FOR IMMEDIATE RELEASE Dana Howard: Dana.Howard@hbex.ca.gov February 13, 2013 Media Line: (916) 205-8403 No Gimmicks, No Surprises – Standard Benefits Covered California Announces Standard Benefit Plans for Consumers SACRAMENTO, Calif.
Californians who must pay for their own health insurance are getting their first detailed look at what health care reform will truly offer. Covered California, the state run program that oversees implementation of the Affordable Care Act, is releasing the standards for benefit plans that will be made available to California citizens who do not rely on employer provided insurance or Medi-Cal for health care coverage.
“The most important aspect of these benefits is they are standardized and they are adjusted according to income to lower costs for those with lower incomes,” said Peter V. Lee, Executive Director of Covered California. “Standardization is a game changer. It lets consumers shop from one insurance provider to the next, knowing that the benefits are the same. This is about removing barriers to care; about changing the focus of health insurance on prevention and on taking care of the sick.”
“Covered California is leading the way for consumers to make apples to apples comparisons when choosing health coverage,” said James Guest, President and CEO of Consumers Union. “Not only can consumers no longer be denied due to pre-existing conditions, they know there will be no surprises or gimmicks, and the benefits are the same from one carrier to the next.”
Consumers have four levels of plans from which to choose – Bronze, Silver, Gold and Platinum. Households earning less than 250 percent of the federal poverty level can receive financial help if they enroll in a Silver plan; the less income they earn, the more financial assistance they can receive. For example, individuals earning between 150 to 250 percent of the federal poverty level can expect to pay $20 to see their primary care physician, while those earning 100 to 150 percent would pay $4.
“California has clearly learned from our experience. Massachusetts launched its health insurance exchange without standardizing benefits, but changed course after recognizing that allowing consumers to make apples-to-apples comparisons among plan options is critical to their ability to make informed decisions about what health plan satisfies their needs and meets their budget.” said Jean Yang, Executive Director of Massachusetts Health Connector.
To be eligible for financial support, consumers must purchase plans from Covered California’s
marketplace. The State of California is leading the health care innovation process by requiring that
all carriers offer these same standard designs to all individuals and small businesses – whether inside
or outside of Covered California.
While higher income individuals choosing one of these plans would
not be eligible for financial help, they would be assured that the plan contains the same essential
health benefits offered, and the exact same benefit design so they can make true comparisons.
Covered California also announced it has launched a social media presence on Facebook, Twitter,
YouTube and Google+.
Critical next steps in the launch of Covered California include the selection of insurance carriers that
will be allowed to participate in Covered California, and determination of the plan pricing.
About Covered California
California is the first state to create a health benefit exchange following the passage of federal health
Covered California is charged with creating a new insurance marketplace that allows
individuals and small businesses to purchase competitively priced health plans using federal tax
subsidies and credits. Coverage starts in 2014.
Covered California is overseen by a five-member board appointed by the Governor and Legislature;
the California Health and Human Services Secretary serves as an ex officio voting member and is its
Thursday, February 21, 2013
Thursday, February 14, 2013
ORANGE COUNTY REGISTER During his State of the Union address, President Barack Obama contended that "already the Affordable Care Act is helping to slow the growth of health care costs." Yet the costs of health insurance continue to climb, a direct consequence of the Affordable Care Act, and many uninsured Americans are likely to remain that way. Health insurers are pushing double-digit premium increases, some as high as 26 percent. Next year, when the Affordable Care Act's requirement to have insurance takes effect, premiums are expected to rise further, and many young Americans will have to choose between buying health insurance or paying a penalty. Although proponents of the law argue that subsidies will entice younger people to buy insurance, it actually is expected to have the inverse effect. Subsidies are too small, and out-of-pocket costs for insurance are much higher. For many young Americans, it makes more sense – although it has negative impacts on the overall health care system – to wait until they are very sick to purchase insurance, since they can't be denied coverage due to a pre-existing condition – or to seek to qualify for so-called "free" insurance, such as Medicaid (called Medi-Cal in California). And the penalty alternative is so much less expensive than the cost of health insurance that the majority of people purchasing insurance figure to be older and less healthy. Younger Americans won't want – or won't be able to afford – to spend so much on health care. It will be young, healthy Americans, therefore, who will tend to become the losers. "If young adults can't afford health insurance policies available in 2014 under the health care law, state insurance officials are worried they won't buy them. And that could drive up the cost of insurance for the mostly older, sicker people who do purchase coverage," notes Kaiser Health News, published by a foundation related to the large health insurer Kaiser Permanente. Higher payroll taxes and taxes on medical devices have now been implemented – yet President Obama wants more "modest" reforms. "Obamacare distorts the marketplace," Joel Hay told us; he's a health economist at the USC Schaeffer Center for Health Policy and Economics. "It takes a broken system and pours gasoline on the fire." Health expenditures in the United States in 2010 were estimated at $2.6 trillion – more than 10 times the $256 billion spent on health care in 1980. The U.S. spends $7,000 per person, 16 percent of gross domestic product, on health care every year. Yet Americans have a life expectancy slightly below average compared with countries that make up the 30 democracies in the Organization for Economic Cooperation and Development, despite spending more than any other OECD nation. Ultimately, one of the major root causes of health care inflation is the lack of competition in medical services. Obamacare, looking like another runaway entitlement program, fails to keep those costs down while pushing Americans in the direction of a government-run system, largely due to skyrocketing premiums for private insurance. And many of those who should be buying insurance at affordable rates in the event of an emergency – young and generally healthy Americans – will be unable or unwilling to do so.