Kevin Knauss: Health, History, Travel, Insurance
Posts on the development and implementation of the California health insurance market place, application, account, enrollment, termination.
It is counterintuitive, but for 2022, increased competition in the health insurance market for Contra Costa County will increase the premiums for Covered California members in the region. How is this possible? The subsidies are based on the Second Lowest Cost Silver Plan. Bright HealthCare, a new health plan, will offer Silver plans in 2022 […]
The new 2022 California Premium Credit Program covers the cost of said rule so that anyone who had a $1 monthly charge, will now have a $0 premium for their health insurance. Of course, the credit could not apply just to people were being charge only $1, everyone must receive the special $1 dollar bonus.
I’m sure many consumers will welcome the passive switch from a Bronze plan to a Silver 94 without having to pay anything more for the health insurance. An equal number of individuals will be perturbed that Covered California assumes they can unilaterally make decisions about a person’s health insurance with no consent from the effected member.
This same couple, based on 2021 rates, would have had a monthly subsidy of $788.47. If the couple were enrolled in the second lowest cost Silver 94 plan at $2 per month in 2021 – with the removal of the unemployment benefit – their new monthly premium will be $566 in 2022, that is a 28,000 percent increase. Plus, they will revert to a standard Silver 70 plan with higher cost-sharing.
I’ve been following the California Health Benefits Exchange and Covered California since their inception. They really have delivered on their mission to administer the Affordable Care Act subsidies to consumers. They have not become a black hole of taxpayer money to fix rotten and decaying computer systems. They have not become a cesspool of nepotism and cronyism that has characterized some California agencies. They have not become famous for indiscreet and corrupt employee expenses for parties and trips to Hawaii.
In this example, the annual amount of the SLCSP is $15,000. The consumer fair share dollar amount of $8,500 is subtracted from the $15,000 to yield a Premium Tax Credit amount of $6,500. The difference of $6,500 is divided by 12 to get a monthly Advance Premium Tax Credit subsidy of $541.67 per month.
The ceremonial announcement of health insurance rate changes, usually a modest increase, is meant for the consumption of politicians, elected officials, regulators, special interest groups, and the media. You know, all those people who have group health insurance and are not subject to the vagaries of the ACA subsidy calculation. The reality of what most consumers pay for their health insurance through Covered California is far more complicated than a celebratory press briefing announcing a 1.8 weighted average percent increase.
The unemployment subsidy benefit further increased the subsidy. Because everyone was now eligible for the Enhanced Silver 94 plan, we switched this member from the Gold to the Silver plan. The new subsidy of $1,016.53 dropped the health plan rate to $1 per month. The better member cost-sharing for copayments and coinsurance will save the family even more money.
Adverse selection is wanting to enroll in health insurance under adverse conditions. The health plans, and society in general, wants everyone in the insurance pool from the beginning. When people climb out of the pool – drop coverage after getting treatment – the big health care bills must be covered by the remaining people in the pool. That raises the rates for everyone in the pool, and that’s not fair.
Covered California will begin processing the extra subsidy increase for applications that indicate unemployment benefits on June 21, 2021. The unemployment insurance benefit could have been for just one week in January. The household income will be taken down to 138.1 percent of the federal poverty level, regardless of the income estimated by the consumer. The 138.1 percent income level will prevent adults from being automatically determined eligible for Medi-Cal. The new subsidy will be based on the lower income and applied to the health insurance premium.
