Affordable Care Act Implementation Updates Joel Diringer, JD, MPH May 2015

Covered California Open enrollment ended February 15 Special enrollment Unaware of tax penalty extension – ended April 30 Qualifying life events (e.g. losing coverage, marriage, divorce, birth, adoption) – year round Next open enrollment for 2016 – starts in Fall Medi-Cal enrollment is year round!!

Statewide enrollment First open enrollment: 1.4 million Californians Second open enrollment: 495,000 Californians Special enrollment through mid-April unaware of tax penalty: >33,000 Losing Medi-Cal: 25,000 Qualifying life event: 22,000 Medi-Cal 2.7 million Californians enrolled from October 2013 to November 2014

Local enrollment Merced County Covered California enrollment First open enrollment: 8,403 person (95% subsidized) Second open enrollment: 2,931 persons Region 10 (San Joaquin, Stanislaus, Merced, Mariposa, Tulare) First open enrollment: 61,499 Second open enrollment 21,289 Carrier selected 73% Anthem Blue Cross 5% Blue Shield <1% Health Net 21% Kaiser (not available in Merced) Metal levels: 24% Bronze, 67% Silver, 5% Gold, 4% Platinum

SB 4 (Lara) Health4All Low income undocumented persons would be enrolled in full-scope Medi-Cal Higher income undocumented persons could purchase private insurance through Covered CA (no subsidies). Costs: $280 to $740 million a year without DAPA (President’s Executive Action) $175 TO $455 million a year with DAPA Placed in Senate Appropriations Suspense File