“The pandemic and recession continue to be a painful reality, and Covered California is doing whatever it can to make sure people have every opportunity to sign up for health care coverage,” said Peter V. Lee, executive director of Covered California. “There are millions of Californians out there without the peace of mind and protection of health care coverage, and now is not the time to be uninsured.”
Similar to the steps Covered California took last year, the new special-enrollment period will allow uninsured individuals to sign up for coverage without needing to meet the normal qualifying life events, such as recent loss of coverage or moving. Anyone who meets Covered California’s eligibility requirements, which are similar to those in place during the annual open-enrollment period, can sign up for coverage through May 15 and have their coverage begin on the first of the following month.
“With this Executive Order the Biden-Harris Administration have demonstrated their commitment to getting as many Americans needed health care,” said Lee. “This marks a sea-change after four years of inaction and Americans across the country will benefit from this leadership.”
The executive order issued by President Biden will strengthen the Affordable Care Act and Medicaid so they can continue to provide access to live-saving care. The order directs federal agencies to reconsider policies that limit access, undermine protections for people with pre-existing conditions – including complications related to COVID-19 – make it more difficult to enroll or reduce affordability. You can view the administration’s fact sheet here.
“Keeping the doors open at Covered California — and reopening them for millions of Americans across the country — is the right thing to do,” said Dr. Mark Ghaly, the California Health and Human Services secretary and chair of the Covered California Board of Directors. “California applauds the Biden-Harris administration and looks forward to working with the federal government to not only respond to the COVID-19 pandemic, but to also get as many Californians covered as possible.”
An estimated 2.7 million Californians are uninsured, including a projected 1.2 million who are eligible for financial help through Covered California, or for low-cost or no-cost coverage through Medi-Cal. The largest portion of these uninsured who are eligible for help are in Southern California, with an estimated 718,000 people living in the Los Angeles, Inland Empire, Orange and San Diego metro areas (see Figure 1: Where California’s Uninsured Who Are Eligible for Financial Help Live).
Last year, Covered California established a COVID-19 special-enrollment period from March 20 to Aug. 31, which allowed any eligible uninsured individual to enroll. In addition, the exchange spent $9 million on an ad campaign to spread the word to those who needed coverage during the crisis. More than 289,000 people signed up for health care coverage during that time, which is more than twice the number who signed up during the same period in 2019.
“While vaccines are being distributed to Californians across the state, it will still be several months before enough people are inoculated to provide the kind of protection
we need,” Lee said. “We are still in the grips of this pandemic, and now is the time to make sure you and your family have health care coverage in case you get sick or injured.”
Financial Help Lowers the Cost of Coverage
The most recent data shows that 1.4 million people, or nearly 90 percent of Covered California’s enrollees, are receiving some level of financial help that lowers the cost of their monthly premium by an average of nearly 80 percent.
Of those receiving financial help, almost half — over 640,000 — are benefiting from the state subsidy program launched in 2020 to make coverage more affordable, including 44,500 middle-income consumers who were previously ineligible for assistance because they exceeded the federal income requirements. Under the landmark state program, Californians earning up to $76,560 — or a family of four with a household income of up to $157,200 — may be eligible for financial help to lower the cost of their coverage.
“Most of the people who are uninsured who can get help do not know they are eligible for financial assistance, or they have not checked recently to see how affordable quality coverage can be,” Lee said. “No one should wait to sign up. Enroll now and tell your family and friends so we can make sure everyone possible has health insurance during this pandemic.”
Medi-Cal and Off-Exchange Coverage
In addition, consumers who sign up through CoveredCA.com may find out that they are eligible for no-cost or low-cost coverage through Medi-Cal, which they can enroll in online. It is important to note that those who are eligible for Medi-Cal can enroll year-round and have coverage that is effective immediately.
The California Department of Managed Health Care (DMHC) and the California Department of Insurance have also extended the special-enrollment period through May 15, which applies to all health plans in the individual market, including off-exchange health plans.
“The impact of this pandemic continues to be felt throughout California, and the DMHC is committed to helping those affected by the COVID-19 emergency,” said DMHC Director Mary Watanabe. “Once again we will be providing continued access to comprehensive and affordable health care coverage options for those who need it through the creation of this special-enrollment period.”