Kevin Knauss: Health, History, Travel, Insurance
When Covered California decided to force health insurance companies to cancel their policies on December 31, 2013, they set in motion a cascading effect that have left many new plan members without access to prescription drug coverage. At least two pharmacies have recognized the problem and are offering help to cover vital prescription medications to new Affordable Care Act health plan members that have yet to received neither member ID numbers nor an invoice.
Consumers are growing frustrated as they find their current doctors aren’t included in new Covered California individual and family plan (IFP) health insurance networks. There is also widespread uncertainty about the rules of in-network providers with the new Exclusive Provider Organizations (EPOs) and California’s new 19 pricing regions. When California consumers are craving information the doctors have been silent and the insurance companies along with Covered California are providing scant information.
Covered California had high expectations for 21st century e-commerce technology but agents and consumers have resort to 19th century pen and paper. There has been an avalanche of paper applications into Covered California significantly slowing down the verification and enrollment process. The sluggish processing of applications means that some families may not have insurance coverage on January 1, 2014 as promised.
The Affordable Care Act and Covered California have made it very clear that undocumented immigrants can not purchase health plans through the new market place or receive tax credits to reduce monthly health insurance premiums. There are a number of different categories of immigrantion status that do qualify individuals and families to receive premium assistance to help pay for health insurance.
People and families from across the Sacramento region descended upon the Coffee Garden to help launch the outreach and educational campaign for the Affordable Care Act this past Sunday, August 4th. The local chapter of Organizing For Action in conjunction with UCDavis Health Systems presented an overview of the Covered California state health insurance marketplace organized under the health care reform legislation known as Obamacare.
The 2026 asset test will be $130,000 and $65,000 for each additional household member. In other words, a single adult with assets over $130,000 will not qualify for Non-MAGI Medi-Cal. A married couple with assets over $195,000 will be ineligible for Non-MAGI Medi-Cal for either individual.
The monthly insurance premium for Part B of Medicare is $185 for individuals who had earned less than $106,000 or $212,000 for a married couple filing a joint federal income tax return. As the household income increases, the insurance premium for Part B increases. For individuals who earned over $500,000, the Part B premium is $628.90 per month for 2025. Remember that the monthly premiums are per person. If a married coupled earned over $750,000 and are eligible for Medicare, each person will pay $628.90 for Part B.
For a married couple, they can earn up to $2,433 per month and still qualify for MAGI Medi-Cal. This represents a 3.44 percent increase from 2024. MAGI Medi-Cal is the expanded Medi-Cal for low-income adults between the ages of 19 and 64 years of age.
If California congressional Republicans vote to repeal the Affordable Care Act and with its expanded adult Medi-Cal access, they will be irrevocably injuring thousands of their own constituents. Not all Medi-Cal programs that provide assistance to Medicare beneficiaries, children, and their caretakers are intertwined with the ACA. However, we all know that an accident or illness that befalls a household’s primary wage earner can lead to cascading effects for the whole family. Medi-Cal helps people bounce back after an accident or illness to support the whole family.
Fourteen years ago, when I changed careers to insurance, my net revenue for the first two years was zero. It wasn’t until 2014, after I had exhausted my retirement funds, that I was making enough money to pay the bills with a net income of $21,724. I never imagined my net revenue would hit six figures and 2024 may be my peak revenue year.
