Covered California Active Members Receive Substantial Federal Assistance to Pay for Healthcare Coverage and Any Reduction to this Assistance Would Jeopardize Gains on the Affordability of Coverage

December 7, 2015

Amid talks of GOP reconciliation bills that would gut federal assistance from the Affordable Care Act (ACA) and leave millions of working people uninsured, many of California’s citizens benefit from buying healthcare coverage through the Exchange, Covered California, with federal assistance. Federal assistance comes in two forms for consumers: advanced premium tax credits (APTC) and cost-sharing reductions (CSR). According to Covered California’s June 2015 active member profile data, approximately 90% of subscribers of individual policies accept APTC to help pay for premiums (table 1). On average, consumers receive more than $400 a month in APTC. Some consumers are also eligible for additional federal assistance in paying out-of-pocket costs (copays and deductibles), referred to as cost-sharing reductions (CSR). About half (52%) of all active members are selecting plans that have these savings built into the plan. Although the passage of such a reconciliation bill is moot, as the President would veto such a bill, it is important to highlight the commitment by the government for individuals to obtain health care coverage. In California that commitment is valued at approximately $4 billion in premium assistance for individual coverage.

Access the entire brief here: Federal Assistance for Covered California Enrollees