The surcharge will not be applied to that plan.\u003c/p>\n\u003cp>Covered California started offering plans in 2014. In the following two years, the agency successfully negotiated 4 percent average premium increases, far below the double-digit rate hikes that were the norm before the federal health law. That streak ended this year when rates shot up.\u003c/p>\n\u003cp>All of the rates are subject to state regulatory review and public comment. But neither of the state’s insurance regulators, the Department of Managed Health Care and Insurance Commissioner Dave Jones, has the authority to block the hikes.\u003c/p>\n\u003cp>The expansion of coverage under the Affordable Care Act has driven the percentage of uninsured Californians to a record low. The proportion of Californians lacking health insurance was 7.1 percent last year, down from 17 percent in 2013, before the coverage-expanding provisions of Obamacare began, federal data show.\u003c/p>\n\u003cp>The expansion of Medi-Cal, the state’s Medicaid program for lower-income residents, accounts for a significant part of that reduction. About 3.8 million Californians became eligible for Medi-Cal coverage under the Affordable Care Act. Total enrollment is 13.5 million, or about a third of the state’s population.\u003c/p>\n\u003cp>\u003cem>Chad Terhune contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/360142/covered-california-expects-12-5-average-rate-rise-in-2018","authors":["byline_stateofhealth_360142"],"categories":["stateofhealth_15","stateofhealth_14"],"tags":["stateofhealth_368","stateofhealth_2519","stateofhealth_365"],"affiliates":["stateofhealth_3036"],"featImg":"stateofhealth_23937","label":"stateofhealth_3036"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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You ask the questions. You decide what Bay Curious investigates. 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Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.","airtime":"THU 10pm, FRI 1am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.commonwealthclub.org/podcasts","meta":{"site":"news","source":"Commonwealth Club of California"},"link":"/radio/program/commonwealth-club","subscribe":{"apple":"https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2","google":"https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw","tuneIn":"https://tunein.com/radio/Commonwealth-Club-of-California-p1060/"}},"considerthis":{"id":"considerthis","title":"Consider This","tagline":"Make sense of the day","info":"Make sense of the day. Every weekday afternoon, Consider This helps you consider the major stories of the day in less than 15 minutes, featuring the reporting and storytelling resources of NPR. Plus, KQED’s Bianca Taylor brings you the local KQED news you need to know.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Consider-This-Podcast-Tile-703x703-1.jpg","imageAlt":"Consider This from NPR and KQED","officialWebsiteLink":"/podcasts/considerthis","meta":{"site":"news","source":"kqed","order":"7"},"link":"/podcasts/considerthis","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1503226625?mt=2&at=11l79Y&ct=nprdirectory","npr":"https://rpb3r.app.goo.gl/coronavirusdaily","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM1NS9wb2RjYXN0LnhtbA","spotify":"https://open.spotify.com/show/3Z6JdCS2d0eFEpXHKI6WqH"}},"forum":{"id":"forum","title":"Forum","tagline":"The conversation starts here","info":"KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.","airtime":"MON-FRI 9am-11am, 10pm-11pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED Forum with Mina Kim and Alexis Madrigal","officialWebsiteLink":"/forum","meta":{"site":"news","source":"kqed","order":"8"},"link":"/forum","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/kqeds-forum/id73329719","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz","npr":"https://www.npr.org/podcasts/432307980/forum","stitcher":"https://www.stitcher.com/podcast/kqedfm-kqeds-forum-podcast","rss":"https://feeds.megaphone.fm/KQINC9557381633"}},"freakonomics-radio":{"id":"freakonomics-radio","title":"Freakonomics Radio","info":"Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. 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How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.","imageSrc":"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png","officialWebsiteLink":"https://www.npr.org/podcasts/510313/how-i-built-this","airtime":"SUN 7:30pm-8pm","meta":{"site":"news","source":"npr"},"link":"/radio/program/how-i-built-this","subscribe":{"npr":"https://rpb3r.app.goo.gl/3zxy","apple":"https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2","tuneIn":"https://tunein.com/podcasts/Arts--Culture-Podcasts/How-I-Built-This-p910896/","rss":"https://feeds.npr.org/510313/podcast.xml"}},"inside-europe":{"id":"inside-europe","title":"Inside Europe","info":"Inside Europe, a one-hour weekly news magazine hosted by Helen Seeney and Keith Walker, explores the topical issues shaping the continent. No other part of the globe has experienced such dynamic political and social change in recent years.","airtime":"SAT 3am-4am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Inside-Europe-Podcast-Tile-300x300-1.jpg","meta":{"site":"news","source":"Deutsche Welle"},"link":"/radio/program/inside-europe","subscribe":{"apple":"https://itunes.apple.com/us/podcast/inside-europe/id80106806?mt=2","tuneIn":"https://tunein.com/radio/Inside-Europe-p731/","rss":"https://partner.dw.com/xml/podcast_inside-europe"}},"latino-usa":{"id":"latino-usa","title":"Latino USA","airtime":"MON 1am-2am, SUN 6pm-7pm","info":"Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg","officialWebsiteLink":"http://latinousa.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/latino-usa","subscribe":{"npr":"https://rpb3r.app.goo.gl/xtTd","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/Latino-USA-p621/","rss":"https://feeds.npr.org/510016/podcast.xml"}},"live-from-here-highlights":{"id":"live-from-here-highlights","title":"Live from Here Highlights","info":"Chris Thile steps to the mic as the host of Live from Here (formerly A Prairie Home Companion), a live public radio variety show. 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Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.","airtime":"MON-FRI 3am-9am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/morning-edition/","meta":{"site":"news","source":"npr"},"link":"/radio/program/morning-edition"},"onourwatch":{"id":"onourwatch","title":"On Our Watch","tagline":"Police secrets, unsealed","info":"For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. 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