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Covered California unveils cost-sharing reduction program


Will help reduce out-of-pocket costs

The Affordable Care Act is making major progress as its Board of Directors approved enhanced benefit designs that will ensure over 600,000 Covered California enrollees see reduced out-of-pocket costs in 2024. In other words, Covered California is looking to provide major assistance with a state-enhanced cost-sharing reduction program which will assist with improving healthcare affordability and fees for everyone.

The Affordable Care Act is ensuring that health plans are responsible for the reduction of cost-sharing amounts and out-of-pocket maximums for consumers at or below 250 percent of the federal poverty level. The new budget package was approved by the Legislature and put into place by Gov. Gavin Newsom. The budget package allows for $82.5 million of the Health Care Affordability Reserve Fund to support a program that promotes financial assistance for 2024.

“Covered California is proud to be a part of another visionary program that strengthens the Affordable Care Act,” said Jessica Altman, executive director of Covered California. “California made history with the State Premium Subsidy program in 2021, and we appreciate the continued leadership from Gov. Gavin Newsom and the state Legislature to make health care access and affordability a priority in our state.”

In order to maximize the benefits of the new program it is important to enroll in the cost-sharing reduction (CSR) plans, specifically designed around the Silver-level coverage. Covered California has planned to automatically move around 35,000 enrollees to the Silver CSR plans if they qualify and provide more generous benefits at the same or a lower cost. Eligible consumers will be contacted by Covered California or can go online or contact the Covered California Service Center at (800) 300-1506 or through one of the 11,000 enrollment partners when the new period begins in October.

A Kaiser Family Foundation survey from March 2022 found that almost half of Americans with health insurance worry about affording outstanding deductibles. The Department of Health Care Services has estimated that between 2 and 3 million people will no longer be eligible for coverage, leaving them in difficult and precarious financial situations. Statistically, more than 75 percent of individuals determined eligible for subsidies after losing Medi-Cal have been eligible for cost-sharing reduction plans and will assist Californians seeking assistance.

“Recognizing that cost is still the key barrier to proper health care for too many Californians, our goal is to improve affordability for our enrollees in every aspect of their health care,” Altman said.