The number of North Bay residents newly enrolling in Affordable Care Act plans is significantly lower than it was at this time last year, possibly a result of the uncertainty over enhanced subsidies set to expire at the end of the year.
Jessica Altman, executive director of Covered California, the state’s health exchange marketplace, said this week new enrollment is down 35% in North Bay counties compared to where it was last year.
That mirrors the statewide decline in new enrollment of about 30%, she said. New enrollment is made up of uninsured people who are enrolling in a Covered California plan for the first time or they haven’t enrolled in the past year.
Altman pointed out that new enrollment is just one segment of Covered California enrollment numbers. Overall enrollment, which also includes those who are renewing or switching from one plan to another, has remained stable since last year, she said.
“We have more people coming in and renewing, so we haven’t seen an overall enrollment drop off,” she said. “Doesn’t mean it won’t happen.”
Altman said some who are considering new enrollment may be “watching and waiting” to see what happens in Washington D.C., where lawmakers are debating the future of enhanced tax subsidies that significantly reduced the cost of health plans offered through health exchanges like Covered California.
“They may come in, they may shop and they’re like, ‘I’m not ready to push that enroll button,’” Altman said during a phone interview Tuesday. “There’s a lot of time left in open enrollment, and some of those people could still come in. For some of them, it may hinge on these enhanced tax credits. We don’t know.”
Tens of thousands impacted in Sonoma and Napa counties
With ACA subsidies set to expire at the end of the month, more than 23,000 residents in Sonoma County and more than 5,800 in Napa County could see their health insurance bills soar next year if Congress fails to extend pandemic-era premium subsidies, according to Covered California.
In Sonoma County, enhanced premium tax credits, adopted by Congress during the pandemic, have increased enrollment total by 11.7% since 2021. Similarly, in Napa County total enrollment grew by 11.9% during that period.
Residents who purchase coverage through Covered California would face average premium increases of 89% in Sonoma County and 85% in Napa County once the enhanced federal tax credits expire. That’s an average net increase in a monthly premium of $175 in Sonoma County and $171 in Napa County, according to the state exchange.
This week, the U.S. Senate is set to vote on both Democrat and Republican health care plans. The Democrats are proposing a 3-year extension to current subsidies.
Meanwhile, the GOP proposal would do away with the enhanced tax credits and put that money into health savings accounts for those who purchase a bronze-level or “catastrophic” plan, a move aimed at helping Americans pay for out-of-pocket costs.
People 18 to 49 year old earning less than 700% of federal poverty level would get $1,000 in HSA dollars while those 50 to 64 would get $1,500. Critics of the GOP plan say a deposit of $1,000 to $1,500 into a health savings account would not be enough to offset the rise in monthly premiums once the tax credits expire.
Altman said her agency is closely following the ongoing debates in both congressional chambers.
“The only way to protect consumers from the looming premium increases next year is by extending the Enhanced Premium Tax Credits,” Altman said in an email Wednesday. “Which help directly lower monthly premiums for consumers and have helped bring down the uninsured rate all across the nation.”
If the enhanced credits expire, thousands of middle-income residents in Sonoma and Napa counties would be forced to pay the full cost of their health insurance premiums.
In Sonoma County, 4,190 Covered California enrollees would lose all their subsidies and be forced to pay the full amount of their monthly premiums. In Napa County, that number is 1,040 people.
On average, in Sonoma County, this middle-income group receives a monthly subsidy of $506 to help pay for a premium that would otherwise cost $988. In Napa County, the average monthly subsidy is $482 for a premium that costs $968.
For the moment, there’s no significant local decline in the number of Covered California renewals. “Watching and waiting” for people who are renewing their plans means they’re not canceling or changing their health plans, she said.
“We automatically renew the majority of people, and so we haven’t seen sort of a drop in renewals, or a significant uptick in current enrollees dropping plans compared to prior years,” Altman said.
“People do drop their plans in normal years,” she said. “Maybe they got a new job or they turned 65. There are normal reasons that people do cancel…we’re not seeing that that big drop.”
But Altman said it’s possible people are “watching and waiting” to see what happens with the subsidies.
You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On X (Twitter) @pressreno.
New Affordable Care Act enrollment down by 35% in North Bay
