October 23, 2019 — Under a new state law, Californians will receive financial assistance from the state, in addition to the financial help they may receive from the federal government, to pay for health insurance in 2020.
The bill reversed the federal rollback of key elements of the Affordable Care Act (ACA), and restored the law that requires consumers to get health insurance if the cost of coverage is below a certain percentage of their income.
Sharp Health Plan experts Cicely Rucker, account manager for Covered California, and Don Truong, manager for Medicare and individual and family plans, identified four key points that Californians need to know before the law goes into effect Jan. 1, 2020.
1. More Californians than ever before will qualify for financial help.
California will be the first state in the U.S. to provide state subsidies to many middle-income consumers who had previously not qualified for financial help.
Californians with an income of up to 600% of the federal poverty level (FPL) — the equivalent of an individual earning up to $74,940 a year or a family of four earning up to $154,500 a year — will be eligible to receive financial assistance
for health insurance through Covered California. This means nearly 1 million Californians will become newly eligible for financial help in the 2020 coverage year. The amount will depend on your household size and FPL. Check with Covered California to see what you may qualify for.
Truong adds, “Many consumers, particularly those who live in high-cost regions, will see significant savings with annual reductions in their health care premiums in the hundreds and even thousands of dollars.”
2. Even if you haven’t qualified for financial help in the past, check again.
Rucker says, “Even if you don’t think you qualify, or if you’re already enrolled in health insurance directly through a health
plan instead of through Covered California, it’s worth checking again. You could be eligible to save hundreds of dollars a year.”
For those who check and discover that they don’t qualify for financial help, Truong offers a silver lining: “The rates for our silver tier plans will be reduced by 15% in 2020, so if you’re enrolled in benefits with Sharp Health Plan,
it’s likely that you’ll see your monthly premium cost go down next year.”
3. The new law requires California tax-filers to have health insurance or pay a penalty.*
“Think of it like the seatbelt law,” says Rucker. “You wear your seatbelt because you know it will protect you if you get
into an accident, and because it’s the law. Just like wearing a seatbelt, health insurance is there to help protect you.”
The tax penalty for not having health insurance will be a minimum of $695 per person or 2.5% of their annual income, whichever is greater.
*Californians whose health care costs exceed a certain percentage of their income will be exempt from the penalty.
4. Take advantage of community resources to help you understand your options and get health coverage that’s right for you.
“If you have trouble understanding how health insurance works, there are lots of community resources
with experts whose job is to help you,” advises Truong. “Health insurance can be confusing, but it doesn’t have to be. We want to make sure people know that help is available.”
Sharp Health Plan hosts free enrollment labs, where you can learn about health insurance options and, if you feel ready, get help with enrollment at no cost to you. Visit sharphealthplan.com/labs for dates and registration.
211 San Diego also offers free enrollment support. You can dial 211 or visit 2enrollme.org to schedule a phone appointment. You can also attend one of Covered California’s enrollment events, or contact the Covered California service center
Covered California’s open enrollment period is Oct. 15, 2019, through Jan. 31, 2020. Find out today if you qualify for financial help.