Affordable Care Act (2024)

Californians may visit CoveredCA.comor call 1-800-300-1506 for more information on the health plans available through the Covered California marketplace.

Covered California will provide more financial assistance thanks to the recently passed American Rescue Plan. The American Rescue Plan provides new and expanded subsidies to Californians. The new law ensures that everyone eligible will pay no more than 8.5% of their income on their health premiums.

The new special enrollment period allows individuals to sign up for coverage through Covered California without experiencing a qualifying life event, such as moving or loss of insurance. Anyone who meets Covered California's eligibility requirements can sign up for coverage through December, and coverage will begin on the first day of the following month they enroll.

As always, my District Office is prepared to answer any questions you may have about what the Affordable Care Act means for you and your family. Please contact us at (510) 370-3322.

Frequently Asked Questions

What if I already have health insurance? Do I have to enroll in the Marketplace?

If you have employer-provided health insurance, public program insurance such as Medicare, or are a veteran receiving VA health care, you are considered covered and can keep your current plan.

If, however, you are unsatisfied with the coverage you currently have or you purchase coverage on the "individual" market, you will have the option to switch to Marketplace coverage.

But, individuals with employer-provided coverage are also receiving numerous new protections and benefits under the ACA, including:

• Your insurer must spend at least 80 percent of your premium on health care as opposed to CEO bonuses or overhead.
• For most people in private plans, you have free coverage of key preventive services.
• Your insurer must give you the option of having your young adult children stay on or join your employer-provided plan until they turn 26.
• Your insurer cannot discriminate against you if you have a pre-existing condition or get sick.
• You are protected by a cap on your out-of-pocket costs.
• If you are a woman, insurers cannot charge you more than men for the same coverage.

What is the Covered California Marketplace?

Covered California is a new, easy-to-use marketplace where you and your family may get financial assistance to make coverage more affordable, and where you will be able to compare and choose health coverage that best fits your needs and budget. By law, your coverage can't be dropped or denied even if you have a pre-existing medical condition or get sick.

The Covered California Marketplace will help uninsured Californians gain access to affordable, quality, and accessible health care, including Essential Health Benefits.

What are Essential Health Benefits?

All health plans purchased through the Covered California Marketplace are required to have Essential Health Benefits. These include services like:

• Doctor visits
• Hospitalization
• Emergency care
• Maternity and newborn care
• Mental health and substance abuse services, including behavioral health treatment
• Prescription drugs
• Rehabilitative and habilitative services and devices
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric services
• Ambulatory patient services, including medical care provided without need of admission to a health care facility (i.e. blood tests, X-rays, vaccinations, and monthly well-baby checkups)

How do I choose a health plan through Covered California?