Health Care Reform


Covered California, The California Health Insurance Exchange, now being called the Marketplace has announced the insurance companies and health plans that will participate. Rates have been filed and general information has been released.

The formation of the California Exchange/Marketplace has been a monumental task. Consider that the population of California was thirty-eight million in 2012. The population of Canada was thirty-four million in the same year. The Marketplace will not be the appropriate vehicle for everyone to purchase health insurance, for the most part those who qualify for a subsidy based on income will purchase through the Marketplace.

The health plans that will participate in the Marketplace are;

  • Anthem Blue Cross
  • Blue Shield of California
  • Alameda Alliance for Health
  • Chinese Community Health Plan
  • Contra Costa Health Services
  • Health Net
  • Kaiser Permanente
  • LA Care Health Plan
  • Molina Health Plan
  • Sharp Health Plan
  • Valley Health Plan
  • Ventura County Health Care Plan
  • Western Health Advantage

These are a mix of commercial for profit , non profit, Medi-Cal and regional plans.

Cigna, Aetna and United Health Care will not participate in the Marketplace but will continue to sell plans in California.

Rates have been filed with the State and are lower than expected. This is not to say that the Marketplace rates will be lower than your current coverage. It is not possible to make exact comparisons to current rates and benefits as the Marketplace benefits are generally more comprehensive than today’s plans. Furthermore, I am prohibited by law to discuss specific rates with anyone until I have completed the Marketplace certification process which will probably occur in late August according to the timeline of Covered California.

The lower than anticipated rates seemingly comes at a huge cost to the consumer. Networks of hospitals, doctors, imaging facilities, etc., are said to be reduced significantly. In my opinion this reduction of choice amounts to rationing of care.

In a previous blog I indicated that smokers will be required to pay a higher premium. This is no longer the case, everyone’s rate will be the same depending on the plan chosen, age and geographic area.

A public education campaign will occur in July and August. Open enrollment for a January 1, 2014 effective date will begin on October 1, 2013.

There will be a Marketplace for small businesses with up to fifty employees called the Small Business Health Options Program or SHOP. The participating health plans will be finalized in June.

The California Marketplace will not affect Medicare.

According to the Los Angeles Times, Covered California Board Member Robert Ross said “The Law is now in the hands of Californians and the clock has begun to tick toward implementation. We are the ones who have to make it work. It is not going to be perfect on January 1. We will have bumps, we will have bruises but we will continue to move forward”.

As a reminder, utilizing my services as a broker is of no charge to the consumer. I will be available to help with your health insurance needs.


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