Covered Cal not waiting for federal guidance

Despite the uncertainty of the Affordable Care Act’s future in Washington, Covered California’s Board of Directors took action last month to promote stability in the state’s individual health-insurance market.

Although the U.S. Congress did not repeal the ACA, the Trump administration has not made any long-term commitments to continue funding the educational and enrollment activities. At the end of August, the Centers for Medicare and Medicaid Services announced that the funding for advertising the new enrollment periods would be only $10 million compared to $100 million in 2016.

CMS argues that the number of enrollees has been declining. In a press release announcing the reduced funding, the agency stated that during last year’s sign up period, “… first-time enrollment declined by 42 percent and effectuated enrollment declined by approximately 500,000 individuals.”

However, Covered Cal decided to move in the opposite direction to encourage more individual enrollment in the state’s health-insurance program.

The Covered Cal board has increased its advertising budget and plans to “increase the number of television and radio ads around key dates throughout the upcoming open-enrollment period.”

Also, Covered Cal’s enrollment period will be Nov. 1 to Jan. 31, 2018. That is twice the length of the federal open-enrollment period, which ends Dec. 15, 2017.

And, the Covered Cal board is developing options for insurers to recover costs associated with the uncertainty of plans and federal reimbursement this year. This includes amending its contracts with carriers to promote participation and lower prices in 2018 by allowing for multi-year adjustments to their margins.

“The lack of clarity and direction at the federal level continues to be a challenge, and Covered California is doing everything it can to stabilize the market and protect consumers,” said Peter V. Lee, executive director of Covered Cal. “A stable market is critical for millions of consumers, and Covered California is showing how it can be done.”

A bi-partisan group of U.S. senators on the Senate Health, Education, Labor and Pensions Committee held hearings last week and this week in hopes of finding common ground to fortify the ACA program for the next year or two.

Chairman Lamar Alexander (R-Tennessee) said as the hearings began, “If Congress acts quickly we can limit increases in premiums in 2018; continue support for co-pays and deductibles for many low-income families; make certain that health insurance is available in every market; and lay the groundwork for future premium decreases.”