Join Our Network

Follow Us:

  • RSS

Health Equity Forum: Covered California Update – July 2014

Covered California Update

Covered California held its latest monthly Board meeting on June 19th. There were updates about the first open enrollment period (October 2013-March 2014), and announcements and decisions about the upcoming open enrollment period beginning November 15, 2014.

At the meeting, Covered California Executive Director Peter Lee shared data on enrollment channels used during the first open enrollment period. According to Covered California data, African Americans were most likely to enroll through a self-service channel (60%) and least likely to enroll through an agent (19%), while Asian Americans were most likely to enroll through an agent (54%), versus other channels such as self-service (34%). Covered California also reported that of those served by Certified Enrollment Counselors and Plan Based Enrollers, 48% and 41% respectively, were Latino. To date, only 20% of Covered California enrollees are Limited English Proficient (LEP, compared to 40% as projected by CalSIM), which may explain why the Asian American and Latino populations were more likely to use in-person assistance – whether through nonprofit entities or agents – rather than self-service channels. An online version of the application for health coverage is still only available in English and Spanish.

The Covered California Board approved a proposal to streamline the Navigator Grant Program and fund it at $16.9 million despite the objections of Having Our Say members and other community-based organizations. The new program raises reimbursement rates, but only pegs funding to enrollment (not to outreach and education) and does not include benchmarks for reaching vulnerable populations, such as immigrants and LEP individuals. Covered California intends to award funds to the highest producing enrollment entities, namely community clinics that did an outstanding job of enrolling their patients into health coverage. However, as advocates pointed out, more analysis is needed on the role of outreach and education grantees and smaller nonprofits in reaching vulnerable populations, including immigrants, LEP individuals, young adults, and LGBTQ individuals. It remains to be seen whether limiting enrollment funds to just the largest enrollment entities, with the majority being health care providers, will be enough to reach these populations and maximize enrollment for all Californians. For grantees interested in applying for the Navigator Grant Program, Covered California released its Navigator Request for Application (RFA) on June 30, 2014.  A letter of intent to apply for funding is due July 8. 

Meanwhile, the Board-approved 2015 budget does include funds for a Diversity Officer to help ensure Covered California meets the needs of the diverse populations it serves through marketing, outreach, and enrollment assistance. 

Covered California also announced that it is currently reviewing insurance rates and preparing to negotiate with health plans, with an announcement of 2015 rates expected in August. All the health plans currently offering coverage through Covered California, with the exception of the Contra Costa Health Plan, will be offering coverage again for the 2015 plan year. After a lengthy consumer advocacy campaign, all the health plans will include a dental offering for 2015 as part of their health insurance package, which will increase access and affordability of dental benefits for exchange consumers. The Board also heard information about a November ballot initiative that would regulate insurance rates and directed Covered California staff to prepare a more detailed analysis of the impact of the initiative on the operations of Covered California moving forward.

Finally, in response to consumer advocacy, the Board voted to continue the current, less restrictive policy of self-attestation of eligibility (rather than requiring third-party verification of documentation) for those applying for coverage during the special enrollment period for the remainder of 2014. However the Board directed Covered California to explore additional safeguards, such as electronic verification of eligibility, in 2015. 

The next Covered California Board meeting is scheduled for August 21st.