Covered California open enrollment ends, but many still will transition in and out

April 2, 2014

Recent media reports about Covered California have focused on the crush of people trying to sign up for the program’s medical insurance programs by March 31, but analysts at UC Berkeley say not to overlook the many people who will join or leave the program after that deadline.

Researchers at UC Berkeley’s Center for Labor Research and Education are providing new data on the large numbers of people who will enter and leave the program over the coming year, outside the open enrollment period, as the program makes more people, due to various life transitions, eligible for coverage.

In a policy brief released today (Wednesday, April 2), the researchers said their data underscores how important it is to recognize the fluidity of California’s health insurance landscape in order to help people smoothly transition from one health plan to another and to avoid becoming uninsured.

“For many people, Covered California is a place where they will access coverage for a short time during a life transition, such as job-loss or divorce. People will enter and leave coverage on a regular basis,” said Ken Jacobs, who co-authored the report along with researchers Miranda Dietz and Dave Graham-Squire.

Their key findings include that:

  • Some 43 to 47 percent of those enrolled in a Covered California plan and also receiving federal tax subsidies to finance their coverage at any point during that time can be expected to leave that plan within 12 months. Of those, a projected 21 percent will move to Medi-Cal due to changing income and 19 percent to job-based coverage.
  • An estimated 16 percent of non-elderly individuals who signed up for Medi-Cal at any point in time are expected within 12 months to become eligible for plans offered through Covered California, due to their crossing over the Medi-Cal income eligibility threshold. An additional 9.1 percent of this group will move into job-based coverage.

Besides those leaving Medi-Cal, the report authors said others will enter the Covered California marketplace outside the open enrollment period when they experience life transitions that trigger a special enrollment period for them. These transitions include loss of job-based coverage; gaining or becoming a dependent through marriage, birth or adoption; becoming a citizen or lawfully present immigrant; and moving into a new service area.

 Making sure people transition successfully from one form of health insurance to another will depend, in part, on how much Medi-Cal and Covered California use existing institutional connections like the unemployment office, the Department of Motor Vehicles and food stamps applications to get the word out to eligible populations.

UC Berkeley’s Labor Center brief stresses the need for outreach, enrollment assistance and effective sign-up processes to be available year-round for potential Medi-Cal or Covered California applicants — not just during open enrollment.

“For health insurance reform to be successful in reducing the numbers of uninsured, Medi-Cal and Covered California will need to be prepared for not just long-term enrollees, but also enrollees who churn through the system and are enrolled for less than a year,” the authors conclude.

The brief is available online.

The Labor Center is a public service and outreach program that concentrates on labor and employment issues.  A major center focus is health insurance. Click here for additional studies relating to health care.

Related Information:

  • A Labor Center interactive map displays estimates of how many Californians are newly eligible for Medi-Cal and Covered California subsidies and the counties they live in.
  • A Labor Center calculator shows how much California families can save by signing up for insurance through Covered California.