The cost of the individual mandate is nothing compared to the cost of a decent health insurance plan. People are not enrolling in health insurance because it is too damn expensive. I don’t know what percentage of the decline in new enrollments for Covered California is due to expensive health insurance and they don’t know either. Talk to any health insurance agent they will tell you they fielded many calls from consumers wanting a lower rate on health insurance. They were willing to take anything, even if crappiest of plans if they could just afford it. I don’t sell them, but I had to inform people of the health care sharing ministries. These health care sharing plans are not insurance, but they can seem like a health plan for half the cost of a Covered California plan. How many people enrolled in these health care sharing plans and by-passed Covered California and the off-exchange plans altogether?
If a consumer does not like their plan or rate, they must make changes to their account and actively renew their coverage by December 15th for a plan effective date of January 1, 2019. Changes to the account and plan selection between December 16th and January 15th will have an effective date of February 1, 2019.
For individuals transitioning into Medicare in 2019 they will see a higher Part B premium. The new Part B premium will be $135.50, up from $134.00. Many Medicare beneficiaries already in Medicare will not pay the full Part B premium because certain provisions limit the Part B premium increase to be no greater than the increase in their Social Security benefits.
Health Net is making it easier to add adult dental and vision to their off-exchange plans. They call the added dental and vision benefits the Plus package. For the EnhancedCare PPO, PureCare EPO, and PPO plans the Plus package of dental and vision benefits is $14.42 per adult. The maximum dental benefit per year is $1,000. Instead of a member cost-sharing percentage these plans have a fee schedule. For example, a filling on one tooth would be $22.
The big change for the Gold plan was an increase in the MOOP from $6,000 in 2018 to $7,200 in 2018. That is a 16% increase. Before 2018, the Gold plans did not make a lot of financial sense considering they were so much more expensive than Silver plans. In 2018 the Gold plan MOOP was reduced to $6,000 and the Silver plans offered through Covered California were artificially inflated by approximately 10%. This meant for consumers receiving very little monthly tax credit subsidy, they were better off enrolling in a Gold plan because for some carriers the rate was less than the Silver plan.
Covered California takes a dig at the federal government correctly pointing out that rate increases, because of the removal of the individual mandate, means the subsidy amounts for consumers in Covered California will increase, “…the federal government will end up paying an estimated $250 million more in higher tax credits.” The loss of consumers will also impact Covered California. They estimate that enrollment in Covered California could decrease by as much as 162,000 individuals. Covered California is funded by a health plan fee for every member who enrolls through Covered California.
The increased revenue is also in light of reducing health plan assessment from 4% of the gross premiums down to 3.75% for the individual and family plan market. The proposed operating budget for FY 2018-19 is $340.2 million. This represents a 6.55 increase over the FY 2017-18 budget or an increase of $20,686,242.