Thursday, February 9, 2017

California's Real World Experience Informing the National Debate

In the midst of the national discussion of what is next for the Affordable Care Act, Covered California just wrapped its fourth open enrollment period. Once again we’ve shown that when you thoughtfully foster market forces — powered by consumers with the financial help they need — you can build a healthy market.

We finished open enrollment with 412,000 new consumers selecting a plan, including nearly 50,000 who signed up over the last two days. In addition, the number of young adults in the 18-to-34-year old demographic continues to remain a strong source of plan selections, giving Covered California a good mix of younger and older consumers, which helps keep rates down for everyone and keeps the entire individual market stable. We also reported, that using federal methodology, counting both new and renewing enrollees, Covered California closes Open Enrollment with over 1.5 million consumers. You can read the entire release here.

During my time traveling across the state, I have had the honor of meeting many of our consumers and hearing their stories. Whether it was about a diagnosis that led to early treatment, or receiving access to medication that allowed them to get back on their feet, I heard how Covered California is working and improving lives. You can see some of their stories here. I encourage you to watch these stories, share them, and let us know if you or someone you know may have a story of their own to tell.

While we continue to work on the day-to-day operations at Covered California, we are also engaged in the national discussion surrounding health care. With a new President and Congress in place, there are plenty of politics in play. The politics, however, are not our concern. What IS our concern is that we believe Covered California has a responsibility to communicate our lessons learned and how a successful model, using market-based solutions, can provide affordable coverage and access to high-quality care.

In California, we have built a competitive market where the consumer is in the driver’s seat, where patient-centered plan designs increase a consumer’s ability to access care and we have committed to an extensive marketing campaign, which has helped us enroll the healthiest mix of consumers in the nation. We believe that policymakers around the nation can benefit from our real world, on-the-ground experiences in making a health care market work for consumers.

We are actively tracking what is happening in Washington D.C. and looking for opportunities to engage constructively in the national discussion in the weeks, months and years ahead. With that goal in mind, to inform the national discussion, Covered California is regularly issuing reports that can support that discussion being better anchored in facts. Three of those that were recently released are:
  • An Integrated Quantitative and Qualitative Study on Post-Election Attitudes Toward Enrolling in and Renewing Health insurance Coverage Covered California commissioned a post-election survey and focus groups, conducted by Greenberg Strategy, of consumers eligible for coverage — new and renewing. The studies found that while consumers eligible to enroll have some concern about future of the Affordable Care Act, their big concern is finding coverage that is affordable. Covered California used this information as we went into our big marketing push in January — and the lessons were borne out by our big new enrollment and renewal numbers.
  • Consumer and Market Implications of Affordable Care Act Repeal Without a Viable Replacement Covered California issued a report that examined the potential consumer and market impacts should a “repeal” of the Affordable Care Act occur without viable changes to transition consumers, health plans and providers to new arrangements. The report makes clear that absent a clear path forward, the individual market — for both those who do and do not receive subsidies — would be in jeopardy, with millions facing immediate loss of coverage.
  • Evaluating the Potential Consequences of Terminating Direct Federal Cost-Sharing Reduction (CSR) Funding Covered California commissioned a study by researchers at the University of California, Los Angeles to assess what would happen if federal officials eliminated direct federal funding to reduce cost sharing that currently benefits more than 50 percent of consumers in Covered California. This study was done to help Covered California plan for potential policy changes in 2018 and found such a policy change would lead to sharp increases in premiums for products at the “Silver tier” (the most popular level selected), while also resulting in approximately 30 percent higher costs for the federal government which would pay these costs under the Advanced Premium Tax Credit.
Covered California is pursuing these educational efforts because we believe we must be constructively engaged in the process of exploring ways to improve and repair the Affordable Care Act, so it works as well as it can for Californians and all Americans. As

we look at the policies being proposed at the federal level we will examine how the policies impact consumers and how they impact coverage, affordability, access to care and consumers’ health status and the economic impact on federal and state budgets, employers and providers.

As major changes in federal policy occur, we will keep our consumers informed. We look forward to both being part of shaping the future of health care and to being nimble, flexible and transparent as we continue our efforts to build a health care system that puts consumers at its center.