CHICO — Ten years ago, the state of California rolled out its first enrollment for health insurance under the Affordable Care Act with 17.2% of Californians uncovered. That rate has dropped to 6.6%, and with open enrollment underway for 2024, the state’s health exchange anticipates further progress.
Covered California is parlaying increased subsidies for premiums and a new program to reduce out-of-pocket costs into greater affordability and accessibility for insurance. The goal: adding to the 1.6 million already enrolled from the 1.3 million either eligible for Medi-Cal (714,000) or for Covered California subsidies (606,000). Ten percent, or 130,000, live in and around the northern Sacramento Valley.
Jessica Altman, CEO of Covered California, has spent the first month of open enrollment (which continues through Jan. 31) traveling around the state for a series of kickoff events. The last was Thursday, the final day of the month, in Redding. Apropos of the agency’s slogan for the year, Bridge the Gap, she appeared with Shasta County health leaders at the Sundial Bridge.
Altman took the job in 2022 after serving as Pennsylvania’s insurance commissioner, there an appointed state office. Speaking by phone as she headed back to Sacramento — by way of Chico, where she’d stop for lunch — Altman explained various aspects of gap-bridging. (The conversation has been condensed for length.)
Q: For bridging the gap, besides the slogan, what things might people look for this year?
A: November is our kickoff month, so this is the time of the year when any Californian who is going without coverage can come to Covered California and and explore their options and, we hope, enroll if that’s the right thing for them. An estimated 1.3 million are eligible for low- or no-cost coverage, either through Covered California or Medi-Cal, despite the fact that we’re at a record-low uninsured rate and that we’ve lowered our uninsured rate more than any state in the nation since the Affordable Care Act passed and Covered California was created.
We’re also bridging the gap in affordability because we know for uninsured Americans that affordability is the No. 1 concern. Covered California is offering the greatest level of affordability than we’ve ever offered, mostly because through the American Rescue Plan and the Inflation Reduction Act federal laws we have the highest level of premium subsidies we’ve had in years — in fact, 90% of the people we cover receive financial assistance, two-thirds of whom can find a plan for a cost of $10 or less.
But this year, with the support of Gov. Newsom and the legislature, we’re also launching a new program to bring care into range by lowering out-of-pocket costs. We have over 650,000 Californians who will be eligible for this new assistance. These people will see no deductibles for our standard benchmark plan, and many will also see lower out-of-pocket costs for things like primary care, generic drugs, emergency visits — really focusing on making sure people feel like they can access the care they need once they are covered through Covered California.
Q: Is it an access issue when people get coverage but then struggle to get into an impacted health-care system, like in this region?
A: Yeah; I think health-care workforce challenges are problematic in many places in California in different ways, certainly in urban areas but particularly in areas like Chico that are rural. We are a marketplace, so we offer a choice of plans — and they (insurers) work very hard to build provider networks that are robust. But at the end of the day, they can’t contract with providers that don’t exist.
California, in addition to the work we’re doing at Covered California, is doing a lot to invest in and try to grow our health-care workforce. In the short term, it’s about how can we maximize the providers we do have and make sure we have the best networks we can have, and also use tools like telehealth and other creative strategies to connect Californians wherever they live to the care that they need.
Q: Heading into an election year, the ACA tends to be skewered as a political football, causing anxiety. Are you feeling confident, or is this something to keep an eye on?
A: I think it is sometimes too easy to forget what our health-care system was like before the Affordable Care act, or “Obamacare” as many people call it. Tens of millions of Americans have coverage; over 150 million Americans who have preexisting conditions don’t have to worry that they’ll be completely locked out of health-care coverage, or face exclusions because or face unaffordable premiums because of their preexisting conditions. We used to have annual and lifetime caps on coverage, and I certainly don’t think Americans — and Californians — are interested in going back to a system like that.
Politics change, and as we hear what campaigns have to say, there are going to be efforts to make changes to the system we have. Here in California, we’re focused on increasing access, covering more people, making coverage better, making care more accessible (and) more equitable — we’re going to be continuing on that path, but we always have to keep an eye on what’s happening in Washington.
Q: What would you like local residents to take away from your outreach?
A: I think the key message is if you’re one of those tens of thousands in this region and 1.3 million in California who are going without coverage, health coverage may be more within reach than you think. Every year, we hear from Californians who say, “In the past, I didn’t shop; I didn’t think it was for me. I thought I made too much money (or) I assumed it was for certain groups of people and I’m not in one of those groups.”
If you don’t have coverage from another source, Covered California is here for you. We don’t have income limits; the financial assistance we offer is on a sliding scale, so the more you need, the more you get. And so many Californians who check say, “It was more affordable than I thought for someone in my circumstance.” It literally takes 30 seconds to enter four pieces of information about your household (online) and get an estimate — if you want to explore and see if it’s worth spending more time, just take that 30 seconds to do that.
Visit coveredca.com or call 800-300-1506 for enrollment and more information on Covered California.
Local coverage
• Butte County currently has 8,100 subscribers in Butte County.
• While the health exchange added plans, Anthem Blue Cross and Blue Shield of California will continue as the local insurers. Enloe Health accepts both.
• Partnership Health Plan will become the only Medi-Cal Managed Care plan in Butte County starting Jan. 1. Subscribers to either Anthem Blue Cross Managed Medi-Cal or California Health and Wellness will transfer automatically.
• Patients with questions specific to Enloe Health services can contact financial counselors at 530-332-6300.