By Peter V. Lee, Executive Director of Covered California
Special to The Bee
What does the Supreme Court decision upholding the Affordable Care Act mean for millions of Californians? If you're a 40-year-old single working mother with three kids – it means a lot. With a family income of $64,000, she's not poor but would be challenged to pay the $14,200 annual premium it would cost her for a family health plan.
The Supreme Court decision was good news for that working mother and millions just like her:In January 2014, she can be covered by a quality, comprehensive health plan offered throughthe California Health Benefit Exchange. Thanks to the Affordable Care Act, she and her familywill get a credit from the federal government that will pay about $8,600 and cover 60 percentof their premium. Their share will be about $470 per month, still a lot of money, but we believe Californians will be willing to pay it to keep their families healthy, safe and secure.
The Affordable Care Act also benefits the millions of Californians who are already insured.Going forward, we will all benefit by having a guarantee that we will never lose our insurance coverage, from lower costs, better preventive care and wellness, and a health insurance system that will be about keeping people well instead of avoiding sick people.
California, long a leader in the effort to reform health care, has already made great strides in implementing the Affordable Care Act. Ten thousand state residents who had previously been denied coverage for pre-existing conditions now have it; 350,000 young adults are now insured through their parents' coverage; and 135,000 California seniors on Medicare have received help with purchasing their prescription drugs. These reforms, and many others, are making a real difference in the quality of life for Californians – and this is just the beginning.
The Supreme Court's decision affirmed the ability of states to create a health care exchange – a marketplace where consumers can compare rates and coverage options and determine if they qualify for health insurance credits. We will continue building this system, making it easier for both individuals and small businesses to compare plans and purchase coverage while dramatically expanding the number of Californians with health insurance. We look forward to making the purchase of insurance through California's Exchange as easy as buying a book on Amazon or shoes on Zappos.
Millions of Californians want to buy health coverage but either can't afford it or have been denied because of pre-existing medical conditions. In October 2013 – 15 months from now – the exchange will start enrolling Californians in affordable, quality health insurance coverage that will begin in January 2014.
No longer will insurance companies be allowed to avoid covering individuals with pre-existing medical conditions – the people who need health insurance the most. Instead, there will be incentives to help those in need get the best care possible. The rules are changing to move the insurance industry from one that rewards "avoiding risk" to one that encourages health plans to deliver the best care possible and keep people healthy. Californians have waited a long time for this day to come. There are simply too many families counting on us to make health reform work. The California Health Benefit Exchange will be working with thousands across the state to make sure we don't let them down.
Click here to view the editorial that originally appeared in the Sacramento Bee.