Preliminary Reports on Covered California Premiums and Plan Participation

Preliminary Reports on Covered California Premiums and Plan Participation


Covered California released its initial report on premiums, premium assistance and plan participation for the coming year (2020). Premiums are down; plan participation is up; coverage is more affordable, and subscriber participation is expected to increase.


The premiums, plans and premium assistance are all in the individual market, not the employer market. This covers about 1.2 million subscribers in Covered California and 1 million subscribers who buy in the individual market outside Covered California.


The average premium increase is 0.8%, a welcome change from the average premium increases of 7.9% over the past five years. This is due in part to recent program changes made by the Governor and state legislature – the reinstitution of a state tax penalty for those who fail to enroll, and the increases in state premium assistance for moderate and middle income individuals and families.


Over 900,000 individuals and families will experience an increase in premium assistance in the coming year due to California’s first in the nation expansion of state premium assistance. Over 200,000 are persons with incomes between 400% and 600% of FPL (about $155,000 for a family of four) who will for the first time qualify for state premium assistance to help pay their premiums.


All eleven health plans are continuing to participate and Anthem Blue Cross is rejoining the program in the Central Valley and Los Angeles regions. 99.6% of customers will have a choice of two plans and 87% will have a choice of three plans.


The restoration of individual responsibility/the mandate/the tax penalty is projected to decrease plan premiums by 3.5% as a healthier population will be enrolling as a result.


What a difference it makes to have a Governor who embraces expanded coverage in stark contradistinction from a President who seeks to repeal the important progress being made under the ACA (Affordable Care Act) and curtail federal premium assistance to low, moderate and middle income Americans.


Prepared by: Lucien Wulsin

Dated: 7/11/19


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