It’s open enrollment season again. Here come higher premiums

Good morning, and welcome to the Essential California newsletter. It’s Tuesday, Nov. 1 — T-minus seven days until the midterms. I’m Jon Healey, senior editor of the Utility Journalism Team, offering explanations and answers from my perch in South Pasadena.

There’s not just an election looming, but it’s also a time when millions of Americans have to decide what kind of health insurance to carry for the coming year. Heaven forfend that we should ever need the coverage, but it’s a risky bet to go without insurance if you can afford it.

Open enrollment for Medicare began on Oct. 15 and runs through Dec. 7. Many employer health plans, which typically have shorter open enrollments and variable dates, have also started briefing workers on their options and calling on them to make decisions.

And for anyone not covered by an employer’s comprehensive health plan, today is when open enrollment begins at Covered California, the health insurance marketplace created by the 2010 Affordable Care Act. Covered California’s subsidized policies are available to some households that have access to an employer’s health plan too, which I’ll explain in a bit.

I’ve been writing about healthcare policy for more than a decade, and I still dread open enrollment. There are just so many variables — premiums! deductibles! copays! networks! tax strategies! — that I struggle to figure out the right path. And I like math.

In part, that’s because the system makes you bet how much care you and your family will need in the coming year. If you don’t think you’ll need much care, you can go for a high-deductible plan and save on premiums. But if you bet wrong, the pain will be both physical and financial.

(One other pain point: Premiums are rising about 6% on average in the coming year, a sharper increase than we’ve seen in the last few years. Oddly enough, the pandemic held insurance costs down by reducing the demand for healthcare, but things are now getting back to normal.)

Covered California has its issues, but it has worked to simplify the choices faced by its customers, who don’t have the benefit of a company human resources team to guide them. It has standardized the insurance plans offered in the various tiers to help you make apples-to-apples comparisons.

For example, the difference between one “silver” plan and another boils down mainly to provider networks and premiums, not how much you’ll pay for which services. Covered California also provides easy-to-grasp quality ratings, and is imposing standards on insurers to push them to improve patient outcomes in key areas.

Yet there is one not-so-simple aspect to getting insurance from Covered California: figuring out whether you and your family qualify for subsidies.

If your employer offers you health insurance, you won’t be eligible for discounted premiums from Covered California unless your health plan at work would cost more than 9.12% of your household’s annual income. But your spouse and kids might be eligible for Covered California’s subsidies if the cost of your employer’s family coverage crosses the 9.12% threshold.

In that case, the lowest-cost approach may well be for you to carry two policies — one for you from your employer, and one for the rest of your family from Covered California. But that might mean two different networks of doctors, dentists and other healthcare professionals.

I explained the situation in greater detail in this piece. But don’t let the complication stop you from signing up for coverage! In California, you have to — the penalty for going uninsured is at least $850 per adult and $425 per dependent child younger than 18.

And now, here’s what’s happening across California:

Note: Some of the sites we link to may limit the number of stories you can access without subscribing.

L.A. STORIES

Clockwise from top left: Chris Estrada, Xolo Maridueña, Mayan Lopez, Kali Uchis, María Zardoya, Harvey Guillén, Natalia Molina, Melissa Barrera.

(Ruby Broobs / For The Times )

La Vanguardia — a look at Latino artists, movers and shakers in Hollywood. A year after lamenting the lack of Latino representation in the entertainment industry, The Times offers the flip side: a survey of the rising writers, actors, directors, architects, thinkers, musicians and other artists who are shaping the culture you are living in now and certainly the culture you’ll be living in tomorrow. Los Angeles Times

An open letter from John Leguizamo to Hollywood. “We Latinos are 19% of the population and the largest ethnic group in America, and we’ve been here long before the conquests of the 1500s. How are we not more visible onscreen and onstage?” Los Angeles Times

And while we’re on the subject of Tinseltown: How Hollywood turned a “blind eye” to Emmett Till for 67 years. Reluctant to tackle the brutal murder of the African American 14-year-old, Hollywood favored civil-rights-themed projects about the Rev. Martin Luther King Jr. and films like 1988’s “Mississippi Burning” in which the dominant characters were white. Los Angeles Times

Where has L.A.’s wine industry gone? Columnist Patt Morrison chronicles the rise and precipitous fall of Los Angeles’ once great vineyards. Los Angeles Times

POLITICS AND GOVERNMENT

Rep. Katie Porter speaks during a campaign stop at the Huntington Landmark senior community in Huntington Beach on Oct. 17.

(Myung J. Chun / Los Angeles Times)

Will Orange County prove too red for Katie Porter? A national Democratic star, Porter is locked in a fierce race against Republican Scott Baugh. It’s a battle not just over her political trajectory and the balance of power in the House but also for Orange County’s ideological identity. Los Angeles Times

Gov. Gavin Newsom campaigned on building 3.5 million homes. He hasn’t gotten even close. “Just 13% of the 3.5 million homes he campaigned on building have been permitted, let alone built.” CalMatters

As Proposition 29 vote looms, dialysis patients brace for change. For the third time, Californians will have a chance next month to vote on whether to impose major new rules on dialysis clinics statewide that could affect as many as 80,000 patients. Los Angeles Times

Last-minute oil millions flowing to moderate California Democrats are a “double-edged sword.” Oil companies are spending heavily on campaign ads in an effort to unseat two Democrats also regarded as moderates (by California Legislature standards). Sacramento Bee

Would Proposition 1 allow abortions after fetal viability? Legal experts say no. It’s not only the language of the proposed constitutional amendment that counts, they say, but also the context. CalMatters

Excuse me, did you forget something? The State Controller’s Office is holding $12 billion in unclaimed property, including funds from abandoned bank accounts and unclaimed life insurance payouts. Sacramento Bee

CRIME, COURTS AND POLICING

Police work outside House Speaker Nancy Pelosi’s Pacific Heights home after the assault on her husband, Paul Pelosi.

(Anadolu Agency via Getty Images)

Attack suspect David DePape intended to kidnap, “kneecap” Nancy Pelosi, prosecutors allege. This story gets more bizarre by the day. Los Angeles Times

Ex-girlfriend of suspect in Paul Pelosi attack says he struggled with mental illness, drugs, believed he was “Jesus for a year.” What I meant was, this story gets more bizarre by the hour. San Francisco Chronicle

Another study finds racial disparities in stop data at sheriff’s departments across the state. Examining data from Sacramento, Los Angeles, Riverside and San Diego counties, Catalyst California and the American Civil Liberties Union of Southern California found that deputies at all departments stopped Black people at higher rates than white people. That was particularly true for traffic stops. San Diego Union-Tribune

$3.4-million ID theft scam targeted poor Southern California homeowners, DA says. Three residents of Los Angeles, Ventura and Riverside counties are accused of fraudulently taking out home improvement loans in the names of 32 different victims. Orange County Register (subscribers only)

Danny Masterson’s accusers feared being kicked out of Scientology — as his stepfather was. “When it happened, I cried. It’s my kids. I raised my children and now they’ve turned against their dad,” Joe Reaiche said in an interview with The Times. “Not because of my decision, but because of the church’s decision. That’s the evil of disconnection.” Los Angeles Times

A West Los Angeles man has been sentenced to 18 years for harassing female VA doctors. “This defendant earned a lengthy prison sentence by terrorizing his victims for years,” U.S. Atty. Martin Estrada said of 51-year-old Gueorgui Hristov Pantchev. MedPage Today

HEALTH AND THE ENVIRONMENT

An aerial view of the Los Angeles River west of DeForest Park in north Long Beach.

(Allen J. Schaben / Los Angeles Times)

Major flood would hit Los Angeles Black communities disproportionately hard, study finds. UC Irvine researchers also find that a 100-year flood in the Los Angeles Basin would put roughly 30 times as many people at risk as the Federal Emergency Management Agency has estimated. Los Angeles Times

Accidental carbon dioxide release at LAX leaves four workers sick, one critically. The leak occurred in an underground electrical room near Terminal 8’s baggage claim area. Much also could be said about deliberate carbon dioxide releases on the LAX tarmac. Los Angeles Times

Atmospheric rivers will hit the West soon. What does it mean for California? It all depends on the route the weather system takes. If you want rain in L.A., hope for the route to dip to the south. San Francisco Chronicle

CALIFORNIA CULTURE

How UC Irvine became an esports hotbed. This isn’t quite NCAA football or basketball, but Irvine has a dedicated esports arena, a coaching staff and uniformed squads playing in leagues based on three popular games: “Overwatch 2,” “League of Legends” and “Valorant.” One can only imagine the Red Bull budget. Los Angeles Times

The Haunted Mansion was especially festive at an after-hours Disneyland event.

(Todd Martens / Los Angeles Times)

How Disneyland’s Haunted Mansion popularized the haunted house and changed Halloween forever. “It turns out we have Walt Disney to thank for revolutionizing modern Halloween entertainment. And it all started with Disneyland’s Haunted Mansion.” SFGATE

For some celebs, pay-to-play Twitter verification is the last straw. Of all the horrors new owner Elon Musk might visit on the platform, could there be anything worse than having to pay $20 a month for a blue check? (Hmm, yes?) Los Angeles Times

CALIFORNIA ALMANAC

Los Angeles: 69, mostly cloudy. San Diego: 68, partly sunny. San Francisco: 57, showers. San Jose: 59, showers. Fresno: 69, rainy. Sacramento: 61, showers.

AND FINALLY

Today’s California memory is from Karen Michel:

If you have a memory or story about the Golden State, share it with us. (Please keep your story to 100 words.)

Please let us know what we can do to make this newsletter more useful to you. Send comments to essentialcalifornia@latimes.com.