As a journalist I’ve covered the Affordable Care Act on and off since it was a gleam in President Obama’s eye. The melodrama of the fierce legislative fight; the subsequent relentless attacks against it; the Supreme Court case; and the catastrophic rollout of healthcare.gov — good times for the news media, though not necessarily the American public.
My first unwelcome surprise came when I input all my information, and the system told me I wouldn’t get a subsidy despite the fact that I knew I was eligible.
But of course, the difference between covering something as a journalist and experiencing it as a citizen is substantial. Last year, in part for health reasons, I gave up my full-time job with KQED News. No more long hours: check. No more crazy deadlines: check. No more health insurance: check … my blood pressure. Because our COBRA costs were going to be astronomical, like 40-percent-of-income astronomical. And my health history rendered me uninsurable on the individual market. At least, on the old insurance market.
All of this made me one of the many poster-children for Obamacare, under which insurance companies, starting Jan. 1, would be required to insure my middle-aged ass, and the government was going to help pay for it to boot. Whether this is a victory for common sense and decency, the end of democracy as we know it, or simply a bad idea, I couldn’t say — and still can’t. I only know that the only rational financial decision, personally, was to try getting an exchange plan through Covered California. Continue reading
Mark Chekal-Bain, district director for Assemblywoman Nancy Skinner (D-Oakland), discusses the benefits of the Affordable Care Act at Lifelong Medical Health Center in Oakland. (Lisa Aliferis/KQED)
“California is open for business,” crowed Mark Chekal-Bain at an event hosted by Lifelong Health Center, a medical clinic in downtown Oakland. Chekal-Bain works with Assemblymember Nancy Skinner (D-Oakland).
Tuesday is D-Day for Covered California. At 8 a.m., the marketplace is scheduled to open for enrollment, more than three-and-a-half years after passage of the Affordable Care Act. Even if Congress can’t come to agreement about the federal budget, the federal government will only partially shut down. The marketplaces will open as scheduled.
“We will be enrolling people into affordable health care,” Chekal-Bain said, including Medi-Cal and private insurance plans available on the marketplace. “All of us at the local, state and county levels are committed to helping you.”
[Related: Covered California Is Now Open, Has First Enrollee]
A handful of government types and advocates spoke, but perhaps the most moving was Amy Shrago. She’s a legislative analyst with Alameda County Supervisor Keith Carson, but she has a personal connection to Obamacare. Continue reading
The full implementation of Obamacare and (potentially) millions more insured is now just over 100 days away, on Jan. 1. Questions abound: Will young, healthy people really sign up? How much will my premium be? How does the Affordable Care Act work anyway?
Floating around in all those Obamacare discussions is another question: Who is going to treat all the newly insured? After all, we already have a shortage of primary care doctors. Out of 7 million uninsured in the state, Covered California estimates 1.4 million people could sign up for insurance next year. Plus another 1.4 million people will be newly eligible for Medi-Cal.
To address this question, San Francisco’s Commonwealth Club invited me to moderate a discussion about the shortage of primary care providers. Kevin Grumbach, a family physician and co-director at UC San Francisco’s Center for Excellence in Primary Care, started off by defining the subject at hand. Continue reading
Editor’s Note: This post is part of a regular column from Emily Bazar with the CHCF Center for Health Reporting. Bazar answers consumers’ questions about Obamacare.
Q: If my family of six qualifies for Medi-Cal under the Affordable Care Act, do we have to sign up for that? Or can we still buy subsidized health care plans through Covered California? … I have real concerns about the quality of care we would get on Medi-Cal. I’m hoping for a positive answer!
A: Sadly, I’m about to disappoint Beth from Modesto and others in her situation.
Medi-Cal is the state’s publicly funded health program for low-income and disabled residents, and currently provides care to more than 8 million Californians. (It is the state’s version of the federal Medicaid program.)
Starting in January, Medi-Cal will broaden its eligibility requirements as a result of Obamacare, allowing applicants with higher incomes and those who were previously ineligible, such as childless adults, to get coverage.
But whether you’re eligible for Medi-Cal now or become eligible then, that fact alone disqualifies you from tax subsidies on the health insurance marketplace, which is called Covered California.
Covered California will offer 13 health plans across the state (not all in each region) that cover a standard set of benefits. Individuals and families who earn between 138 percent and 400 percent of the federal poverty level will be eligible for sliding-scale tax credits to purchase those plans. Continue reading
By Dan Diamond, California Healthline
United Healthcare has more than 4,700 hospitals in its national network.
Valley Health Plan has four, all located in Santa Clara County.
That relative scale is one reason why United’s departure from California’s individual market last week got so many headlines — even though United only covers 8,000 people in the state — while the news of Valley’s inclusion in Covered California last month got almost none.
And on the surface, the thought of losing the nation’s largest health insurer doesn’t seem to augur much good for the Golden State’s health reform efforts. Especially in the wake of Aetna’s similar announcement last month.
But take the glass half-full approach, a handful of experts say: Think about who’s stepping in to fill the void. Continue reading
(Photo: David McNew)
The Obama administration announced Tuesday afternoon that the federal health law’s employer mandate, which requires large employers to provide health insurance to full-time workers or pay a fine, has been delayed for one year.
Other key elements of the Affordable Care Act will stay in place, such as the individual requirement to have health insurance and the new marketplaces, such as Covered California.
The administration’s announcement cited “concerns about the complexity of the requirements and the need for more time to implement them effectively” as the reason for the change.
“As far as Covered California is concerned, we don’t see this affecting our implementation of the exchange.”
“This is a wise, sensible and pragmatic decision on the part of the administration,” said Bill Kramer, executive director for national health policy at the Pacific Business Group on Health, a large employer group focused on health care. He called the reporting requirements an “administrative burden” on businesses, and said this delay “allows both the administration to simplify reporting requirements and allows employers more time to put in place their own systems to insure to insure that they can meet those reporting requirements.” Continue reading
By Julie Small, KPCC
The state’s health insurance marketplace, Covered California, authorized a set of benefits months ago that included dental care for children, but now the marketplace is telling insurance companies to strip out the dental coverage. People would then have to pay extra for a dental plan for their children.
California’s insurance commissioner Dave Jones warns the move could reduce children’s access to dental care and urged Covered California to include the benefit in plans that will be sold when the marketplace formally opens October 1. The change will also drive up costs for consumers, he says.
In a June 27th letter to the board that runs Covered California, Jones says he talked with insurers that originally submitted bids to sell their products on the state’s marketplace and argues dental care is essential. “A child’s overall health and well-being requires access to dental care to ensure oral health,” he wrote.
Covered California is the state’s new health insurance exchange set up as part of the federal health law. It will open Oct. 1 and will be a place where individuals can shop for health insurance which will go into effect Jan. 1. Covered California’s website still shows pediatric dental services as a covered benefit under its health insurance plans. The Affordable Care Act does not require that health plans include dental coverage for children. Continue reading
By Mina Kim, KQED
Doreena Wong will lead a $1 million effort to educate the state’s Asian populations on the state-run insurance market Covered California.
There’s talk the Obama administration will try to enlist the help of NBA players to sell the federal health law to young men. For its part, Covered California, the state’s new health insurance marketplace, plans to spend millions on an ad blitz and social media strategy. But in a state as diverse as California, one of the toughest challenges will be reaching ethnic communities where English is a second language.
In Orange County’s Little Saigon neighborhood where suburban-style strip malls fill with Vietnamese storefronts, the Affordable Care Act isn’t top of mind.
By Jordan Rau, Kaiser Health News
A strong majority of young adults, whose participation in the health law may be key to its success or failure, strongly believe health insurance is important for them and worth the money, according to a new poll.
As California and other states — as well as the federal government — prepare new online marketplaces for people to purchase insurance this fall, the willingness of young people to buy coverage has been a topic of great uncertainty. Their participation in these marketplaces is considered crucial, since the young tend to be healthier than older people and, therefore, will use fewer medical resources, allowing their premiums to help subsidize the care of the old and sick.
Among age groups, the young are considered the hardest sell on insurance, because the coverage mandated under the 2010 health law is more comprehensive — and therefore more expensive — than the catastrophic policies that many now obtain. Young adults are considered more likely to believe they won’t suffer any horrible illnesses or injuries — a trend that has led to them being labeled “young invincibles.”
More than 71 percent of adults 30 or younger say having health insurance is “very important to them.”
The poll found some reason to believe that the young may not shun the health law requirement that they hold insurance starting next January. More than 71 percent of adults 30 or younger say having health insurance is “very important to them,” according to the poll
from the Kaiser Family Foundation. When the pollsters put the question differently by asking whether “insurance is something I need,” more than 74 percent of people under age 30 agreed. Continue reading
By Kelley Weiss, CHCF Center for Health Reporting
A proposed law seeks to close the so-called “Walmart Loophole.” (Justin Sullivan/Getty Images)
For many businesses Obamacare is downright intimidating. The requirement to provide coverage to full-time employees or potentially face thousands of dollars in fines is what’s really worrying some large companies.
Most employees at large businesses already receive health insurance through their employer. But there are still some exceptions.
Barbara Andridge is a sales associate at a Walmart near Sacramento. She’s not sure if she’s eligible for the company’s health insurance program because her hours are all over the map — from eight hours one week up to 36 hours the next.
To qualify for company benefits she says she’d have to be working at least 30 hours per week.
“We don’t support big companies that can afford health care costs for their employees simply pushing those costs onto taxpayers.”
“I really had to sit down and think about my hours and if I’m going to have enough hours to qualify to have health care all year,” Andridge says.
With no guarantee of hours Andridge decided to enroll her six-year-old son in Medi-Cal, the government health insurance program for low-income Californians. Andridge plans to apply for herself soon as well.
Some health care advocates are concerned there will be even more employees like Andridge applying for Medi-Cal once Obamacare kicks in next year. They fear companies will limit hours for workers just to avoid having to pay for their health insurance.
“Employers should not be able to skirt their responsibility simply by exploiting a vulnerability in the law,” says Steve Smith with the California Labor Federation. Continue reading