Merced County residents among nearly 30,000 enrolled in Covered California health insurance plans

03/07/2014 12:42 AM

03/07/2014 12:45 AM

In the first four months of enrollment, almost 30,000 consumers signed up for health insurance through the Covered California exchange in a five-county region that includes Merced County.

Of the 29,696 people who enrolled in the health plans through Jan. 31, 91 percent, or 27,157, are eligible for subsidies to reduce their premiums. The remaining 9 percent are required to pay the full premium.

The numbers are for Stanislaus, San Joaquin, Merced, Mariposa and Tulare counties, which were grouped in a pricing region by Covered California, the exchange created to spearhead the Affordable Care Act in the Golden State.

The exchange has estimated that 108,000 residents of the five counties are eligible for subsidized coverage under President Barack Obama’s health care overhaul. Stanislaus and San Joaquin are the biggest counties, with more than 1.2 million residents combined and large ethnic populations that face barriers to health care.

The four approved insurers in the region offer a range of options, from platinum plans, costing $416 to $508 per month for a 40-year-old adult and covering 90 percent of bills, to bronze plans costing $223 to $348 per month for 60 percent coverage. Lower-wage earners eligible for tax credits have reduced their premiums to as little as $20 a month.

The state is entering the final leg of the enrollment campaign, which began Oct. 1 and ends March 31. The law signed by Obama in 2010 will assess tax penalties on those who remain without insurance.

Since October, almost 730,000 residents statewide have signed up through Covered California, with 86 percent eligible for help with premiums.

In releasing the data this week, Covered California said that it quickened the pace of Central Valley enrollments by adding call center phone lines, improving website efficiency and providing content in Spanish.

The exchange tallies enrollments when consumers finish their applications and choose a health plan. Consumers are not insured until they receive an invoice from the insurer and make the initial payment.

The numbers don’t reveal how many uninsured residents of the region have gained coverage during the campaign, which has been fraught with website glitches, long wait times and delays in receiving insurance cards. Many previously insured customers have shopped on the exchange, including those who had their individual-market policies canceled because they didn’t meet the new federal standards.

In addition, individuals and families meeting certain guidelines can obtain lower-cost health plans to replace more expensive insurance.

According to the regional data, silver plans covering 70 percent of medical costs were chosen by 68 percent of customers; 20 percent chose the bronze plans; 6 percent gold; and 5 percent platinum. Catastrophic coverage was selected by 1 percent, or 277 residents.

Close to 19,480 residents in the five counties, or 66 percent, signed up with Anthem Blue Cross. Kaiser Permanente added 5,847 members, Blue Shield enrolled 3,913, and HealthNet took in 455.

Mike King, chief operating officer for Doctors Medical Center in Modesto, said some patients with Covered California plans are using the hospital for elective surgeries or other treatment. “We are seeing some activity, but it is not a lot,” King said. “It is hard to know if they are newly insured or they simply made changes in their health plans.”

Jose Rodriguez, chief executive officer of El Concilio in Modesto, said the Latino community group is making every effort to increase enrollments. He said many “mixed status” families are reluctant to use the exchange: Some members are eligible, but others are not because of their immigration status.

He added that some low-income residents don’t want to enroll in Medi-Cal under the expanded income eligibility because of the perception it is welfare. He suggested a name change, such as Cal-Med, could make it more appealing.

King said hospital officials are tracking the new insurance marketplace.

“There is progress being made in terms of people getting coverage,” he said. “However, there is still a long way to go.”

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