Covered California Board Update

Here’s a report from today’s Covered California board meeting from our director of Administrative Advocacy, Elizabeth Abbott:

The Big Headline News  There was much hoopla at the Covered CA Board meeting this afternoon to mark their successful enrollment of more than a million people in the California Exchange. . .1,018,315 to be exact.  There were congratulations all around to Exchange staff, health plans, brokers/agents, enrollment counselors, hospitals, health professionals, clinics, advocacy organizations, community groups and others for this accomplishment.  These numbers exceeded projections of enrollees, using even the most optimistic estimates.  California is miles ahead of other states in enrollment and comprising a huge chunk of all of the enrollment nationally.  To put this in context, for example:

  • Ohio, although a state with about a third of the population of California, has enrolled only 78,000 people to date.
  • If you rank order LA County enrollments separately, they would rank fourth highest compared to the other 50 states in the U.S.

This is no small achievement—and we still have 11 days left through the end of the month.  People can still purchase insurance through the end of the first open enrollment period on March 31, 2014. 

There was also some encouraging information regarding eligibility and demographic groups within California.  Specifically,

  • 87% of the people who enrolled in Covered CA were eligible for subsidized coverage. 
  • There was a whopping increase in Latino enrollment from 18% of the total for the first three months of the open enrollment to 32% so far in March. 
  • Waiting times to talk to a customer service representative have gone down because of an increase in staff, phone lines, and hours of operation, although they admitted they were not yet meeting their standards. 
  • More counties have met their geographic targets, with the lead awarded to the Greater Bay Area where more than twice the number of people have enrolled than were projected.  Two counties have improved their enrollment numbers, but are still a little behind—Fresno and San Bernardino counties. 
  • All age groups have met their targeted enrollments, except for those in the 18-25 year olds as calculated through the end of February. 

While all speakers spoke enthusiastically about these accomplishments, there were comments and cautions as well.

  1. Medi-Cal does not have a limited open enrollment period—it is open year ‘round—so eligible people should continue to apply for Medi-Cal by contacting their county of residence or calling the Exchange to sign up.
  2. Many advocates emphasized that although the general enrollment period ends on March 31, many people would be eligible for a “special enrollment period” when they experience a change in their life circumstances.  When that happens, for example, losing employer-based health insurance, consumers should promptly contact the Exchange to see if they can qualify to enroll at that time.  Many advised the Exchange that their work will largely continue even after the open enrollment period ends, “so don’t send all your staff home on April 1!”
  3. Many see the transition coming from enrolling for coverage to utilization of health care.  There is more education to do for some enrollees who have never had health insurance before, including how to access a provider and what some confusing insurance terms mean, such as “deductibles” and”co-insurance.”
  4. Board members and advocates urged the Exchange staff to carefully analyze what outreach and marketing worked—and which did not—in order to make the best use of their resources as we approach the 2015 open enrollment period in November.
  5. The Exchange will be placing emphasis on the accuracy and standardization of their Provider Directories, which are not currently available online.  Many consumers use them as guide as to whether their physician or clinic is part of a plan’s network and so these directories are critical for their selections.  Many acknowledged confusion resulting from using different names for the same health systems and providers offered by the same plans inside and outside of the Exchange or among different plans regarding the same facilities.

A Preview of Coming Attractions

There was some discussion of things to be discussed at the next Covered CA board meeting in April.  They included:

  • Proposed 2015 Standard Benefit Designs—The Exchange staff emphasized stability and consistency for the 2015 plans in line with the 2014 offerings—without wholesale changes.
  • Certified Application Counselor Regulations will be unveiled.
  • The Exchange staff is exploring the possibility of including a Family Dental Benefit and will offer what that might look like for 2015.
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