Record-breaking subsidies available for health care coverage – San Francisco Bay Times

By Assemblymember Phil Ting–

It is remarkable how the Affordable Care Act (ACA) has made progress in reducing the number of uninsured Californians. In fact, our uninsured rate is at an all-time low. We went from 17.2 percent in 2013 to 6.4 percent last year, the largest percentage drop for any state in the country. Over the years, nearly six million Californians have gotten their health insurance through the state’s insurance marketplace, Covered California, which was made possible by the ACA.

However, there are still 1.3 million uninsured people in our state, about ten percent of whom are from the LGBTQ+ community. If you need coverage, open enrollment currently runs through January 25, 2025. Simply visit the Covered CA website (https://www.coveredca.com/) to find a plan that’s right for you. Financial assistance is also available to reduce premiums. Covered California mainly helps those who cannot get health insurance through work but have an income too high to qualify for Medi-Cal.

The good news is that the governor and state Legislature have increased grants to $165 million next year, providing record-breaking financial support to help reduce costs. As a result, all Californians with incomes above 200 percent of the federal poverty level (which is $30,120 for a single person and $62,400 for a family of four) are now eligible to enroll in a higher plan, called Enhanced Silver 73, with no deductible and lower out-of-pocket costs. Those below 200 percent of the federal poverty level will continue to have access to higher benefits.

Additionally, a recent change to federal rules began this month, making approximately 40,000 DACA (Deferred Action for Childhood Arrivals) recipients eligible to enroll in a health plan through Covered California. Eligible DACA recipients can receive financial assistance (https://bit.ly/3YzUcQX) if they qualify. Applicants must select the “acquired lawful presence” option from the list in the Special Enrollment Period section when applying. The deadline for this group is December 31, 2024.

But the exciting progress we’ve made in insuring more Californians is in jeopardy. The expansion of federal premium tax credits in 2021 created these gains, and they will expire after 2025. If that happens, some of the predicted consequences include:

• Coverage gains among communities of color will be reversed. Communities of color have experienced some of the largest increases in enrollment. Without improved premium tax credits, premium costs will increase by 76% for Latinos, 71% for Asians, and 67% for Black/African Americans.

• Nearly all self-employed Californians will pay more. More than 1 in 4 Californians are self-employed, with the vast majority earning less than about $58,000 per year. 90% of self-employed people will see an increase in premium costs if the increased premium tax credits expire. Middle-income members would see premiums increase by 77% and pay up to 17% of their annual income on health insurance.

• Older enrollees will see large premium cost increases. Nearly half a million older Californians (ages 55 to 64) are enrolled in Covered California. Those earning less than about $58,000 per year will see their monthly premium costs increase by 46%, or about $227 per month. Older middle-income people earning more than $58,000 lose all financial support and have to pay nearly 25% of their income for health insurance.

To keep access to health care affordable, we must start lobbying our federal representatives. I hope you will see the value of this program and write or call members of Congress next year to let them know that financial assistance must continue. Nearly 90 percent of Covered California enrollees receive this assistance. Without this insurance, people will drop their coverage and the consequences for individuals and our health care system would be devastating. A thriving health insurance market only works if everyone is included.

Phil Ting represents the 19th Assembly District, which includes the west side of San Francisco along with the communities of Broadmoor, Colma and Daly City, as well as part of South San Francisco and San Bruno.

Assemblymember Phil Ting
Published on November 7, 2024