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Covered California not worried about lack of middle- and upper-income customers

Peter Lee, Covered California executive director, will oversee implementation of the Affordable Care Act in California.
Peter Lee
Covered California Executive Director Peter Lee.

Covered California has confirmed that only 14 percent of those who bought health insurance in the first two months of open enrollment earned too much for a federal subsidy, even though that income group makes up about half of the 5.3 million Californians believed eligible to buy a plan through the state-run marketplace. But Covered California says it is not concerned that it has attracted so few middle- and upper-income people , noting that it is still early in the sign-up process, and things change a lot during open enrollment. An independent analyst says those in higher income brackets are probably taking their time to enroll. 

Only those who make less than four times the federal poverty rate - about $46,000 for an individual and $94,000 for a family of four - are eligible for subsidies. While Covered California's original statistics for October signups showed nearly 26,000 enrollees who made too much for subsidies, the numbers it released on Thursday for signups in October and November combined showed that number had fallen to about 15,000.

 "During open enrollment period, you’re going to see numbers fluctuate quite a bit," said Covered California spokesman Dana Howard.
He pointed to a variety of possible factors: some people might have cancelled their plans, gotten insurance through a new job, passed away, moved out of state, or updated their applications.
Howard predicted that the enrollment numbers will stabilize as we approach the end of the sign-up period. Californians have until December 23rd to sign up for health insurance that takes affect January 1st. The full open enrollment period runs until March 31st. 

An independent expert said he is not surprised that the initial numbers include so few wealthier enrollees. "They’re higher income groups, they’ve always been able to afford insurance as long as they didn’t have a preexisting condition, and now they’re deciding which plan to buy," said Dylan Roby, an assistant professor of health services at UCLA's School of Public Health and a research scientist with the school's Center for Health Policy Research
Roby said that among those deciding late may be some of the roughly one million Californians whose plans are being canceled for not meeting the Affordable Care Act's basic coverage requirements. Because it wasn’t clear until late November that they would not get those plans back, they may just now be looking for new coverage, Roby said.
It’s also possible that, since they don't qualify for subsidies, many higher income people will buy their plans outside of Covered California, he added.