Health Insurance Exchange


Calif’s Health Insurance Exchange Sets Plans, Premiums; No Apparent ‘Rate Shock’


(Joe Raedle/Getty Images)

Update: Aug. 7, 2013: Covered California announced Wednesday that 12 insurance companies have formally signed contracts with the agency to offer plans on the new marketplace. Since the initial announcement (below), one company, Ventura County Health Plan, has withdrawn from offering coverage on the marketplace. The following companies will offer plans on the marketplace, although not all companies will offer plans in every region of California:

·      Alameda Alliance for Health

·      Anthem Blue Cross of California

·      Blue Shield of California

·      Chinese Community Health Plan

·      Contra Costa Health Plan

·      Health Net

·      Kaiser Permanente

·      L.A. Care Health Plan

·      Molina Healthcare

·      Sharp Health Plan

·      Valley Health Plan

·      Western Health Advantage

Last week, Covered California announced tentative plans and premiums for its small business marketplace, also called SHOP.


The state’s health insurance exchange, Covered California, announced Thursday morning the plans and premiums that will be available to millions of Californians.

And what everyone wants to know is: how much will it cost. Experts had warned of “rate shock,” that premiums might skyrocket for all kinds of reasons. That has not happened.

Covered California says that individuals will pay an average premium of $321 per month for a “silver” plan. (More on silver plans below.) Many people will be eligible for subsidies to reduce that cost further.

Across the state, people who had been working toward this day seemed to heave a collective sigh of relief.

“This is a home run for consumers in every region of California,” said Peter Lee, executive director of Covered California, in a release to reporters. “Californians should be proud of how not only health plans in this state, but doctors, medical groups and hospitals have stepped up — creating a market that will allow millions of consumers to enroll in affordably priced products.”

Charles Bacchi, executive vice president with the California Association of Health Plans called it an “important day” and commended both insurance companies and providers for working together “to deliver quality, affordable health care. We couldn’t have done this without providers willing to join us to make the Affordable Care Act a success,” he said in a reference to provider groups working to keep rates low.

The plans on the exchange are required to offer a standard set of comprehensive benefits. It’s hard to compare premiums next year to what’s in place this year, since there is no standard set of benefits at present. Covered California chose as the best comparison the average premium for a small business plan. The rates in Covered California range from 2 percent above to 29 percent below that benchmark. Continue reading

Hard Enough Understanding Health Law in English; Try in Mongolian, Khmer or Even Spanish

By Judy Lin, Associated Press

Screen Shot 2013-03-04 at 10.15.47 AMOAKLAND, Calif. (AP) — Set on a gritty corner of Oakland’s International Boulevard, the nonprofit Street Level Health Project offers free checkups to patients who speak a total of 22 languages, from recent Mongolian immigrants seeking a doctor to Burmese refugees in need of a basic dental exam.

It also provides a window into one of the challenges for state officials who are trying to implement the Affordable Care Act, President Barack Obama’s sweeping health care overhaul.

“‘Covered California’ translates to ‘California Cubierto’ in Spanish — but what exactly does it mean?”
Understanding the law is a challenge even for governors, state lawmakers and agency officials, but delivering its message to non-English speakers who can benefit from it is shaping up as a special complication. That is especially true in California and other states with large and diverse immigrant populations.

California has the largest minority population of any state, about 22.3 million people. That’s followed by Texas with 13.7 million, and New York with 8.1 million. Continue reading

State’s Health Insurance Exchange Lands $674 Million Grant from Feds

By David Gorn, California Healthline

California's insurance marketplace, Covered California, will open in October, 2013. People will be able to buy insurance, which will take effect January 1, 2014.

California's insurance marketplace, Covered California, will open in October, 2013. People will be able to buy health insurance, which will take effect January 1, 2014.

Peter Lee could hardly contain himself yesterday.

“In 2010, California was the first state in the nation to say we want a state-based exchange. Then, earlier this month, the federal government approved our blueprint for the exchange,” said Lee, the executive director of the state’s health insurance exchange, Covered California.

“And now,” Lee said, “the feds have given us the resources we need to launch Covered California. This is an historic moment.”

Yesterday federal officials awarded $674 million to the California exchange, a grant that funds the set-up of the exchange through the end of 2014.

It was slightly short of the $706 million originally requested for the grant, but Lee was not about to quibble.

“The feds reduced 2014 potential payment for outreach and enrollment by about $30 million,” Lee said. “But we think we have enough resources on hand to do the biggest outreach that I’ve ever seen.” Continue reading

Blue Shield CEO: Challenge, Opportunity in 2013 and Beyond

By Alvin Tran and Sarah Barr, Kaiser Health News

Bruce Bodaken is CEO of Blue Shield of California. (Photo Courtesy of Blue Shield)

Bruce Bodaken is CEO of Blue Shield of California. (Photo Courtesy of Blue Shield)

As chairman and CEO, Bruce Bodaken led Blue Shield of California to become one of the fastest growing health plans in the state — it currently has more than three million members. But after 12 years of service, the 61-year-old recently announced his plans to retire at the end of 2012.

Bodaken’s successor, Paul Markovich (the chief operating officer), may not have an easy time of it. He’ll have to implement provisions of the federal health law while trying to keep costs as low as possible. “That will be the biggest challenge that I think any health plan CEO will face over the next several years,” Bodaken said.

Bodaken’s views on the health law and the current state of the insurance industry were among the many topics during a recent interview with Kaiser Health News. Here are edited excerpts:

Q. Why retire now?

A. One thing I told my board when I first came on, after a decade or so, you need to think about changing your CEO as a policy matter. There is a time for these things for any corporation, for any person. I’ve been doing this for 12 years. I don’t see this retirement as me dropping out of sight.

Q. What do you think insurers will have to contend with as they head to 2014, when the federal health law will fully kick in? Continue reading

Field Poll: Strong Statewide Support for Health Care Law

Supporters demonstrate in favor of the Affordable Care Act on June 28, 2012 when the U.S. Supreme Court issued its ruling on the health care overhaul. (SEIU International: Flickr)

Supporters demonstrate in favor of the Affordable Care Act on June 28, 2012 when the U.S. Supreme Court issued its ruling on the health care overhaul. (SEIU International: Flickr)

While Americans as a whole remain sharply divided over the Affordable Care Act, a majority of California voters — 54 percent — support the federal health care overhaul, a new Field Poll shows. Just over a third of Californians — 37 percent — oppose the law.

This strong support is not terribly surprising in a heavily Democratic state. In addition, more than one in five Californians is uninsured. Support for the health care overhaul is two-to-one among those without insurance or people who say they or a family member has gone without coverage in the last two years.

The Field Poll also dug into the nitty-gritty of the requirements of the Affordable Care Act, specifically the Health Benefit Exchange, an online marketplace where people will be able to shop for health insurance. California was the first state to pass legislation to commence setting up an exchange. Starting next fall, people will begin enrolling for coverage that will begin January 1, 2014. Continue reading

Bill Frist To GOP Governors: Get Cracking On Exchanges

By Marilyn Werber Serafini, Kaiser Health News

Former Senator Bill Frist in 2009. (Tracy Russo: Flickr)

Former Senator Bill Frist in 2009. (Tracy Russo: Flickr)

A former GOP power player is urging Republicans to rethink their rejection of the health law and to implement state insurance exchanges –- and to do it now.

Bill Frist, a former Republican Senate majority leader and a heart transplant surgeon, today argued in a column that state officials should not pass up the opportunity to build the insurance exchanges that are right for them. Under the law, if a state that doesn’t create its own exchange, the federal government will parachute in to do the job.

“Originally a Republican idea, the state insurance exchanges mandated under the Affordable Care Act (ACA) will offer a menu of private insurance plans to pick and choose from, all with a required set of minimum benefits, to those without employer-sponsored health insurance,” Frist wrote. “These exchanges are expected to bring health insurance to an additional 16 million Americans. Unlike the Medicaid expansion, these Americans will gain private insurance, and can choose the plan that’s right for them.

“State exchanges are the solution.”

Fifteen states have taken the first steps to set up exchanges, basically online insurance marketplaces. The health law has received withering criticism from many Republican governors, and some have refused to establish exchanges.  Some were waiting for a decision on the law from the Supreme Court, and are now moving forward. Still others are holding out hope that Republicans will win big in November and repeal the entire law. Continue reading

Just in Time for the Weekend! Background on Health Care in California

(alycat: Flickr)

(alycat: Flickr)

Admit it. The Supreme Court’s scrutiny of the health care overhaul has piqued your interest. You’ve read or heard stories about the oral arguments. But you feel guilty. You haven’t been able to keep up on how the federal health care law is playing out in the Golden State. State of Health is here to help.

We’ve rounded up four stories — filed by KQED Health Reporter Sarah Varney over the last 10 months — to help give you an overview. These stories all have to do with how California is moving forward in implementing the Affordable Care Act. Yes, the Supreme Court might overturn the ACA, but then again, it might not. Presuming the law goes forward, California is in a better position than most states to meet the 2014 full implementation.

In just under 22 minutes, you can get up to speed on where California stands. So put on your headphones and listen to the following stories: Continue reading