Navigating Enrollment in Covered California

While the Patient Protection and Affordable Care Act (ACA) has been the law for eight years now, most Americans still may have trouble understanding how coverage works, whether they qualify for coverage, and how to enroll in programs.

The infographic Pathway to Enrollment: A Virtual Tour of Covered California’s Online Application can help. Originally published by the California Health Care Foundation and created in partnership with Social Interest Solutions, the infographic shows the overall process illustrating scenarios of three representative families applying for health care through Covered California, where Californians purchase insurance under the Patient Protection and Affordable Care Act. The infographic showcases what goes into assessing eligibility, what subsidies (if any) enrollees are entitled to, and what insurance plans are available. The three families represented in the infographic include:

• A part-time worker and her 14-year-old daughter
• A married couple who have legal residency and are expecting their first child
• A single man who has an insurance offer from his employer

“It’s a practical resource for consumers so they can visually see what is involved behind the scenes in enrollment for coverage,” says Hilary Dockray, SIS project lead. “It is also a valuable tool for health care advocates because it provides ready-to-use examples they can point to in their outreach, and is an effective reference tool for think tanks, academics and elected representatives who are interested in understanding all the steps that go into enrollment.” You can check the infographic at https://www.socialinterest.org/pathway_to_enrollment/index.html.

The ACA has provided a path to health coverage for many Americans not covered by employer-sponsored health insurance. The ACA also introduced mandates that ushered in significant changes for many Americans by eliminating lifetime and annual limits, letting children up to 26 stay on their parents plan, forbidding companies from dropping employees who get sick, and–perhaps the component that has helped the most people–eliminating policies that exclude anyone with a pre-existing condition.

Most people are surprised to learn the ACA benefits the middle class more than the poor. Though some believe it provides health insurance to illegal immigrants at taxpayer expense, it does not.

The ACA offers subsidies to families who earn roughly between $47,000 and $94,000, and who do not have access to employer sponsored health insurance. These families earn too much income to qualify for Medicaid, yet are usually priced out of private health plans. The ACA will offer $1.039 trillion in subsidies between 2015 and 2024.

Covered California will open for 2019 coverage on November 1 and run through January 31, 2019.  Last year 8.8 million Americans signed up for 2018 coverage via the federal health insurance exchanges created by the ACA, despite a shortened registration window that ended on December 15. That volume of sign-ups signals there continues to be a great demand for the affordable coverage provided by the ACA despite increasing fluctuations in the price of premiums from state to state.