Health

Uncertainty Over Federal Money Could Spur Covered California Rate Hikes

Published

9 years ago

June 16, 2017

By Emily Bazar, Kaiser Health News

If the federal government does not clarify by mid-August whether it will continue an important health insurance subsidy for consumers next year, California’s state-run exchange will instruct its insurers to sell plans with significantly higher premiums to cover the loss of the money.

“Bottom line, we have come to the conclusion that if there’s no federal commitment to fund [the subsidies] by mid-August, we will presume they will not be funded and use higher rates for 2018,” Amy Palmer, director of communications for Covered California, said in an email.

At issue are the so-called cost-sharing subsidies that reduce what some consumers pay out of their own pockets for medical expenses such as physician visits, prescription drugs and hospital stays. These reduced rates are only available to Covered California enrollees who choose silver-level plans, the second-least expensive among the exchange’s four tiers. The subsidies are to help people whose annual income is between 139 percent and 250 percent of the federal poverty level, or about $34,200 to $61,500 for a family of four.

As of last summer, about half of the exchange’s enrollees — currently about 1.4 million people — benefited from cost-sharing reductions, Palmer said.

The subsidies are under challenge in a pending lawsuit by House Republicans, and President Donald Trump has threatened to stop making the payments, which go directly to health insurers to cover the cost of lowering consumers’ out-of-pocket expenses. The subsidies are separate from the federal health law’s tax credits, which reduce monthly premiums for qualified consumers.

A recent analysis commissioned by Covered California estimated that premiums for silver plans would jump by 16.6 percent if federal funding for cost-sharing subsidies were lost. That is over and above any annual rate increases on the table.
Last week, Covered California instructed participating insurers to submit alternative premium hike proposals for 2018 in the event they lose the federal payments. The agency told them to apply the hikes only to silver-tier plans, since the cost-sharing subsidies are available only to people who buy those plans.

The insurers’ proposed rates are due to Covered California by June 30, and the agency will publicly announce the final rates in mid-July, after negotiations with the health plans.

After that, the exchange can’t wait too long before determining which rates consumers will face in 2018, Palmer said. State regulators will still have to review the rates, and Covered California as well as the health plans will need to time to prepare for open enrollment in the fall.

As a result, the exchange determined this week that it will move forward with the higher rates in August if the uncertainty remains about the federal payments.

“As we hear about health plans exiting some markets, and as we work hard to create necessary market stability, waiting for clear federal guidance on [the subsidy] funding is no longer an option,” Covered California Executive Director Peter Lee wrote in an email to colleagues and health policy leaders on Wednesday.

Lee noted that if Covered California adopts the higher premiums to cover the cost of the subsidies, many consumers would nonetheless be protected from them. That’s because as premiums rise to make up for the loss of the cost-sharing subsidies, federal tax credits would grow to offset those higher premiums.

“These increased costs will be borne by the federal government … and will be significantly more than the federal government would pay if it continued making direct payments” for the subsidies, Lee wrote in a separate letter to Seema Verma, head of the Centers for Medicare & Medicaid Services.

Oakland Post

Posts by Oakland Post

Related Topics:Affordable Care Act Covered CA federal dollars Health Trumpcare

Up Next

Rev. William Barber: Anti-Voter Laws Worse Than Russian Meddling

Don't Miss

Report: Special Prosecutor Investigating Trump for Possible Obstruction of Justice

Oakland Post

Click to comment

Activism

COMMENTARY: The Biases We Don’t See — Preventing AI-Driven Inequality in Health Care

For decades, medicine promoted false assumptions about Black bodies. Black patients were told they had lower lung capacity, and medical devices adjusted their results accordingly. That practice was not broadly reversed until 2021. Up until 2022, a common medical formula used to measure how well a person’s kidneys were working automatically gave Black patients a higher score simply because they were Black. On paper, this made their kidneys appear healthier than they truly were. As a result, kidney disease was sometimes detected later in Black patients, delaying critical treatment and referrals.

Published

2 months ago

February 10, 2026

Oakland Post

Sen. Akilah Weber Pierson, M.D (D-San Diego). File photo.

By Sen. Akilah Weber Pierson, M.D., Special to California Black Media Partners

Technology is sold to us as neutral, objective, and free of human flaws. We are told that computers remove emotion, bias, and error from decision-making. But for many Black families, lived experience tells a different story. When technology is trained on biased systems, it reflects those same biases and silently carries them forward.

We have seen this happen across multiple industries. Facial recognition software has misidentified Black faces at far higher rates than White faces, leading to wrongful police encounters and arrests. Automated hiring systems have filtered out applicants with traditionally Black names because past hiring data reflected discriminatory patterns. Financial algorithms have denied loans or offered worse terms to Black borrowers based on zip codes and historical inequities, rather than individual creditworthiness. These systems did not become biased on their own. They were trained on biased data.

Healthcare is not immune.

These biases were not limited to software or medical devices. Dangerous myths persisted that Black people feel less pain, contributing to undertreatment and delayed care. These beliefs were embedded in modern training and practice, not distant history. Those assumptions shaped the data that now feeds medical technology. When biased clinical practices form the basis of algorithms, the risk is not hypothetical. The bias can be learned, automated, and scaled.

For us in the Black community, this creates understandable fear and mistrust. Many families already carry generational memories of medical discrimination, from higher maternal mortality to lower life expectancy to being dismissed or unheard in clinical settings. Adding AI biases could make our community even more apprehensive about the healthcare system.

As a physician, I know how much trust patients place in the healthcare system during their most vulnerable moments. As a Black woman, I understand how bias can shape experiences in ways that are often invisible to those who do not live them. As a mother of two Black children, I think constantly about the systems that will shape their health and well-being. As a legislator, I believe it is our responsibility to confront emerging risks before they become widespread harm.

That is why I am the author of Senate Bill (SB) 503. This bill aims to regulate the use of artificial intelligence in healthcare by requiring developers and users of AI systems to identify, mitigate, and monitor biased impacts in their outputs to reduce racial and other disparities in clinical decision-making and patient care.

Currently under consideration in the State Assembly, SB 503 was not written to slow innovation. In fact, I encourage it. But it is our duty must ensure that every tool we in the healthcare field helps patients rather than harms them.

The health of our families depends on it.

About the Author

Sen. Akilah Weber Pierson (D–San Diego) is a physician and public health advocate representing California’s 39th Senate District.

Oakland Post

Posts by Oakland Post

Activism

As California Hits Aging Milestone, State Releases Its Fifth Master Plan for Aging

“California’s Master Plan for Aging started a powerful movement that is shaping the future of aging in our state for generations to come,” Gov. Gavin Newsom said in a statement, calling the initiative a “future-forward” model delivering real results for older adults, people with disabilities, and their families.

Published

2 months ago

February 9, 2026

Oakland Post

iStock.

By Bo Tefu, California Black Media

On Jan. 27, California released its Fifth Master Plan for Aging Annual Report,titled “Focusing on What Matters Most,” outlining the state’s progress and priorities as its population rapidly grows older.

The report, issued by the California Health and Human Services Agency (CalHHS), provides updates on the Master Plan for Aging’s “Five Bold Goals”: housing, health, inclusion and equity, caregiving, and affordability.

The report comes as Californians aged 60 and older now outnumber those under 18 for the first time, a demographic shift expected to accelerate over the next decade.

Launched in 2021, the Master Plan for Aging takes a “whole-of- government” and “whole-of-society” approach, coordinating state agencies, local governments, community organizations, and private partners. The annual report highlights significant milestones, including more than 100 California communities joining AARP’s Age-Friendly Network and $4 million in state funding awarded to local organizations to develop aging and disability action plans in 30 communities statewide.

The report also underscores California’s leadership at the national level, noting that dozens of states have followed its example and that federal legislation inspired by the plan was reintroduced in the U.S. Senate in December 2025.

CalHHS Secretary Kim Johnson emphasized the plan’s focus on equity and resilience amid ongoing challenges.

“The Master Plan for Aging continues to provide a vision, a focus, and a platform for collaboration,” Johnson said. “Equity is at the center of all that we do.”

Looking ahead, the report notes that by 2030, one in four Californians will be age 60 or older, positioning the Master Plan for Aging as a central framework for meeting the state’s long-term social, economic, and health needs.

Oakland Post

Posts by Oakland Post

Community

Candidates Vying for Governor’s Seat Debate at Ruth Williams–Bayview Opera House in San Francisco

The gubernatorial debate participants included Antonio Villaraigosa, former Los Angeles mayor; Matt Mahan, San Jose mayor; Betty Yee, former California state controller; Xavier Becerra, former U.S. Secretary of Health and Human Services, and attorney general of California; Steve Hilton, political commentator and political adviser; Tom Steyer, entrepreneur, and Tony Thurmond, California’s superintendent of public instruction.

Published

2 months ago

February 9, 2026

Oakland Post

The gubernatorial debate was hosted by KTVU’s Greg Lee, KTTV’s Marla Tellez and KTVU’s Andre Senior. The candidates are (l.-r.): Xavier Becerra, Steve Hilton, Matt Mahan, Tom Steyer, Tony Thurmond, Antonio Villaraigosa, and Betty Yee.

By Carla Thomas

On Tuesday, Feb. 3, seven candidates took the stage at the historic Ruth Williams–Bayview Opera House in San Francisco for the gubernatorial debate, hosted by the Black Action Alliance (BAA) in partnership with KTVU and sister station KTTV Fox 11 in Los Angeles.

For many voters, it marked a first opportunity to hear directly from several candidates seeking to lead the nation’s most populous state.

Crucial topics and issues addressed throughout the debate included housing, crime, immigration, climate change, health care and homelessness.

The debate was moderated by KTVU political reporter Greg Lee alongside KTVU’s Andre Senior and KTTV Fox 11’s Marla Tellez.

Candidates also addressed inflation and the rising costs across the state, impacting everything from groceries to childcare and health care.

Thurmond vowed to generate 2.3 million units of housing by placing 12 units on each parcel of available land in the 58 counties of California. Steyer agreed that billionaires should pay their fair share of taxes.

Hilton wanted to cut taxes, help working-class families, and end the Democrats “climate crusade and insane regulations.”

Yee offered a more transparent governmental approach with accountability, given the state’s debt.

Gonzalez said, “This debate was a great way to see who has great ideas and who has substance.”

“It’s important to have the debate within a community that requires the most,” said business leader Linda Fadekye.

Attendees included State Controller Malia Cohen, representatives of the National Coalition of 100 Black Women, the National Coalition of 100 Black Men, the San Francisco African American Chamber of Commerce, and Black Women Organized for Political Action, among others.

Event host, the Black Action Alliance (BAA) was established to amplify the voices of the Bay Area’s Black community, whose perspectives have too often been overlooked in politics and public policy.

Loren Taylor, CEO of BAA, said it was important to bring the event to the Bayview in San Francisco and shared his organization’s mission.

“The Black Action Alliance (BAA) stands for practical, community-driven solutions that strengthen public safety, address homelessness, support small businesses, expand affordable housing, and ensure access to quality education—issues at the heart of the Black experience in the Bay Area,” said Taylor.

California’s primary election will take place on June 2 and the general election will take place on Nov. 3.