|Jurisdiction||Health insurance marketplace for U.S. state of California|
Covered California is the health insurance marketplace in the U.S. state of California. Because of the Patient Protection and Affordable Care Act (ACA), the exchange enables individuals and small businesses to purchase health insurance at federally subsidized rates. It is administered by an independent agency of the government of California.
California was the first state in the U.S. to set up a health insurance marketplace. The California Health Benefit Exchange was created in September 2010 when then-Governor Arnold Schwarzenegger signed Assembly Bill 1602 (the "California Patient Protection and Affordable Care Act") and Senate Bill 900 into law. Organizations such as the California Taxpayers Association and California Chamber of Commerce had opposed the bills in whole or in part, but Schwarzenegger had made Obamacare in California a priority.
The program was named "Covered California" in October 2012. Efforts to educate potential enrollees about Covered California began in 2013, including $37 million in grants to 48 organizations. Enrollment started on October 1, 2013; during the first month of operation, 35,364 people enrolled in health plans offered through Covered California, more than were enrolled through the flawed website for the federal exchange (HealthCare.gov) in the same period. As of November 2013, over 360,000 people had completed applications.
By the close of the first open enrollment period in April 2014, the number of people enrolled in Covered California was about 1.4 million; furthermore, another 1.1 million had signed up for Medi-Cal (California's Medicaid program, which was expanded as part of the ACA) through the Covered California web portal. In the second open enrollment period beginning in November 2014, Covered California's goal was to enroll 500,000 more people. The California Medical Association and other professional organizations pledged to work with Covered California to promote enrollments. Furthermore, the United States Department of Homeland Security and immigrant rights groups tried to assure potential applicants that any personal information disclosed to Covered California would not be shared with U.S. Immigration and Customs Enforcement.
There were 474,000 potential new enrollees by the end of the second regular open enrollment period in February 2015. It was announced that a special enrollment period would be held between February 2015 and April 2015 to reduce tax penalties in 2015 for 600,000 Californians who needed to pay a tax penalty in 2014 because they were uninsured.
Governance, staff, and budget
Covered California is governed by a board composed of five members: the Secretary of the California Health and Human Services Agency or his or her designee as a voting, ex officio member; two members appointed by the Governor; one member appointed by the Senate Committee on Rules; and one member appointed by the Speaker of the Assembly. All board members serve four-year terms.
The staff consists of 1,230 authorized positions in fiscal year 2014-15. Covered California receives no funding from state taxes; as of January 2014, it had received $1.1 billion in federal funds, but needed to be self-supporting by January 2015. The estimated expenditures for personnel in fiscal year 2014-15 were $108 million. It is projected that in fiscal year 2015, that Covered California will have a multi-million dollar deficit.
Participating insurance providers
As of 2017, 11 insurance companies are participating in the individual and family exchange:
- Anthem Blue Cross of California
- Blue Shield of California
- Chinese Community Health Plan
- Health Net
- Kaiser Foundation Health Plan
- L.A. Care Health Plan
- Molina Healthcare
- Oscar Health
- Sharp Health Plan
- Valley Health Plan (owned by Santa Clara County)
- Western Health Advantage (partnership of Dignity Health Sacramento, UC Davis Health System and NorthBay Healthcare)
- Brand New Day
Nancy Pelosi said in January 2013 that the Exchange "will serve as a critical marketplace for millions of middle class Californians and uninsured workers to evaluate private health insurance options, purchase high-quality affordable plans, and secure vital coverage for themselves and their families." A 2014 analysis estimated that "between 1.1 and 1.3 million people will be enrolled in Covered California with subsidies at any point in time" due to the churn rate.
A recent study in the journal Health Affairs indicates that while hospital networks sold on the marketplace are narrower than their commercial counterparts, geographic access is similar, and the quality of care may even be better.
- Colliver, Victoria (November 12, 2012). "Health care exchange will offer policies". San Francisco Chronicle. Retrieved April 16, 2015.
- Haeder, Simon; Weimer, David (2013). "You Can't Make Me Do It: State Implementation of Insurance Exchanges under the Affordable Care Act". Public Administration Review. 73 (s1): S34–S47. doi:10.1111/puar.12065.
- "AB 1602, Statutes of 2010, Chapter 655". Retrieved April 16, 2015.
- "SB 900, Statutes of 2010, Chapter 659". Retrieved April 16, 2015.
- "Schwarzenegger approves new health exchanges, but not without a fight". October 4, 2010. Retrieved April 16, 2015.
- Bartolone, Pauline (October 30, 2013). "‘Covered California’ the New Name for California’s Health Benefit Exchange". KPBS.org. Retrieved April 16, 2015.
- Gonzales, John M. (August 25, 2013). "Health reform’s hard sell: State’s diverse middle class". Los Angeles Daily News. Retrieved April 16, 2015.
- Kupfer, Dina (September 16, 2013). "Enrollment for Covered California Opens Oct. 1". KXTV News. Retrieved April 16, 2015.
- Kardish, Chris (November 4, 2013). "State-Run Exchanges Signed Up More Than Healthcare.gov". Government Technology. Retrieved April 16, 2015.
- Abram, Susan (November 21, 2013). "Californians continue to enroll into Obamacare, but thousands will lose policies". Los Angeles Daily News. Retrieved April 16, 2015.
- Colliver, Victoria (April 17, 2014). "Covered California enrollment numbers surpass goals". San Francisco Chronicle. Retrieved April 16, 2015.
- Covered California (April 17, 2014). "Covered California’s Historic First Open Enrollment Finishes with Projections Exceeded; Agents, Counselors, Community Organizations and County Workers Credited as Reason for High Enrollment in California (press release)". Retrieved April 16, 2015.
- Abram, Susan (December 2, 2014). "Covered California, medical groups partner to push health insurance enrollment". Los Angeles Daily News. Retrieved April 16, 2015.
- Abram, Susan (December 3, 2014). "Covered California works to ease deportation fears among Latinos". Los Angeles Daily News. Retrieved April 16, 2015.
- Abram, Susan (February 20, 2015). "Covered California opens enrollment for uninsured who face tax penalties". Los Angeles Daily News. Retrieved April 16, 2015.
- "Board of Directors of the California Health Benefit Exchange". Retrieved April 16, 2015.
- California Department of Finance. "Salaries and Wages Information: 4800 California Health Benefit Exchange" (PDF). Retrieved April 16, 2015.
- Rauber, Chris (January 23, 2014). "Covered California gets $1 billion from feds". American City Business Journals. Retrieved April 16, 2015.
- Rauber, Chris (17 February 2015). "Covered California enrollment falls well short of 2015 goal". San Francisco Business Times. Retrieved 25 April 2015.
"Covered California prepares for budget deficit". San Francisco Chronicle. Associated Press. 9 February 2014. Retrieved 25 April 2015.
Sisson, Paul (29 December 2013). "Health exchange projects deficit in 2015". San Diego Union Tribune. Retrieved 25 April 2015.
- "Health Insurance Companies and Plan Rates for 2015" (PDF). Covered California. Retrieved April 16, 2015.
- Pelosi, Nancy (January 3, 2013). "Pelosi Statement on Approval of the California Health Benefit Exchange". pelosi.house.gov. Retrieved April 16, 2015.
- Roby, Dylan; Jacobs, Ken; Watson, Greg; Bronshteyn, Alla; Graham-Squire, Dave; Keller, Michelle (2014). "Health care reform in the US: an analysis of implementation of the Affordable Care Act in California". BMC Health Services Research. 14 (Suppl 2): P103. ISSN 1472-6963. doi:10.1186/1472-6963-14-S2-P103.
- Haeder, Simon; Weimer, David; Mukamel, Dana (2015). "California Hospital Networks Are Narrower In Marketplace Than In Commercial Plans, But Access And Quality Are Similar". Health Affairs. 34 (5): 741–748. doi:10.1377/hlthaff.2014.1406.