RIVERSIDE COUNTY, CA — The Board of Supervisors Tuesday approved roughly $1.6 million in appropriations to fill early gaps in the current fiscal year budget, drawing down the county’s cash reserve, without notable impacts to the General Fund.

In a 4-0 vote without comment — and with Supervisor Karen Spiegel absent — the board signed off on the Executive Office’s expenditure request as part of a first-quarter 2024-25 “clean-up,” which typically occurs every September, after the state’s budget for the new fiscal year is in operation.

The appropriations will reduce the contingency cash balance from $7.5 million to $5.9 million, according to the Executive Office. The largest share of the outgo will be for costs tied to the March Air Reserve Base Joint Powers Authority, as part of an ongoing revenue sharing agreement, officials said.

Despite the draw-down, General Fund inflows and outflows for the current fiscal year remain on track, and in a few cases, agencies identified higher estimated revenues. There was no projection for a significant change in the $9.2 billion appropriations blueprint approved by the board in June.

The current budget represents an 11% increase over the 2023-24 spending plan.

One of the bright spots for the current fiscal year is the county’s reserve pool is expected to hit $698 million, compared to $590 million at the end of 2022-23. Executive Office staff estimated county discretionary revenue — which, unlike programmed funding, the board may use for any purpose — will top out at $1.22 billion, a $100 million increase over 2023-24.

County CEO Jeff Van Wagenen confirmed at the end of June there are remaining 2021 American Rescue Plan Act funds in the county treasury, but they’ll have to be spent by Dec. 31. The county received $480 million in ARPA allocations and another $500 million in 2020 Coronavirus Aid, Relief & Economic Security Act money. The federal infusions have been applied to “budget stabilization,” community development, infrastructure projects and related programs.

Under the current budget, $2.6 billion is going to the Riverside University Health System, the largest set-aside in the spending plan, at 27% of total expenditures. The outgo translates to a 5.6% increase in healthcare-oriented obligations.

Public safety agencies are next, with $2.2 billion in expenditures, 8.5% more than last year’s outlays and 23% of the composite budget, while the social services portfolio will get $2.1 billion in General Fund receipts, also representing an 8.5% increase compared to 2023-24 and comprising 21.4% of the budget.

A quarterly report on county finances is due in November.

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The Health and Human Services (HHS) Secretary Xavier Becerra and the Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure are making one final nationwide reminder to get Americans to sign up for quality, affordable health insurance on Healthcare.gov before the January 15, 2022 Open Enrollment deadline. This announcement is bolstered by a new HHS report that shows the majority of consumers enrolled in Affordable Care Act (ACA) coverage on HealthCare.gov have deductibles under $1,000 thanks to the ACA’s cost-sharing reductions (CSRs). The report, produced by HHS’s Office of the Assistant Secretary for Planning and Evaluation (ASPE), shows that CSRs provide substantial financial protection to eligible Marketplace enrollees by lowering deductibles, co-payments, and out-of-pocket maximums. And now, thanks to the general financial assistance under the American Rescue Plan (ARP), many enrollees are likely to find quality, affordable coverage with even lower deductibles.  

“Health coverage should not make or break anyone’s bank, particularly amidst a once-in-a-generation pandemic,” said Health and Human Services Secretary Xavier Becerra. “As this report shows, people across America can buy high quality health insurance for historically low prices, thanks to the American Rescue Plan and the Affordable Care Act. The Biden-Harris Administration will continue to build on the success of these important laws to ensure health care is accessible to everyone who needs it. We urge everyone to sign up for affordable health coverage by the January 15 deadline.” 

“Thanks to the Biden-Harris Administration and the greater financial assistance under the American Rescue Plan, most enrollees now have access to lower cost-sharing in the Marketplaces,” said CMS Administrator Chiquita Brooks-LaSure. “This ASPE report validates the remarkable impact of the ACA and the American Rescue Plan for people who need quality health care coverage. Consumers still have time to take advantage of this financial help by enrolling before January 15.”  

The ASPE analysis of CMS data from the 2021 Open Enrollment Period (OEP) shows that just over half (51 percent) of HealthCare.gov consumers who enrolled during the 2021 OEP received CSRs, making plans with CSRs the typical selection in HealthCare.gov. Silver metal tier plan deductibles after CSRs among HealthCare.gov enrollees decreased from $1,000 to $750 between 2017 and 2021, prior to implementation of the ARP. CSRs are generally available to consumers with incomes up to 250 percent of the federal poverty line (for example, for 2022, for most states $32,200 for a single adult and $66,250 for a family of four). 

Among new consumers enrolling through the 2021 HealthCare.gov Special Enrollment Period, the median deductible fell from $450 to $50 after the ARP premium reduction provisions were implemented on April 1, 2021, indicating that most new consumers are opting into generous silver plans with CSRs. 

Over the past decade, deductibles have generally been rising in private insurance plans, but today more than half of Marketplace enrollees receive the ACA’s generous CSRs, and for plans with CSRs, median deductibles have been decreasing year-over-year. HealthCare.gov enrollees with CSRs generally have smaller deductibles than those with employer coverage; where employer coverage deductibles averaged over $1,400 in 2021.  By offering even greater financial assistance to consumers, the ARP has led to a shift towards plan enrollment with lower deductibles. 

The latest data shows that more than 14.2 million people have selected plans for 2022 health coverage since the start of the 2022 OEP on November 1, 2021. This includes over 10 million people selecting plans or being automatically re-enrolled in Marketplace coverage through January 12, 2022 in the 33 states with Marketplaces using HealthCare.gov. The 17 states and the District of Columbia with State-based Marketplaces (SBMs) that use their own platforms reported to CMS that through January 8, 2021, 4.2 million selected plans or were automatically re-enrolled in a plan for 2022 health coverage. 

There is still time to select a quality health insurance plan for the new year. The Biden-Harris Administration extended this year’s HealthCare.gov OEP until January 15, 2022, for coverage starting on February 1, 2022, to give an extra month to sign up for affordable and comprehensive coverage. 

Consumers can visit HealthCare.gov and CuidadoDeSalud.gov or call 1-800-318-2596 to fill out an application. To find local help consumers should go to https://localhelp.healthcare.gov. Consumers in states with SBMs should visit their Marketplace for additional information on coverage deadlines. 

Read the new ASPE report https://aspe.hhs.gov/reports/marketplace-deductibles-federal-platform-2017-2021.

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The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), is awarding $20 million in American Rescue Plan (ARP) grant funding to State-based Marketplaces (SBMs) to increase consumer access to affordable, comprehensive health insurance coverage. The grants will be used by 21 SBMs to modernize IT systems and/or conduct targeted consumer outreach activities to help make health care coverage enrollment smoother. As a result, consumers will have access to increased financial assistance and eligibility determinations will be made faster.

“It should be easy and convenient for anyone to sign up for a health care plan,” said Health and Human Services Secretary Xavier Becerra. “This investment from the American Rescue Plan will help states cover more uninsured residents while providing a smooth transition to other sources of health coverage for Medicaid enrollees who may lose coverage. The Biden-Harris Administration is committed to ensuring access to health care for everyone is possible, and will continue to make improvements in the system.”

The grant funding issued today not only helps states provide swifter eligibility and enrollment processes for new consumers purchasing Marketplace coverage, but also helps states to reassess current enrollees’ eligibility for increased savings made available through the ARP. The ARP reduced health coverage costs for consumers with many consumers finding plans for $10 or less per month. As a result of the ARP, most consumers purchasing Marketplace coverage are now eligible for increased Advance Payments of the Premium Tax Credit (APTC) that reduce their portion of monthly premiums.

“When we improve access to quality, affordable health coverage – people sign up. With these American Rescue Plan funds, we are investing in increasing consumer education and awareness about the greater financial assistance now available,” said CMS Administrator Chiquita Brooks-LaSure. “Producing consumer notices in additional languages and targeting outreach to the underinsured and uninsured are just a few approaches states will use to connect members of these communities, particularly vulnerable and underserved populations, to affordable health coverage.”

The 21 SBMs that received the ARP grant funding include the District of Columbia and the following states: Arkansas, California, Colorado, Connecticut, Idaho, Kentucky, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, and Washington. States with a Federally-Facilitated Marketplace (FFM) were not eligible for this funding opportunity. Grant award amounts range from $500,000 to $1,107,392, and are based on the SBM model and number of successful applicants. The period of performance is from September 10, 2021 through September 9, 2022.

For more information on the 21 SBMs that received the funding and use of the funds, please visit:

https://www.cms.gov/files

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