[UPDATE: The latest version of what’s new in health insurance can be found here.]
With added options, expanded access to Medi-Cal, and even more financial help, getting health insurance has never been this affordable.
Buying health insurance for 2023? It’s a good idea to get up to speed on the new rules and regulations, and how to get or stay covered. So, here’s what you need to know.
More Financial Help Thanks to the American Rescue Plan and the Inflation Reduction Act
Enacted in the wake of the COVID-19 pandemic, the American Rescue Plan (ARP) made health insurance more affordable for people during a difficult economic time. The ARP was originally set to expire at the end of 2022, but thanks to the recent Inflation Reduction Act, savings will continue through 2025.
A whopping 2.4 million Californians stand to benefit from this financial help—and people who enroll through Covered California save an average of $5,000 a year on health insurance. What’s more, nearly one-quarter of those who qualify for financial help have a $0 monthly premium. And two out of three enrollees can get coverage for $10 or less per month. All of that means more money back in your pocket.
Expanded Choices for Buying Health Insurance
Covered California now has expanded to 12 health insurance companies. No matter where you live, in 2023, you’ll have a choice of at least two companies—and 93 percent of people can choose from three or more. More options mean more flexibility to find a plan that’s right for you.
Major Fix for the Affordable Care Act’s “Family Glitch”
Almost 400,000 Californians could take advantage of more affordable coverage through Covered California by a fix to the Affordable Care Act (ACA) “Family Glitch.” The “Family Glitch” describes an issue where the cost of employer health insurance coverage was considered “affordable” based solely on the cost of covering that employee. If the employee had a family, the additional cost of coverage wasn’t factored in, and in many cases, meant family members did not qualify for financial help for health insurance through Covered California.
Beginning 2023, spouses and children who don’t have access to affordable employer health insurance coverage can qualify for this financial help based on their household income.
Some Parents Can Now Sign On to Their Adult Children’s Health Insurance
California will become the first state in the country to allow adult children to add parents and step-parents to their health insurance plan thanks to the Parent Healthcare Act. There’s no age requirement for parents, but they must meet the federal definition of a “qualifying relative,” meaning their annual gross income is very limited and the adult child covers more than half of their total annual expenses. This new rule may be especially helpful for older adults who aren’t eligible for Medicare, including green card holders who haven’t lived in the U.S. for the required five years.
Public Health Emergencies Will Now Be Qualifying Life Events
In the aftermath of the COVID-19 pandemic, California is looking to the future to make sure everyone has access to health insurance in the case of another crisis. As such, all public health emergencies (such as COVID or monkeypox) count as qualifying life events, an opportunity for impacted Californians to enroll in a new health plan through Covered California outside of the normal open enrollment window. Publicly declared state of emergencies are also qualifying life events. This includes natural or human-caused disasters such as a wildfire or flood. Californians have 60 days from the date that the emergency was declared to sign up for coverage.
More Access to Medi-Cal Benefits, Regardless of Immigration Status
California is expanding Medi-Cal eligibility even further so more people can get covered. As of May 2022, all qualifying low-income adults 50 and older can enroll in Medi-Cal, regardless of immigration status. Californians under age 26 have benefited from this coverage rule since 2020. And, in 2024, access will be expanded to adults 26 to 49, thereby covering all ages of people with qualifying incomes.
Cheaper Prescription Medication for Older Adults
In addition to keeping health insurance more affordable for millions of Americans, the Inflation Reduction Act is making prescription medication less expensive for older adults. The federal government will now be able to negotiate prices for some of the most expensive drugs covered by Medicare. The Act also caps insulin co-payments for many people on Medicare—a much needed relief for the nearly 16 million seniors living with diabetes in the United States.
Staying Covered When Your Medi-Cal Eligibility Has Changed
Losing your Medi-Cal benefits can be stressful. The good news is that it’s never been easier to get quality brand-name health insurance.
If your household income qualifies you for financial help for health insurance, you’ll be automatically enrolled in the lowest cost Silver plan through Covered California. Many who qualify will pay as little as $0 per month for their monthly premium. However, you’ll need to confirm or change your plan to stay covered.
If you weren’t auto-enrolled, you need to take immediate action in order to prevent a coverage gap. Rest assured, you won’t pay more than 8.5 percent of your income for a benchmark Silver plan (the second lowest cost Silver plan in your area). There is plenty of support and options available to you. Learn more about getting covered here.
Stay Covered During a Labor Dispute or Strike
Employees on strike, in a labor dispute, or in a forced workplace lockout imposed by their employer are no longer at risk of going without health insurance. Beginning July of 2023, employees who lose coverage during this time may qualify for coverage through Covered California. Workers will receive the maximum financial help available (the same as an individual with a household income of 138.1% of the federal poverty level) and, beginning January 1, 2024, may not be subject to a deductible for any covered benefit. Coverage will be available immediately upon application.
Affordable Health Insurance for College Students
California residents, and their dependents, are required to have health insurance or face a penalty. Enrolling in student health insurance is one way to meet that requirement. However, low-cost coverage may also be available through Medi-Cal or through Covered California. You might even qualify for a $0/month premium. See what options and financial help is available to you here.
Can’t Be Denied Coverage Renewal Over Late Payments
During the Trump administration, insurance companies were allowed to refuse renewal of coverage to those who had fallen behind on their premium payments. That will no longer be the case. If you got behind on your monthly premium payments (or lapsed coverage due to nonpayment), you can still sign up for health insurance for 2023 from that same insurance company. And the payment required to begin coverage cannot be applied to past-due premiums.
We’ve Still Got You Covered!
Just like buying health insurance, your life and your family’s needs may change year to year. Covered California is always here to help you find the best plan for you as you navigate what 2023 may bring. Plus, you can find out quickly and easily if you’re one of the millions of people who qualify for financial help to pay for health insurance. Explore your options now and get the coverage you need through Covered California—or contact us at any time.
