California May Extend Health Coverage to Illegal Immigrant Children

The California Senate recently approved a bill that would provide California health coverage for illegal immigrant children. This will make California the first state in the United States to provide health care coverage to kids who are in the country illegally, which means that they are requesting federal authorization to be able to sell private insurance to immigrants without requiring documentation.



There are between 195,000 and 240,000 children under the age of 19 from low-income families that would be able to benefit from state-funded Medi-Cal, which is the state’s version of Medicaid, even if they are illegal immigrants. The legislation will also seek a federal waiver that would allow the state to sell unsubsidized private health care insurance through Covered California, which is California’s health exchange. Now that the legislation has been approved by the State Senate, the bill only needs to be passed and signed by the Governor in order to go into effect. 

While many Senators believe that this is an important step in helping to expand access to health care throughout the state, some believe that the bill will amount to nothing more than an empty promise, believing that it won’t actually help illegal immigrants to obtain access to doctors since there already is a shortage of providers that accept Medi-Cal.

Although President Obama recently enacted an executive order that helped keep some immigrants from being deported because of a lack of comprehensive immigration reform, his action excludes any immigrants that came to the United States illegally from being able to qualify for federal health benefits. The cost to expand Medi-Cal to immigrant children could end up costing $135 million a year even without an executive action by the President.

For more about California health coverage for illegal immigrant children, contact us at the Benefits Store today.

Individual Health Insurance Trumps That of Small Businesses in California

According to a recent report by the California Healthcare Foundation, individual health insurance coverage in California has surged over the last few years, growing by 47 percent in 2014 and surpassing the coverage in the small-business market, which declined 11 percent last year.



The data shows the impact that Obamacare has had on the state of California. The individual health insurance market has been booming over the last two years because of the Covered California marketplace, which was established in part to offer premium assistance to those with lower incomes. Not only is it easier for California residents to obtain individual health insurance, they also have a financial incentive to do so – not buying health insurance will result in a fee that they will have to pay under Obamacare law. This fee grows by the year – in 2014, it was 1 percent of your household income or $95 per person – whichever was higher. This year, it’s 2 percent of your household income or $325 per person – whichever is higher.

The number of small businesses that have dropped benefits in the last few years has risen substantially, although the number of businesses that have done this to let employees get their own health insurance through Covered California remains unclear. This is the first time that individual health insurance has surpassed small employer group coverage, although there is no old data to compare it to since it wasn’t until 2012 that legislation required the California Department of Managed Health Care and the California Department of Insurance to publicly release its end-of-the-year enrollment figures for the insurers and health plans that they regulate.

Individual health insurance coverage in California continues to grow while small employer group coverage has been declining. For more information about health insurance coverage in California, contact the Benefits Store.

One Important SC Case Could Influence California Health Care

There have been a lot of California health care reform initiatives over the last few years, and this doesn’t look to change any time soon now that another case looks to influence health care reform as it is brought before the Supreme Court.

Health care reform


There are actually several pending cases that could result in national healthcare repercussions. The one you may have heard about is King v. Burwell, which challenges federal subsidies for health insurance. However, a new case has popped up in Vermont that involves claims data reporting that could have a huge impact on the way the government collects and analyzes healthcare data.

Over the last ten years, 16 states have established mandatory APCD (All-Payer Claims Database Systems) that collect and analyze information from health insurers in order to guide payment reform efforts. Around 30 other states are either considering or pursuing some type of data gathering similar to APCD. The issue is that Liberty Mutual Insurance, an insurer in Vermont, which is one of the 16 states with mandatory APCD systems, is refusing to provide its information to the state. The insurer’s argument is that Vermont law is superseded by the Employee Retirement Income Security Act of 1974. They are contending that self-insured plans require claims data reporting already and that the state’s laws are interfering. 

Experts believe that this case could have a huge effect not only on Vermont but the entire country as well. While the results of the case may not have a direct impact on California health care reform initiatives, all states will take the decision into account before they consider making a long-term investment in APCDs.

The Liberty Mutual Insurance case in Vermont could affect healthcare reform throughout the country. For more healthcare information, contact us at the Benefits Store today.

California’s Individual Health Insurance Market Grows 64%

Data from a new report has revealed that the California individual health insurance market has grown leaps and bounds since Obamacare went into effect last year – this shouldn’t be too big of a surprise considering the fact that individuals who chose not to purchase health insurance would be penalized by increasingly bigger fees.



According to the report, there are roughly 2.2 million Californians that now have individual health insurance – an increase of 64 percent.

As of December 31st, 2014, 843,607 Californians jointed the individual market both on the inside and outside of the Covered California insurance exchange. According to the Kaiser Family Foundation, the California individual health insurance market along with those of Florida, Georgia and Texas, account for half of the country’s enrollment growth of individual policies. By the end of 2014, a total of 15.5 million people across the country have purchased their own health insurance policy. This is a 46 percent increase from 2013.

While the fact that the Affordable Care Act requires most Americans to pay a penalty if they do not purchase health insurance, another factor in the huge increase in health insurance purchases is the fact that everyone in the country is guaranteed coverage regardless of what their medical conditions are. The act also provides financial subsidies to lower-income consumers.

Roughly 50 percent of California residents get their health benefits through their employer; however, the percentage of California businesses that provide coverage to employees has been decreasing. Only 58 percent of the state’s employers offered employees coverage in 2014, while almost 69 percent had offered coverage back in 2010.

Around 1.4 million people are currently enrolled in the Covered California exchange. For more information or advice about purchasing health insurance in California, be sure to contact us at the Benefits Store today.

Covered California Reveals 2015-16 Budget Proposal

The Covered California 2015-15 budget proposal was just revealed on May 13th and it showcases the same prudent fiscal planning that helped it to establish the biggest state health exchange in the country.

Source: Facebook

Source: Facebook

The federal Patient Protection and Affordable Care Act resulted in the establishment of Covered California’s insurance marketplace, which it created in partnership with the California Department of Health Care Services.

The following are a few of the highlights of the Covered California 2015-16 budget proposal:

  • This upcoming year will be the last year that federal establishment funds will be used. Covered California will receive roughly $100 million in federal funding for this year in order to continue to fund planning, development and implementation activities to continue to establish the biggest state exchange in the country. After this year, Covered California will begin relying on fees that it collects from its health plans in addition to the reserves saved from federal funds.
  • The fiscal year should end with almost $194 million in unrestricted reserves, which is enough for more than six month’s of operating funds. This means that Covered California is currently on strong financial footing.
  • If enrollment in the upcoming year ends up being larger than anticipated, then Covered California will lower the assessment they charge health plans. If enrollment ends up being lower than expected, they will explore the reduction of costs and either reduce reserves or increase the assessment they charge health plans.
  • In order to maintain a positive balance sheet, Covered California will begin to rely more on state personnel and less on contracted services in order to accomplish their goals and serve their customers.

These are just a few of the highlights of the Covered California 2015-16 budget proposal. For more information about Covered California, contact us at the Benefits Store today.