Weeks after Democratic lawmakers forced Gov. Gavin Newsom to make good on a four-year-old pledge to use tax penalty proceeds from fining the uninsured to increase health insurance subsidies for low- and middle-income Californians, Covered California officials announced they will funnel that money into reducing out-of-pocket spending for many enrollees struggling with the cost of care.
The state’s health insurance exchange will zero out some patients’ hospital deductibles, up to $5,400; lower the copay of primary care visits from $50 to $35; and reduce the cost for generic drugs from $19 to $15. Some enrollees will also see their annual out-of-pocket spending capped at $6,100, down from $7,500.
Covered California CEO Jessica Altman argues these are tangible reductions — savings on deductibles and copays on top of subsidies to lower monthly premiums — that will affect hundreds of thousands of people and entice them to use their coverage.
“Deductibles uniquely detract people from seeking care, so that’s a significant focus,” Altman told California Healthline. “California is really grappling with affordability and thinking about, ‘What does affordability really mean?’ Many people simply do not have $5,000 sitting in their bank account in case they need it for health care.”
Additional reductions in patients’ out-of-pocket costs — on top of existing federal health insurance subsidies to reduce monthly premiums — will take effect in January for people renewing or purchasing coverage during Covered California’s next enrollment period, which begins in the fall. The state could go further in helping reduce patients’ costs in subsequent years with future budget increases, Altman said.
Still, those savings may be offset by higher costs…
Read the full article here
