Covered California adds more options for consumers, CalOptima considers joining marketplace in 2024


Soraya Marashi


In addition to a 6% increase in health insurance premium rates, Covered California announced last week that it has added a 13th health plan to the marketplace and expanded the coverage zones of 2 existing health plans for 2023.


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As reported in a news release, Aetna CVS Health will begin offering coverage in El Dorado, Fresno, Kings, Madera, Placer, Sacramento, and Yolo counties. Anthem Blue Cross will continue offering coverage to San Diego County, becoming Covered California’s second statewide insurer next to Blue Shield of California. Blue Shield of California will expand its Trio HMO plan into parts of Monterey County.

Covered California says this expansion has been possible due to its record high enrollment in 2022, reaching 1.7 million, which is in large part due to the financial assistance made available through the American Rescue Plan. Covered California also reports that their consumer pool is still among the nation’s healthiest, ranking 2nd in the nation for 3 years in a row.

As a result of these additions and expansions, all Californians enrolled through Covered California will have 2 or more options for health coverage. In her announcement, Executive Director Jessica Altman said that 93% of Californians will be able to choose from 3 or more carriers, and 81% will be able to choose from 4 or more. 

Kristof Stremikis, Director of Market Analysis and Insights at the California Health Care Foundation, told State of Reform that increased competition in the health insurance marketplace is generally a good thing for consumers, but competition in the health care delivery system is just as important.

“We need to ensure that there’s healthy competition in the delivery system as well in order for consumers to really benefit,” he said. “Unfortunately for consumers in California, the health care delivery system is very consolidated in most parts of [the state], and in many parts of the state, it’s reaching monopolistic levels.”

California Medicaid managed care plans CalOptima and Inland Empire Health Plan have also announced that they may begin selling individual insurance on Covered California in 2024, joining the only other Medi-Cal plan participating in the marketplace, which is LA Care Health Plan. 

In a news release, CalOptima CEO Michael Hunn said that by participating in the state exchange, CalOptima could offer better continuity of care to members.

“Currently, CalOptima is the single largest health insurer in Orange County, providing Medi-Cal coverage for one in four residents. Yet our members often experience changes in employment or in family circumstances that make them ineligible for Medi-Cal,” said Hunn. “By offering a Covered California plan as a bridge from Medi-Cal, CalOptima can provide the continuity of care that is essential to member health — members can choose to stay with the CalOptima network of contracted providers even as their circumstances change.”

CalOptima’s Board of Directors will hold a hearing with the Orange County Board of Supervisors on August 9th to amend a county ordinance to allow for development of CalOptima’s Covered California plan. Once approved, the plan option would begin in January 2024.