Covered California has insured 11,000 in San Luis Obispo County

November 05, 2015
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Tonya Strickland, San Luis Obispo Tribune

About 11,000 people in San Luis Obispo County, primarily from the North and South counties, are enrolled today in individual health insurance policies through Covered California, County Health Officer Dr. Penny Borenstein said Wednesday.

Before Covered California was established in 2014, about 43,000 people, or 16 percent of the county’s total population, were uninsured. Today, that figure is down to 10 percent, Borenstein said.

“We have made a huge dent in that 43,000 number,” she said.

Borenstein’s message was part of a morning event promoting Covered California at Twin Cities Community Hospital in Templeton, when the state health exchange’s executive director stopped there as part of a 38-city bus tour across California to let the public know that open enrollment has started for 2016. The event attracted a few dozen attendees.

Morro Bay resident Nate Hedges is among the 11,000 county residents who have bought an individual health insurance policy through Covered California. Also a certified Covered California enrollment counselor, Hedges spoke at the event.

“My family and I have had Covered California since the beginning, and we’ve benefited from having access to great doctors,” Hedges said. “I recall a time where we missed an appointment with one doctor in San Luis Obispo. And I picked up the phone and made two phone calls and was able to find an excellent specialist right here and that worked out very well for us.”

As a certified enrollment counselor, Hedges said he’s been able to help several people sign up for an insurance policy and to explain the income-based federal subsidies available to offset the cost of monthly premiums. About 90 percent of the 1.3 million Californians enrolled in a health plan through Covered California this year receive some type of subsidy.

Hedges noted that under the federal Affordable Care Act, no one can be denied coverage for a pre-existing condition. Before the health care law went into effect, many people with chronic conditions, such as diabetes, were denied coverage or paid exorbitant amounts for health insurance. Today, that’s not the case, “with many of them paying under $100 a month (for monthly premiums), which is just incredible,” he said.

Open enrollment to buy a 2016 individual health insurance policy through Covered California started Sunday and continues through Jan. 31.

San Luis Obispo County residents can choose from three insurance providers for the first time. This year, as in the past, people can compare and purchase a policy on the Covered California website and by calling its information line, or through insurance agents and enrollment counselors certified by Covered California to assist people free of charge. In San Luis Obispo County, about 150 insurance agents and six community agencies have been certified.

Covered California Executive Director Peter Lee spoke at Wednesday’s event.

Afterward, Lee said that this year’s bus tour has a dual focus: making sure Californians know that federal subsidies exist to help cover premiums and to communicate that plans offered through Covered California offer consumers local referral access to big-name medical providers, such as Stanford and Cedars-Sinai medical centers.

“Twin Cities is a front-line hospital, but if you have the worst conditions possible, you have access to … the best hospitals in the world,” Lee said.

Lee said Covered California redesigned its website this year to better highlight the real out-of-pocket costs of the health care plans. For example, in its “shop and compare” online tool, entering a person’s annual income, age and zip code brings up information on what health care plans are available to them and the cost of each plan’s monthly premiums.

The average health care premium cost for an individual is about $600 a month, but subsidies can reduce the out-of-pocket cost for many consumers to $150 per month and as low as $50 depending on income. In previous years, the website didn’t make clear upfront that most of that $600 cost would be covered by subsidies, which may have meant the program lost some sign-ups.

“People just had sticker shock and clicked away,” Lee said. “Now we’ve been pounding the pavement saying that the subsidies exist.”

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