Covered California Announces American Rescue Plan Roadmap to Lower
Premiums and Help Millions Get Covered
March 18, 2021
CALIFORNIA BUILDING ON ITS HISTORY OF MAKING THE
AFFORDABLE CARE ACT WORK
• Since launch of ACA, California
experienced the nation’s largest drop
in the uninsured rate.
• More than 4.7 million Californians
have gained coverage since 2013.
• As of 2019, there are about 3 million
uninsured, with about 60%
undocumented/ineligible for federal
programs.
• In 2020, California implemented state
subsidies and a state penalty, which
resulted in a 40% increase in new
enrollment and contributed to
premium increases of less than 1%
for 2020 and 2021.
• COVID Special Enrollment Period in
2020 led to surge in sign-ups
2013 2014 2015 2016 2017 2018 2019 2020 2021
0
%
CA
17.2
%
6.5 million
U.S.
14.5
%
45.2 million
CA
7. 7
%
3.0 million
U.S.
9. 2
%
29.6 million
Launched
Enrollment
Biden/Harris’
American
Rescue Plan
Uses ACA to
Help Millions
COVID-19 Pandemic
& Recession
Trump Administration
Source: U.S. Census 2014-2020
1
WHO CAN BENEFIT FROM THE AMERICAN RESCUE PLAN’S NEW HEALTH
SUBSIDIES:THE NATIONAL AND CALIFORNIA PICTURE
2
Landscape of the 25 Million Americans Eligible for New Assistance*
US Total California
ACTION
NEEDED BY
CONSUMER
Currently
Uninsured
Uninsured Marketplace Eligible, below 400% FPL 11.2M 45%
990,000 32%
Uninsured Marketplace Eligible, above 400% FPL 2.1M 8%
230,000 8%
SUBTOTAL: Currently Uninsured - Action Needed to Benefit 13.3M 54%
1,220,000 40%
Currently
Insured
Off-Exchange Enrollees, below 400% FPL
.8M 3% 210,000 7%
Off-Exchange Enrollees, above 400% FPL
.7M 3% 220,000 7%
SUBTOTAL: Currently Enrolled - Action Needed to Benefit
1.5M 6% 430,000 14%
NO ACTION
NEEDED BY
CONSUMER
Currently
Insured
Marketplace Enrollees, below 400% FPL - No Action Needed to Benefit 9.1M 37%
1,270,000 42%
Marketplace Enrollees, above 400% FPL - Newly Eligible for ARP .9M 4%
140,000 5%
SUBTOTAL: Currently Enrolled - No Action Needed to Benefit 10.0M 40%
1,410,000 46%
TOTAL Total Eligible to Benefit from Subsidies
24.9M 100% 3,060,000 100%
ACTION
NEEDED
Currently
Uninsured
Uninsured Medicaid Eligible 7.3M 1.0M
TOTAL Total Eligible to Benefit from Affordable Coverage 32.2M 4.0M
Average New Monthly Financial Help For Current Marketplace Enrollees, below 400% FPL
$ 80 $ 74
Average Monthly Financial Help for Newly Enrolling Individuals, below 400% FPL
$ 571 $ 527
Average Monthly Financial Help Per Newly Eligible Enrollee, above 400% FPL
$ 335 $ 309
* Table only shows those estimated to be eligible for subsidies based on maximum required contribution percentage of househol
d income using available administrative data (on income, age, and benchmark premiums) from California's
marketplace: the actual eligibility may differ to the extent that there are differences in the age, income, and premium costs
for other states and the off-exchange from what is observed in Covered California's data
. Not shown are the estimated
1.4 million consumers who may receive higher subsidies because they are receiving unemployment insurance income.
Additionally, off-exchange estimates do not include consumers who may be enrolled in coverage that is not ACA
compliant (e.g. "grandfathered" plans), who may also benefit from new subsidies.
** Federally
-Facilitated Exchanges includes State-Based Exchanges utilizing the Federal Marketplace Platform.
*** The "states with largest drops in unsubsidized enrollment" reflects total of the nine States (which were all in FFE) that
had 2016 to 2019 drop of unsubsidized enrollment of over 70% (AZ, GA, IA, MS, NB, NH, OK, TN, WV).
WHO CAN BENEFIT FROM THE AMERICAN RESCUE PLAN’S NEW HEALTH
SUBSIDIES: 25 MILLION AMERICANS
3
American Rescue Plan
–
Landscape of the 25 Million Americans Eligible for New Assistance*
US Total
Federally-
Facilitated
Exchanges
States with
Large Drops in
Unsubsidized
Enrollment
State-Based
Exchanges
ACTION
NEEDED BY
CONSUMER
Currently
Uninsured
Uninsured Marketplace Eligible, below 400% FPL 11.2M 45% 8.5M 49% 1.8M 54% 2.7M 37%
Uninsured Marketplace Eligible, above 400% FPL 2.1M 8% 1.4M 8% .3M 8% .7M 9%
SUBTOTAL: Currently Uninsured - Action Needed to Benefit 13.3M 54% 9.9M 57% 2.1M 62% 3.4M 46%
Currently
Insured
Off-Exchange Enrollees, below 400% FPL
.8M 3% .4M 2% .0M 1% .4M 5%
Off-Exchange Enrollees, above 400% FPL
.7M 3% .4M 2% .0M 1% .4M 5%
SUBTOTAL: Currently Enrolled - Action Needed to Benefit
1.5M 6% .7M 4% .0M 1% .8M 11%
NO ACTION
NEEDED BY
CONSUMER
Currently
Insured
Marketplace Enrollees, below 400% FPL - No Action Needed 9.1M 37% 6.4M 36% 1.1M 34% 2.7M 37%
Marketplace Enrollees, above 400% FPL - Newly Eligible for ARP .9M 4% .4M 3% .1M 3% .5M 6%
SUBTOTAL: Currently Enrolled - No Action Needed to Benefit 10.0M 40% 6.8M 39% 1.2M 36% 3.2M 43%
TOTAL
Total Eligible to Benefit from Subsidies
24.9M 100% 17.5M 100% 3.4M 100% 7.4M 100%
ACTION
NEEDED
Currently
Uninsured
Uninsured Medicaid Eligible 7.3M 4.8M 1.3M 2.5M
TOTAL
Total Eligible to Benefit from Affordable Coverage 32.2M 22.2M 4.7M 9.9M
Average New Monthly Financial Help For Current Marketplace Enrollees, below 400% FPL
$ 80 $ 85 $ 91 $ 70
Average Monthly Financial Help for Newly Enrolling Individuals, below 400% FPL
$ 571 $ 603 $ 648 $ 497
Average Monthly Financial Help Per Newly Eligible Enrollee, above 400% FPL
$ 335 $ 353 $ 380 $ 291
* Table only shows those estimated to be eligible for subsidies based on maximum required contribution percentage of househol
d income using available administrative data (on income, age, and benchmark premiums) from California's
marketplace: the actual eligibility may differ to the extent that there are differences in the age, income, and premium costs
for other states and the off-exchange from what is observed in Covered California's data.
Not shown are the estimated 1.4
million consumers who may receive higher subsidies because they are receiving unemployment insurance income.
Additionally, off-exchange estimates do not include consumers who may be enrolled in coverage that is not ACA
compliant (e.g. "grandfathered" plans), who may also benefit from new subsidies.
** Federally
-Facilitated Exchanges includes State-Based Exchanges utilizing the Federal Marketplace Platform.
*** The "states with largest drops in unsubsidized enrollment" reflects total of the nine States (which were all in FFE) that
had 2016 to 2019 drop of unsubsidized enrollment of over 70% (AZ, GA, IA, MS, NB, NH, OK, TN, WV).
THE AMERICAN RESCUE PLAN: PROVIDING MORE HELP TO MILLIONS AND
MORE THAN COVERING CALIFORNIA’S TEMPORARY STATE SUBSIDIES
The new “required contribution curve”
will significantly reduce the share of
income that consumers must pay
towards their premiums, fully
replacing the current ACA policy
design for plan years 2021 and 2022.
The Rescue Plan also includes a
provision that allows anyone
receiving Unemployment Income in
2021 to receive Advanced Premium
Tax Credits (APTCs) at the level of
eligibility at 138% FPL (meaning they
pay 0% of their monthly income
towards their benchmark plan and be
eligible for Silver 94).
Required contribution curves are for the 2021 plan year.
4
2.07%
3.10%
4.12%
6.52%
8.33%
9.83%
6.24%
7.8%
8.9%
9.68%
14%
16%
18%
2.00%
4.00%
6.00%
8.50% 8.50%
8.50%
0.00%
2.00%
4.00%
6.00%
8.00%
10.00%
12.00%
14.00%
16.00%
18.00%
20.00%
0% 100% 200% 300% 400% 500% 600%
Required Contribution Percent
FPL Level
ACA State Subsidy
St imulu s
AMERICAN RESCUE PLAN LOWERS PREMIUMS AS A SHARE OF INCOME
5
2021 Coverage Year: Percent of Household Income Paid for Benchmark Silver Premium
Income Range Required Contribution as Share of Income
Enrollees to be redetermined
without taking action
Income
As Percent of Federal
Poverty Level (FPL)
Income
for Single Household
Affordable Care Act
California State Subsidy
Program
American Rescue Plan
Covered California
enrollees
Percent of total
Under 138%*
$0 to $17,609 2.07% 0.0% 0.0% 38,000 3%
138%
– 150%** $17,609 to $19,140 3.10% – 4.14% N/A 0.0% 226,000 16%
150%
– 200% $19,140 to $25,520 4.14% – 6.52% N/A 0.0% – 2.0% 442,000 31%
200%
– 250% $25,520 to $31,900 6.52% – 8.33% 6.24% – 7.80% 2.0% – 4.0% 236,000 16%
250%
– 300% $31,900 to $38,280 8.33% – 9.83% 7.80% – 8.90% 4.0% – 6.0% 198,000 14%
300%
– 400% $38,280 to $51,040 9.83% 8.90% – 9.68% 6.0% – 8.5% 192,000 13%
Over 400%
$51,040 and up Not eligible for subsidies 9.68% – 18.0%*** 8.5% 112,000 8%
NOTES:
*Individuals with income at or below 138% of the federal poverty level are generally eligible for Medi-Cal, California’s Medicaid program. In certain limited circumstances, however, they are eligible for the federal
premium tax credit and the California state subsidy program.
** Under the American Rescue Plan, Covered California enrollees receiving Unemployment Insurance (UI) in 2021 are treated as though their income is no more than 138.1% of the federal poverty level for the
purposes of the federal premium tax credit meaning their required contribution for a benchmark plan will be 0%.
*** Eligibility for the California state subsidy program ends at 600% of the federal poverty level.
SAVINGS TO CALIFORNIANS UNDER THE AMERICAN
RESCUE PLAN
6
Uninsured Californians earning between $19,000 and $32,000 per year – comprising 2/3rds of the eligible uninsured – can
enroll in a benchmark silver plan (with reduced cost sharing) for an average cost of $61 per month, and virtually all can get a
Bronze plan for $1 per month per member.
Off-exchange consumers over 400% FPL, who enroll with Covered California in May, will receive on average of $500 per
month in federal financial assistance, for a potential savings of nearly $10,000 if enrolled for 20 months from May 2021
through December 2022.
Current Covered California consumers who will receive subsidies, will pay an estimated $119 less per month per household
on average, which translates to $1,428 per year.
Note: Modeling assumes uninsured population characteristics match Covered California membership, including plan choice. Source: Covered California administrative data of
effectuated enrollees’ current plan selections, and only reflect those who are estimated to receive subsidies greater than $0. Premiums are at the household level.
Monthly Premiums
Savings Due to American Rescue Plan
(for those who receive credits only)
Income Ranges for
Single Person
Household
Share of
Enrollment
Gross Premium
Consumer’s
Premium After
American
Rescue Plan
Assistance
Monthly Savings
compared to ACA
Monthly Savings
compared to
Gross Premium
Savings from 20
months of ARP
subsidies
(compared to gross)
Under 150% FPL
Under $19,140
18% $734
$55 $59 $679 $13,588
150%
- 250% FPL $19,140 - $31,900
47% $766
$61 $93 $704 $14,088
250%
- 400% FPL $31,900 - $51,040
27% $964
$228 $144 $736 $14,720
Over 400% FPL
More than $51,040
8% $1,100
$507 $593 $593 $11,860
Total
100% $820
$118 $119 $702
SCENARIO: YOUNGER UNINSURED IN LOS ANGELES CAN
NOW GET SILVER PLAN FOR LESS THAN $50 PER MONTH
7
Uninsured younger consumers in low-cost regions can now get even more
affordable coverage: a 21 year old in LA earning $25,520 per year (200%
FPL) can purchase a benchmark plan (Enhanced Silver 94) for $43 per
month, or a Bronze plan for $1 per month.
ACA Baseline American Rescue Plan
One
-Person
Household
Benchmark Silver Premium (monthly)
$275 $275
Los Angeles, CA
Cap on Share of Income for
Benchmark Plan
6.52% 2%
21 year old
Net Premium (monthly)
$139 $43
Income: $25,520
Federal Subsidy (monthly)
$137 $233
200% FPL
Federal Subsidy
(if enrolled all of 2021 and 2022)
$2,736 $4,659
SCENARIO: MIDDLE-INCOME OFF-EXCHANGE COUPLE CAN
SAVE $14,000 IF SWITCH TO MARKETPLACE THROUGH 2022
8
A couple in Oakland, both 45 and earning $77,580 (450% FPL) purchased a
benchmark silver plan off-exchange.* Now, if they switch to enroll at Covered
California, they can keep the exact same place and receive financial help worth
$722 per month, or over $14,000 if enrolled from May 2021 to December 2022.
Enrolled Off-Exchange American Rescue Plan
Difference for Enrolling
through Covered California
Couple
Benchmark Silver Premium (monthly)
$1,271 $1,271
Oakland, CA
Percent of Income Spent on Premium
19.6% 8.5%
11.1% of income saved
Both Age 45
Net Premium (monthly)
$1,271 $550
$722 saved
Income: $77,580
Federal Subsidy (monthly)
$0 $722
$722 new monthly credits
450% FPL
Federal Subsidy
(20 months in 2021 and 2022)
$0 $14,438
$14,438 savings if enrolled 20
months
* Not shown: this household would have been eligible for $366 per month in state subsidy had they enrolled on-exchange for 2021.
FOR THOSE RECEIVING SUBSIDIES NOW THROUGH COVERED
CALIFORNIA AVERAGE “NET PREMIUMS” WILL DROP A LOT
For current Covered California members, “net
premiums” – the monthly amount consumers
pay after the federal subsidy – will decrease by
an estimated $119 per household per month
($1,428 annualized) compared to what costs
would be under the ACA.*
Many consumers in the lower income range will
become newly eligible for $1 Enhanced Silver
premiums, while consumers over 400% of FPL
will see significant reductions thanks to new
federal premium assistance.
We estimate the American Rescue Plan will
provide over $1.5 Billion in new financial help
for current enrollees alone.
Note: Modeling assumes uninsured population characteristics match Covered California membership, including plan choice. Source:
Covered California administrative data of effectuated enrollees’ current plan selections, and only reflect those who are estimated to
receive subsidies greater than $0. Premiums are at the household level, and net premiums do not include state subsidies.
9
$113
$155
$372
$1,100
$237
$55
$61
$228
$507
$118
$0
$200
$400
$600
$800
$1,000
$1,200
Under 150%
FPL
150% - 250%
FPL
250% - 400%
FPL
Over 400%
FPL
Total
Average Household Net Premium by FPL and
Policy Design
Current ACA American Rescue Plan
MOST CALIFORNIANS PAYING FOR INSURANCE TODAY “OFF-
EXCHANGE” CAN REDUCE THEIR COSTS IMMEDIATELY
10
Covered California estimates, based on income alone, that nearly three-quarters of all off-exchange households could be
eligible to receive subsidies under the stimulus based on their income:
• Of households eligible to receive subsidies (of more than $0), 94% could receive more than $100/month, representing
substantial benefit to these off-exchange consumers.
• For those households earning between 400% and 600% FPL, an estimated 82 percent would be eligible for financial help
which would average $690 per household – that assistance would have a value of $13,800 for a household that
enrolled for May 2021 coverage and kept their insurance with same subsidy until December 2022.
• Off-exchange households are ineligible due to their incomes meaning they can purchase a benchmark plan that costs less
than 8.5% of income, and thus would qualify to receive subsidies.
FPL Group
Average
Household
Subsidy
Individuals Eligible to
Receive Subsidies
Share of Total Households
Eligible to Receive
Subsidies
Less than 400% FPL
$800 210,000 100%
400%
-600% FPL $690 120,000 82%
More than 600% FPL
$500 100,000 43%
* Not shown are an additional over 150,000 Californians enrolled in grandfathered plans who may also benefit from new financial help.
ENROLLING AS MANY OF THE 25 MILLION ELIGIBLE NATIONALLY
AND 3 MILLION IN CALIFORNIA IS THE RIGHT THING TO DO
• These provisions can provide fast and significant relief to Americans who are struggling with the
pandemic and its economic repercussions. New subsidies will help uninsured GET coverage and those
who have coverage without subsidies KEEP coverage while putting money in their pockets.
• The increased subsidies provide additional financial help to those currently enrolled which will help them
stay covered and give financial help to lower income and those in communities of color most impacted
by the COVID-10 pandemic and resulting recession.
• By enrolling consumers during 2021 and in the 2022 open enrollment period, the individual market would
benefit from lower premiums in 2022 due to the healthier consumer pool. Covered California estimates
effective enrollment could lead to 2022 premiums being 4 percent lower than they would otherwise be –
saving the federal government over $2 billion in reduced Premium Tax Credit spending.
• The American Rescue Plan can show how the Affordable Care Act (ACA) can meet the needs of
consumers during a pandemic and recession, by delivering real results quickly through the existing
infrastructure of the law. Successful implementation is critical as we look ahead to the potential of
expanding coverage by making permanent improvements to the ACA.
11
POTENTIAL DOES NOT MEAN WILL BENEFIT: THE CONGRESSIONAL BUDGET OFFICE
PROJECTS ONLY ABOUT ONE IN TEN OF ELIGIBLE UNINSURED WILL BENEFIT
The Congressional Budget Office projects that over 2021 and 2022 combined about 10 percent of
uninsured eligible for the American Rescue Plan increased subsidies will enroll and 20 percent of
those currently insured but unsubsidized will enroll. They think millions of Americans will leave big
money on the table for good reasons:
• Most uninsured want insurance they just don’t think they can afford it. The CBO does not think
the Rescue Plan will change that.
• The American Rescue Plan is starting “mid-year” when consumers are less likely to switch.
• Since the program is temporary, many will just sit on the sidelines.
And there are other reasons for conservatism:
• Moving Consumers from “Off-Exchange” IS Difficult (inertia is a powerful force)
• Nationally need to rebuild awareness of Healthcare.gov and support navigators
• Danger of lower than needed marketing spending and risk that health plans don’t “lean in”
12
BUT –THE AMERICAN RESCUE PLAN PROVIDES NEW OPPORTUNITIES
BY MAKING COVERAGE MORE AFFORDABLE THAN EVER BEFORE
There are clear pathways and huge needs to be met that can help ensure consumers access
subsidies:
• Uninsured: the new subsidies are large and make coverage MUCH more affordable than ever before for
millions of Americans, IF Americans are told how much they can save.
• Currently Insured “Off-Exchange” Consumers: Qualified Health Plans and insurance agents can help
consumers understand they can save thousands of dollars and convert to coverage that meets their
needs.
• Currently Subsidized Marketplace Consumers: Consumers who are currently enrolled in either the
Federally Facilitated Exchange (FFE) or a State Based Exchange (SBE) can gain the bigger subsidies
automatically – either in the form of lower monthly premiums or by receiving a bigger tax refund at the
end of the year without any action necessary on their part.
• Health Insurance Carriers Can and Should Lean In: New subsidies will help ensure that off-exchange
enrollees in their plans will no longer terminate their plans prematurely because they can now better
afford coverage.
13
COVERED CALIFORNIA’S CORE STRATEGIES TO MAXIMIZE
ENROLLMENT AND HELP AS MANY CALIFORNIANS AS POSSIBLE
1. Establish a NEW American Rescue Plan special-enrollment period
starting April 12th through the end of 2021.
2. Maintain consumer-focus, support agents and navigators, new
partnerships and significant marketing investments April, May, and
June.
3. Hold health carriers accountable by encouraging them to invest in
marketing and reaching out to every consumer who is eligible for a
subsidy.
14
COVERED CALIFORNIA STRATEGY 1:
NEW AMERICAN RESCUE PLAN SPECIAL ENROLLMENT PERIOD
Establish a NEW American Rescue Plan Special Enrollment Period – Covered California will
have a special enrollment period starting April 12
th
and going through the end of 2021
• The Special Enrollment Period needs to be NEW because the benefits to consumers ARE NEW
– need to create buzz, discussion and engagement by all interested (and disinterested)
individuals so uninsured consumers “check-again.”
• A longer Special Enrollment Period allows for roll-out of effective marketing and will allow for
broader word of mouth – minimum period should be through June 30, 2021.
• There is virtually no risk of “adverse risk selection” – Covered California’s 2020 COVID Special
Enrollment saw same risk mix as our overall enrollment
• We do NOT want to turn away an uninsured person who is newly eligible for $800 a month in
subsidies (and many able to get virtually free coverage) in July to tell them “come back for
coverage starting in January
• AND we can and must still market with the “sell” of urgency and “sign-up now” (which is often
triggered by a deadline) with BIG marketing focus April through June.
15
COVERED CALIFORNIA STRATEGY 2:
DOING ALL WE “NORMALLY” DO AND DOING IT WELL
Covered California must do all its “regular” activities and more – and we’ve got to do them
well – to effectively reach and enroll all possible eligible consumers
• Consumer-centered technology to support getting the increased subsidies TO CONSUMERS
as quickly as possible.
• Robust marketing – leaning in for April through June as if it were an Open Enrollment Period
• Major spending, with current plans of spending $20 to $30 million in April through June.
• Disproportionately targeting communities hardest hit by the recession: communities of
color and lower income
• Benefiting from lower cost of media buying AND we will “own” the health insurance
market
• Actively reach out to subsidized members and eligible consumers in our “funnel” and provide
great customer service for consumers and for those who help consumers (e.g., navigators and
agents)
• Engage in partner activities with major state entities: the Employment Development
Department, the Franchise Tax Board and California’s Medi-Cal Department
16
MARKETING TO PROMOTE THE NEW LOWER COST
COVERAGE FROM THE AMERICAN RESCUE PLAN
17
• Covered California plans a statewide marketing campaign mirroring
Open Enrollment levels with $20-30 million investment reaching at least
97% of consumers 18 times April 12 – June 30.
• Build strong momentum out the gate with maximum media weight
levels in the first three weeks of the campaign.
• Enhanced emphasis on ethnic market media across Hispanic, Asian
and African-American/Black audience segments in all mediums
possible within the timeline. Highlights include:
□ Dedicated digital buys on contextually relevant sites.
□ Purchase the most circulated Spanish, Black and API print
publications in CA.
□ Purchase through every Black-owned radio station in the state as
well as partner with influential Black, Hispanic and Asian radio
personalities to deliver our message.
IN COMMUNITIES THROUGHOUT CALIFORNIA, THOUSANDS OF
CERTIFIED AGENTS AND ENROLLERS ARE READY TO HELP
3,753 Navigators and other
Community-Based Organizations
10,000 Certified Insurance
Agents
581 Covered California
Storefronts
18
COVERED CALIFORNIA WILL PARTNER WITH KEY STATE AND OTHER
GROUPS TO MAKE A DIFFERENCE
Covered California will work to promote insurance enrollment with our public partners,
including key state agency partners:
• Employment Development Department (EDD) – for Californians receiving Unemployment
Insurance: Covered California will continue to work with the Employment Development Department
(EDD), California’s unemployment insurance agency, to provide messaging that will be sent by EDD to
unemployment compensation recipients. We will also work with EDD to explore any opportunities for
data sharing to enable direct outreach by Covered California to unemployment compensation recipients.
• California Franchise Tax Board (FTB) – for Californians who paid penalty for being uninsured in
2020: By state law, California’s Franchise Tax Board will share data with Covered California to enable
direct outreach to penalty payers. Covered California will develop material to make penalty payers aware
of the new subsidies and the stimulus special enrollment period.
• California Department of Health Care Services (DHCS) – for Californians leaving Medi-Cal
coverage: Covered California with partner with the Department of Health Care Services, California’s
Medicaid Agency, to plan for the expected influx of newly eligible individuals coming from Medicaid when
the public health emergency is lifted at the end of 2021 and early 2022.
19
COVERED CALIFORNIA STRATEGY 3:
MAKE SURE CONTRACTED HEALTH PLANS DO THE RIGHT THING
Covered California will provide the tools and implement the policies to ensure its eleven
contracted health plans do the right thing for consumers, including:
• Requiring health plans to actively reach out to all their off-exchange consumers to encourage
them to see if they are eligible for assistance AND to help them “convert” if they are:
• Covered California building “microsite” of CoveredCA.com for each carrier to facilitate
these conversions and plan-based enrollment activities
• Requiring health plans to establish consumer-first conversion policies:
• Assure any spending is carried over to credit deductibles with their new plan
• Making sure they either keep same doctors/networks or understand the implications of
changing
• Making sure continuity of care issues are well addressed
• Do their fair share of marketing and promotion while coordinating with Covered California’s
efforts.
• Support and partner with their agents (including paying fairly and being sure all transferring
clients are still credited to those agents)
20
California’s plan to make the American Rescue Plan work
well is based on the same principles that have supported
its effective implementation of the Affordable Care Act:
• Do the right thing for millions of Californians who can and
will benefit
• Invest in marketing and supporting ground-up efforts in
every community across the state
• Target efforts in communities of color and lower-income
Californians
• Focus not just on coverage, but assuring consumers get the
right care at the right time and delivering on health equity
and quality.
Thanks to all the Californians who are working to make
high quality, affordable health care real for millions of
people in every community across the state.
21
