Health insurance California has already undergone some changes as a result of the Patient Protection and Affordable Care Act (PPACA) of 2010. The big changes that everyone is waiting for take effect in late 2013 and early 2014. The most popular changes already in effect include the following: Guarantee issue coverage for children under the age of 19, dependent children can be on their parent’s health insurance until age 26, annual and lifetime benefit maximums no longer exist for individual, family or group health insurance plans, and preventive care is available before the plan deductible at no charge to all subscribers on individual, family and group health insurance plans.
The major changes from the PPACA having the largest impact on Americans include the following: There will be a health plan option for individuals and families requiring no health underwriting, there will be a health insurance exchange established in each state where subscribers can go to buy their health insurance plans, and the cost of care is expected to decrease.
No health underwriting is a big deal, especially for people with chronic health conditions who pay for all of their medical expenses out-of-pocket. Because of the PPACA a set of plans will be established for individuals and families allowing them to enroll in a plan regardless of their current health status. This will be a dream come true for many who have the money to pay premiums but can’t get approved because of their health. What about the people who can’t afford health insurance premiums? Government subsidies are expected to be available for people who fall below a certain percentage of the federal poverty level. Subsidies are expected to be available to pay for premiums, deductibles and co-insurance.
Health insurance exchanges are going to be a big part of reforming the health care system. In late 2013 each state is expected to begin launching their version of a health insurance exchange. If they have not established an exchange on their own, the federal government will step in and design one for them. These exchanges are expected to be fully operational on January 1st, 2014 and will provide an avenue for individuals and families to easily apply for a guarantee issue health plan.
The big idea for reducing the cost of health insurance is that by adding millions of uninsured people to the risk pool, more money will be available all around. With more people paying into the system the government and private insurance carriers should be able to reduce premiums for everyone. However, this idea only works if everyone participates. That is why the Internal Revenue Service (IRS) will be instituting a penalty for everyone that does not buy health insurance by a certain date. The burden of paying a penalty will hopefully sway Americans to go online and enroll in a plan.
Health Insurance California is certainly in for some major changes. One can only hope that the cost of coverage will be reduced for everyone. Some speculate that the increased costs of insuring those with chronic health conditions will bankrupt the system, and those with the chronic health conditions can hardly wait for the day they can finally enroll in a plan. One thing is for sure, health care reform is finally going to happen. We don’t quite know how it will look on the other side but at least we’ve got the ball rolling in the right direction.
Many non elderly Women Have Limited Incomes
One-third (34%) of non elderly women in California were low income in 2007, with family incomes below 200% of the Federal Poverty Level (FPL).1 Among the women in this group, 17% had family incomes that were 0-99% FPL, and another 17% had family incomes at 100-199% FPL. An additional 23% were moderate income, with family incomes that were 200-399% FPL. Among the subgroups of women ages 18-64, those with higher proportions of low-income women were African Americans (41%), American Indian/Alaska Natives (47%), Latinas (58%), younger women (ages 18–29; 46%) and single parents (66%).
Poor Health
Is More Prevalent among Women in Mid-Age and Women of Color Approximately one in five (18%) non elderly women reported being in fair or poor health; the rate nearly doubled for women with low incomes (32%). Additionally, among low income women ages 45–64, almost half (48%) reported being in fair or poor health.
High Blood Pressure Nearly one in five (19%) non elderly women had ever been diagnosed with high blood pressure.2 Rates increased with age: 11% of women in the 18–44 age group had been diagnosed with high blood pressure, compared to 33% of women ages 45–64. Within subgroups of women 45–64, this high prevalence condition had been diagnosed in half or more of American Indian/Alaska Native (50%) and African American (59%) women, as well as in approximately one in three Latinas (34%), Asian/Pacific Islander women (33%) and white women (29%).
Diabetes
Five percent of non elderly women reported having ever been diagnosed with diabetes.3 Prevalence rates rose with age and differed by race and ethnicity. Among all women 45–64, the prevalence of diabetes was 9%; rates were higher among African American women (17%) and Latinas (15%), who had approximately twice the rate of both white and Asian/Pacific Islander women (7% each).
Overweight and Obesity
Based on self-reported height and weight, one in five (21%) non elderly women was obese, and an additional 29% were overweight.5 Women ages 18–29 had the lowest rate of obesity (13%), with the rate increasing to 22%-26% among women ages 30–64.
Smoking Rates Still High for Some Groups
Slightly more than one in ten (12%) non elderly women—approximately 1.3 million— reported that they smoked cigarettes.
Lack of Coverage Is Associated with Less Preventive Care:
Physician Visit
Overall, 13% of non elderly women had not visited a physician in the past year, with rates three times higher for uninsured women (29%)
than for women with employment-based coverage (8%).
Mammography Screening
Overall, 79% of women ages 40–64 had received a mammogram within the past two years.
Pap Test Screening
Among women ages 21–64, 90% had received a Pap test screen in the past three years.
Discussion
Many disparities in health and health care access exist among non elderly women in California. The recently enacted health care reform provides opportunities to reduce some of these disparities. Implementation of provisions of the reform will begin this year and will continue through 2014, when the major reforms that expand access to health insurance coverage will be fully in place.
Let’s face the facts, health insurance is about as interesting as college level calculus. You never really think twice about it until you need it the most. Many choose to go without health insurance because they cannot afford it or have pre-existing health conditions. Worse yet many have not yet found out the harsh reality of what it is like to be stuck with expensive medical bills and will go with out coverage even though they are healthy!
If you have applied for individual health insurance before and experienced frustration with the medical underwriting process then you may want to look into going with a California short term health insurance plan.
Here are some important things you may not have known about short term health coverage:
Coverage is effective the next day from when you apply
Yep you heard it right. Your health insurance policy will go into effect the next day from when you submit a short term application. With individual coverage it can take up to a month or sometimes longer depending on the extent of your medical history. It is important to keep in mind that a short term health health plan is catastrophic only coverage meaning you preventive care is not covered. In the long run it is better to have a short term policy than nothing at all simply because going with out health coverage can leave the door open for bankruptcy to creep in!
The application is much simpler
You will have anywhere from 10-12 eligibility questions to answer on a short term application. If you’ve ever filled out an application for individual coverage than you understand it can be frustrating. If you don’t have medical records handy that contain specific dates of past medical services then you can’t complete the application unless you have an unbelievable photographic memory! Bottom line, the short term application brings with it much less stress.
Short term health plans offer excellent catastrophic coverage
Like individual coverage, short term health plans offer great coverage for major accident or illness. The only downside is that these plans are on a limited term basis so if you run out of coverage and need to apply for a new policy you are on the hook for any pre-existing conditions. Yes, that broken arm was covered quite nicely on your previous short term plan but now if you find yourself needing physical therapy and were able to transfer into a new policy, the physical therapy will be considered pre-existing and not be covered! While a short term health plan is excellent catastrophic coverage we recommend you get an individual or group insurance plan if they are available. This way you will save yourself the hassle of dealing with pre-existing conditions.
