California Health Coverage Update
This October, people whose HIV counted as a “pre-existing condition” and excluded them from health insurance will be able to enroll in health care plans through the new insurance marketplaces (formerly known as “exchanges”) created in each state under the Affordable Care Act.
Covered California, the state’s health insurance marketplace, announced yesterday the selection of 13 health plans that will be available to residents, including tens of thousands who are living with HIV.
Under the plans accessible through Covered California, the average premium (the amount individuals must pay for health insurance) is roughly $300 per month.
“Although that premium does represent a significant monthly cost for many people, it’s actually lower than advocates had feared,” observes Courtney Mulhern-Pearson, state and local affairs director for San Francisco AIDS Foundation.
In addition, Mulhern-Pearson explains, individuals with incomes below 400% of the federal poverty limit (approximately $45,000 per year) will be eligible for subsidies to help make these plans more affordable. And as indicated in the May 2013 revised budget for California, the State Office of AIDS is working to create a payment program that would cover insurance premiums and HIV drug co-pays for people who qualify.
“This will mark the first time many people living with HIV, in California and beyond, have been able to purchase private insurance,” adds Mulhern-Pearson. “It’s a victory for HIV-positive people.”
To learn more about Covered California and the health insurance plans available to the state’s residents, check out the press release excepted below, and find the full release and other resources at CoveredCA.com.
May 23, 2013
Consumers will have access to more than 80% of practicing physicians, 80% of acute care hospitals through 13 commercial health plans
SACRAMENTO, CA – Covered California today announced 13 diverse health insurance plans that will offer in 2014, affordable, quality health care coverage to millions of Californians. The plans reflect a mix of large non- profit and commercial plan leaders, along with well-known Medi-Cal and regional plans.
The tentative selection of health plans is subject to a rate review by state regulators. It is difficult to make a direct comparison of these rates to existing premiums in the commercial individual market because in 2014, there will be new standard benefit designs under the Affordable Care Act, and the actual change in an individual’s premium will depend on the person’s current insurance coverage. However, Covered California believes that a valuable frame of reference for its premiums, is comparing them to the small employer market in California. Both the small employer market and Covered California are competitive markets, and offer guaranteed issue – you cannot be denied for pre-existing condition….
Resources—California and Beyond
Want to learn more? Live outside California? Take advantage of these online resources to understand your new health care options.
- HIVHealthReform.org: Keep on top of the changing health insurance landscape with blog posts, fact sheets, and state-by-state resources compiled on HIVHealthReform.org, produced by several HIV/AIDS advocacy and policy groups (including San Francisco AIDS Foundation).
- State Health Insurance Marketplace Profiles: In-depth state-by-state profiles, provided by the Henry J. Kaiser Family Foundation.
- Status of State Health Insurance Exchange Implementation (PDF): This analysis by the Center on Budget and Policy Priorities explores states’ progress in setting up insurance marketplaces.
Reilly O’Neal is the editor of BETA.