California Obamacare (Affordable Care Act) Facts 2020

Essential facts about the Affordable Care Act (ACA or Obamacare) in California, including whether you must get health insurance, how much it will cost, and how you can save money.

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What California Residents Need to Know About Obamacare for 2020

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UPDATE: Due to the coronavirus (COVID-19) outbreak, Covered California is OPEN until June 30 for new health insurance signups.

This website provides information about getting health insurance under the Affordable Care Act (ACA), including:

To begin, keep in mind these key points about health insurance in California:

1. California law requires you to have health insurance.

The federal tax penalty for going without health insurance ended in 2019, but a handful of states, including California, have enacted laws to replace it. If you are uninsured in 2020 and you don't qualify for an exemption, you'll face a penalty when you file your California taxes in 2021.

To learn more about the penalty and to find out whether you qualify for an exemption, see Do I Have to Get Health Insurance in California?

2. Open enrollment has ended for 2020 health care plans, but you can still get health insurance if you qualify for a special enrollment period.

[SPECIAL UPDATE: Due to the COVID-19 outbreak, Covered California is OPEN until June 30 for new health insurance signups.]

In California, the ACA open enrollment period ended on January 31, 2020. This means that, unless you qualify for an exception, you won't be able obtain health insurance through Covered California until the 2021 open enrollment period begins in the fall of 2020.

To learn whether you qualify for an exception that will let you get covered, see What Happens If I Missed the California Obamacare Enrollment Deadline?

3. Your health insurance marketplace is located at Covered California.

During open enrollment, or whenever you qualify for an exception, you can use the website Covered California to choose your health insurance plan, apply for cost-saving tax credits, and get other help you need.

To learn more about enrollment, see How Do I Sign Up for Obamacare in California?

4. Insurers are sticking with the marketplace and premium rates are stable.

In California, all 11 insurers in the marketplace are expected to continue to offer plans for 2019. One of them—Anthem Blue Cross—will expand its offerings. This means that most Californians will be able to choose between three or more insurers. Even better, preliminary filings show that rates for California insurance coverage are set to go up an average of just 0.8%.

5. New California state subsidies are available to save you money.

More people than ever who sign up for insurance through Covered California will be eligible for premium subsidies. In addition to the existing federal tax subsidies for those with very low incomes, new subsidies offered by the state will help middle-income people pay less for coverage.

Federal premium subsidies. The federal government provides help with premium payments for those whose incomes fall between 100% and 400% of the federal poverty level. For 2020, for example, a family of four earning as much as $103,000 can qualify, as can an individual who earns up to $49,960.

New California state subsidies. Three groups of consumers will benefit from new subsidies offered in California for 2020 health plans:

  • Californians who earn between 400% and 600% of the federal poverty level will be eligible to save an average of 23% on their monthly premiums. For 2020, 600% of the federal poverty level is $74,940 for an individual and $154,500 for a family of four.
  • Those earning between 100% and 400% of the federal poverty level will be eligible to receive state subsidies in addition to federal assistance. The state subsidy will contribute additional average savings of 5% on monthly premiums.
  • State residents whose annual household income is less than 138% of the federal poverty level will see premiums for certain plans lowerd to just $1 per person, per month. The 2020 earnings cutoff for this level is $17,237 for an individual and $35,535 for a family of four.

Those with very low income may continue to qualify for for free or low-cost coverage through Medicaid in California (Medi-Cal). Eligibility for susidies or Medi-Cal will be automatically determined when you sign up for coverage at Covered California.

For more information, see Ways to Save Money on Obamacare in California.

6. California has banned the sale of "short-term insurance plans" lasting more than 12 months.

In 2018, the Trump administration made it easier to purchase short-term insurance plans. These plans don't have to cover preexisting conditions or the essential health benefits provided by Obamacare plans. The new federal rules say that short-term plans can last for as long as three years. But California placed its own limits on the expansion of short-term plans. Under California law, insurers may not sell short-term plans lasting longer than 12 months.

If you’re genuinely caught without health insurance and need it for a few months to cover a new health condition, you might want to consider a short-term plan to get you through to the next open enrollment period. Otherwise, be careful of plans that don’t meet the requirements of the Affordable Care Act. Shop around to look for coverage that truly meets your needs.

Remember, if your income is very low, you may qualify for free or low-cost coverage through Medicaid in California.

7. You can get help signing up if you need it.

A couple years back, the Trump administration drastically cut funding for the programs that provide help with health insurance enrollment. It also killed the budget for promoting the federal health insurance exchange. The good news is that California doesn't rely on federal funding for its outreach and enrollment assistance programs so you still have plenty of ways to get help.

An insurance agent or broker may be the best bet for sorting out your options. To find one or to learn about other support resources available to you, see How To Sign Up for Obamacare in California.


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