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California taxpayer-funded health insurance draws more than 1.5M signups

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More than 1.5 million people in California have purchased health insurance through a taxpayer-funded marketplace, state officials announced Tuesday, the first increase in enrollment after three years of decline.

The 1.6% increase comes after California lawmakers approved a new tax on the uninsured and offered new subsidies to help middle-income earners pay their monthly health insurance premiums. Both were first-in-the-nation changes meant to boost enrollment at a time when the federal government under Republican President Donald Trump’s administration has seen enrollment fall nationwide.

But even though the open enrollment period ended Jan. 31, California’s numbers could still increase this year. State officials have decided anyone who did not know they would have to pay a tax for not having health insurance can still sign up for coverage through April 30. That’s because the state has decided to make that ignorance a “qualifying life event,” which would let them purchase coverage.

To be eligible for coverage, people will have to check a box on a form that says they did not know about the penalty. But Covered California Executive Director Peter Lee said people won’t have to sign an affidavit or take a lie detector test.

“I encourage everyone who does not have qualifying health insurance to take advantage of the special enrollment period,” State Controller Betty Yee said in a news release. “I like signing tax refund checks, not assessing penalties.”

Former President Barack Obama’s health care law lets people who don’t have health insurance through their jobs buy coverage through a marketplace, where insurance companies sell individual plans. The law also requires the federal government to help some of those people pay their monthly health insurance premiums, depending on how much money they make.

Most states let the federal government run the marketplace for them. But California has its own marketplace, called Covered California. Nationwide, the number of people purchasing health insurance through these marketplaces has been dropping since Trump took office and the federal government reduced its marketing budget and Republicans in Congress eliminated a tax on people who refuse to buy health insurance.

But last year, under new Democratic Gov. Gavin Newsom, California doubled down on its efforts to boost enrollment. They spent millions of dollars to offer new subsidies to people — so much that families of four earning up to $154,500 could be eligible for assistance. They passed a law that taxes people for not having health insurance, a penalty that could cost a family of four up to $2,000.

California gave people more time to sign up for coverage, extending its deadline through Jan. 31, more than a month after the federal deadline. And they spent a whopping $121 million on advertising, which included for the first time “influencers” on social media.

The result, announced Tuesday: a 1.6% increase in enrollment in Covered California, while enrollment on the federal marketplace dropped 0.5%.

State officials say a closer look at the numbers shows more reasons to celebrate. California has gotten its enrollment almost back to where it was in 2016. Total enrollment in Covered California is down 2% since 2016, while enrollment in the federal marketplace is down 14%.

But state officials are the most excited about the number of people who signed up for coverage this year who did not have coverage last year. That number — more than 418,000 — is a 41% increase over last year. Lee said new enrollments are important because they tend to be people who are healthier, which helps keep rates down for everyone.

This year, health insurance rates on Covered California increased 0.8%, the lowest increase in five years.

“Californians are seeing that by building on — instead of undercutting — the Affordable Care Act, they are directly benefiting from lower health care costs and more people being insured,” Lee said.

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