[LA FEATURE]Covered California: Affordable Care Act

LA FEATURE

What you need to know about the Affordable Care Act and how it affects Californians

"Sometimes I Feel Like I'm the Worst Father": Family Lacking Health Care Hopes Reform Will Help

Open enrollment begins Oct. 1

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    The Gardners, of Redondo Beach, are business owners, but still cannot afford health insurance for their three young children. Come Oct. 1, Jeffray Gardner says the Affordable Care Act won't just give them access to doctors -- it'll provide peace of mind.

    Jeffray Gardner owns Marsatta Chocolates in Redondo Beach and while it pays the bills, he says he still can’t afford health insurance for his family. Gardner has three children under 9 years old. They’ve been without coverage for years.

    “As far as checkups, sometimes I feel like I’m the worst father. That’s probably why I work the longer hours. I work 14, 16, sometimes 18 hours because I feel that I’m not providing,” Gardner said.

    Soon, the Gardners and many others facing similar challenges will be able to seek help through the new health insurance marketplace called Covered California, according to Peter Lee, executive director of Covered California.

    “This is historic,” Lee said. “Millions can get access to affordable health care they didn’t get before.”

    In Southern California, about 1.5 million people will be eligible for government subsidies, including individuals making less than $46,000 per year, and families of four making less than $94,000.

    More 4 You: Covered California

    Southern Californians have six insurance companies to choose from, each offering four levels of coverage -- platinum, gold, silver and bronze. Benefits are standardized at each level across all insurance companies involved.

    “Today unfortunately, a lot of health insurance, you may be getting a big gotcha down the road when you actually file a claim and say ah, that’s not covered,” Lee said. “With the (Affordable Care Act), health insurance is going to be meaningful, real and covering what you need to have covered.”

    Plans are based on age, income and where you live. That’s it. Applicants cannot be turned away for a pre-existing condition. Maternity care is included, and so are some preventative care and prescription drugs.

    While not everyone is happy about being required to buy health insurance, for the Gardners it may mean insuring the entire family for less than $300 a month.

    “I’m really looking forward to finding out what can be offered and if we fit in to one of those plans. I’ll be a happy camper that’s for sure,” Gardner said.

    Next year, every American has to have health insurance, or pay a penalty.

    If you already have insurance through your employer, you can keep it.

    If you don’t, you can get an estimate of your premium through Covered California’s online calculator.

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