Deadline to get mandated health insurance through Covered California is Jan. 31
The Jan. 31 deadline is looming for Californians who don’t get health insurance through their employers to apply for coverage through the state marketplace, Covered California, made possible through the federal Affordable Care Act.
This year, more people will qualify for subsidies and new funding will lower monthly costs of health insurance for middle income individuals and families. But a new state law also brings back a cash penalty against people who don’t have health insurance that the federal government dropped last year.
Gov. Gavin Newsom championed a state penalty to replace the defunct federal one, plus increased subsidies for the middle class to help deflect the Trump administration’s attempts at dismantling the landmark program that has helped millions of uninsured people get health coverage — dropping the uninsured rate in California from 17% to 8% in the four years after Affordable Care Act started in 2014.
“I tell people: paying for health insurance is cheaper than paying the tax penalty,” said Chris Hightower, an access coordinator with West County Health Center who enrolls people in state programs including Covered California and Medi-Cal.
People who don’t sign up for some form of health insurance by the Jan. 31 deadline will see the penalty on next year’s tax bill. The penalty will either be assessed as a flat fee, starting at $695 per adult and $347.50 per child, or 2.5% of gross income — whichever amount is higher.
Covered California is the state agency created through the Affordable Care Act to sell health plans to people who don’t get insurance through their employers. The state negotiates premiums with health providers. The more people enrolled, the better position California has to get a better deal.
When the federal government dropped the penalty for the uninsured last year, enrollment in Covered California dropped from 1.43 million in March 2018 to 1.39 million in March 2019, according to an agency report.
In Sonoma County, 21,520 consumers were enrolled in an insurance program through Covered California as of March 2019, the latest data available from the state.
In the region, 51,310 customers purchased insurance through the state marketplace for Marin, Napa, Solano and Sonoma counties.
Hightower said he gets about 20 calls a day from people asking about health coverage plans such as Covered California and Medi-Cal, the state’s insurance program for the poor.
In 2014, when Covered California was new, Hightower said he spent a lot of time talking with people about the benefits of having health insurance, such as free preventative care like immunizations and screenings.
Today, more people seem to understand the benefits of having health insurance, and their concerns are primarily whether they can make the monthly payments even with subsidized plans, he said. Hightower said others simply don’t trust the government.
Affordability is a universal concern, said Pamela Moore with Redwood Community Health Coalition, a Petaluma-based consortium of health centers in Sonoma, Napa, Marin and Yolo counties. Moore is the program manager for the local Covered California grant that funds enrollment counselor positions at health centers across the North Bay, including 14 clinics in Sonoma County.
The counselors provide free assistance to people applying for coverage through Covered California or Medi-Cal.
“Most people want insurance but as you know Sonoma County has a lot of expenses making it challenging — especially if you have low income — to make ends meet,” Moore said. “Typically if people aren’t getting insurance it’s because they can’t afford the premiums.”
This year, people previously not eligible to get health insurance through Covered California might now qualify because the 2019-2020 state budget expanded Covered California medical coverage subsidies for people earning wages between four and six times the U.S. poverty line.
Once the Jan. 31 deadline passes, people can still enroll if there is a special circumstance, such as a new baby, marriage or job loss. Native Americans can apply at any time of the year.
“We really want people to come in and see us and to discuss their options and look at what’s possible,” Moore said. “Especially those people who thought they might make too much money, we want them to know that they can get help.”
You can reach Staff Writer Julie Johnson at 707-521-5220 or firstname.lastname@example.org. On Twitter @jjpressdem.