Affordable California health insurance

Are you eligible due to a “qualifying event?” (See list.)

Do you qualify for a subsidy? (Find out more.)

You still have
health insurance
options:

Find affordable health insurance

California health insurance

A snapshot of health in the Golden State – and how Obamacare will help

california guide to health insurance

By
healthinsurance.org contributor
August 5, 2014

Do you wonder how you and your neighbors in California are doing healthwise? Looking for information on how political viewpoints have impacted the rollout of the Affordable Care Act in California? If so, this brief summary will help you get a handle on the public health indicators and medical insurance coverage in your state.

California health ratings

In a comparison of the 50 states and the District of Columbia, California is ranked 26th by the Scorecard on State Health System Performance 2014. California ranked 29th in the 2009 analysis. The comparison is based on an overall health score, which rolls up health indicators in four categories. See California’s Scorecard for the details.

America’s Health Rankings, compiled by the United Health Foundation, places California at 21st in its most recent rankings, which were completed in 2013. California scores well for low smoking and physical activity rates as well as low infant mortality, cancer deaths and premature death rates. California’s public health challenges include air pollution levels, a high uninsured rate, and low immunization rates. Note that California’s uninsured rate dropped significantly following the initial open enrollment period of the ACA, so the state’s ranking in that category will likely rise.

The 2014 edition of Trust for America’s Health also evaluates a variety of public health indicators. Visit the site for Key Health Data About California.

Given California’s size and diversity, a statewide view might not provide the level of information you want. Get county-by-county health rankings for California, which were developed by the Robert Wood Johnson Foundation and the Population Health Institute at the University of Wisconsin.

California and the Affordable Care Act

The Affordable Care Act was signed into law in March 2010. California’s Congressional delegation voted along party lines. Both Democratic senators voted yes as did 34 Democratic representatives. Nineteen Republican representatives voted “No.”

At the state level, legislators moved quickly to pass bills in support of a state-based marketplace – making California the first state to do so. Former Gov. Arnold Schwarzenegger, Republican, signed both the Assembly and Senate bills into law on Sept. 30, 2010. Current Gov. Jerry Brown, a Democrat, called a special session in late 2012, enabling additional legislation to implement the ACA in California.

How did the ACA help California?

As noted above, California’s uninsured rate showed a significant decline following the 2014 ACA open enrollment period. A study by The Commonwealth Fund showed California’s uninsured rate dropping from 22 percent in July-September 2013 to 11 percent in April-June 2014. The Commonwealth Fund, along with a Gallup-Healthways poll and the Urban Institute’s Health Reform Monitoring Survey all show the national uninsured rate dropping to the 13-to-15 percent range.

Californians’ enrollment in QHPs

A Kaiser Family Foundation estimate from November 2013 put California’s potential market for its health insurance exchange at 3,291,000 people. Kaiser further estimated that 1,903,000 of those people would qualify for premium subsidies to help them purchase policies from qualified health plans (QHPs).

Actual enrollment data from the U.S. Department of Health and Human Services (HHS) shows that 1,405,102 Californians enrolled in QHPs – that’s 42.7 percent of the eligible market. Eighty-nine percent (or about 1,250,400) of those enrolling in a QHP qualified for financial assistance.

Covered California, the state-run marketplace, has announced that 10 insurers will sell marketplace policies for 2015:

  • Anthem Blue Cross of California
  • Blue Shield of California
  • Chinese Community Health Plan
  • Health Net
  • Kaiser Permanente
  • L.A. Care Health Plan
  • Molina Healthcare
  • Sharp Health Plan
  • Valley Health Plan
  • Western Health Advantage

Medicaid in California

California embraced Medicaid expansion in addition to implementing a state-run marketplace. Expanding Medicaid eligibility – to include nearly all nonelderly adults with incomes at or below 138% of poverty – is one of the ACA’s main strategies to reduce uninsured rates.

Between October 2013 and March 2014, about 1.7 million Californians were deemed eligible for Medicaid. Enrollment and disenrollment for these programs continues throughout the year, so the total number of enrollees fluctuates monthly.

Learn about California’s Medicaid program, which is called Medi-Cal. Note: California’s Children’s Health Insurance Program (CHIP) was previously known as Healthy Families. In 2013, California transitioned Health Families enrollees to Medi-Cal.

Does California have a high-risk pool?

Prior to the ACA’s reforms in the individual health insurance market, medical history was a factor in eligibility for private plans in nearly every state, including California.  Applicants with pre-existing conditions were often unable to buy individual plans in the private market, or if coverage was available it came with a higher premium or with exclusions on pre-existing conditions.

The California Major Risk Medical Insurance Board (MRMIB) was created in 1991 to provide a coverage option for people who were ineligible for coverage under a private plan because of medical history.

Under the ACA, all new health insurance policies became guaranteed issue starting on January 1, 2014. This change largely eliminated the need for high risk pools, since pre-existing conditions are no longer a barrier to obtaining coverage.

The California Budget Act of 2014 included a provision for MRMIB to cease operations as of July 1, 2014. Most of the MRMIB insureds had already been able to obtain coverage through the exchange or expanded Medicaid, but remaining members were transitioned to the California Department of Health Care Services on July 1.

Health reform legislation in California

Here’s a summary of legislative action regarding healthcare reform at the state level in California:

More California resources

California state health insurance exchange

California’s exchange

Find out what your state’s health insurance exchange will look like.

obamacare-state-rebates.jpg

$74 million to 1,877,186 families

Insurance companies were forced to return an average of $65 per California family in 2012.

how-voted.jpg

healthreformvotes.org

Find out how your member of the California Congressional delegation voted on health care.

CA state government resources

California Department of Health Care Services

Responsible for health care services for…

California Health Care Reform

How the state government will implement provisions of the Affordable Care…

California State Department of Insurance

The California State Department of Insurance deals with issues of individual health insurance in California, as well as other types of…

Consumer Information from the California State Department of Insurance

Health insurance topics and information geared specially for…

Medicare information from California State Department of Aging

State government resources for Californians needing help with Medicare and other government health insurance programs on federal, state and local…

Office of Multicultural Health, California State Department of Health Services

The state agency which tries to reduce inequality in health status, information and resources on multicultural…

CA advocacy resources

California HealthCare Foundation

The foundation is an independent philanthropy committed to improving California’s health care delivery and financing systems and to ensure that all Californians have access to affordable, quality health…

California Nurses Association — guaranteedhealthcare.org

GuaranteedHealthcare.org is a project of the California Nurses Association/National Nurses Organizing Committee, and patients and community groups around the…

California One Care

California OneCare is an online organizing network that exists to activate and empower people into a grassroots and netroots movement for universal health care in…

Health Access California

Health Access California is a non-profit organization dedicated to achieving quality, affordable health care for all Californians. For more than 15 years, Health Access has played a significant role in leading the movement for health care reform in…

Health Care for All — California

HCA is a nonprofit grassroots organization working for high quality, universal, single-payer health…

Single Payer Now

Volunteers educating voters since 1994 to talk with their friends, co-workers, and neighbors about health care minus the insurance…

Other CA health insurance links

California Association of Health Plans

The Association promotes affordable health care for California consumers through legislative advocacy, informational communications and collaboration with other…

California health insurance companies

AARP Insured By Aetna
Aetna
Anthem Blue Cross
Blue Shield of CA

Celtic Ins. Co.
Health Net
Kaiser Permanente of CA
PacifiCare

NOTE: Kaiser Permanente of CA is a non-profit company.

Health insurance for CA individuals

Resources for those individuals seeking health care insurance in California. If you are looking for California Medicare, visit our site for health insurance over 65.