The California Health Benefit Exchange will be the primary marketplace for individual health insurance in California in 2014.
Big Challenges
The challenges facing the health insurance exchange in California are unique. At any given time, 7 million Californians have no health insurance - a number exceeding the entire population of Massachusetts. The diversity of Californians will tax outreach efforts. It’s individual health insurance market is huge - over 2 million people.
Great Opportunities
Yet, the Exchange has the potential to greatly expand coverage, and to significantly improve the quality and affordability of health care coverage in California. The California legislature has given the Exchange an “active purchaser” role, granting it the authority to selectively contract for coverage with qualified health insurance companies.
Guiding Principles of the California Health Benefit Exchange
- Maximize the Exchange’s ability to be operational and successful starting in January 2014
- Maximize the enrollment and retention of individuals in the Exchange, Medi-Cal, and CHIP
- Maximize affordability of coverage
- Promote efficient and simplified Exchange operations
- Minimize the possibility of adverse selection
- Minimize administrative burdens and costs on consumers, employers, providers, health plans and public agencies.
Key Roles of the California Health Insurance Exchange
- Certify qualified health plans to be offered in the exchange
- Provide easy access for California individuals and families to a choice of essential benefit plans including comparative information on cost, quality, coverage, etc
- Determine eligibility for individual subsidies or enroll qualified applicants in Medi-Cal or Healthy Families
- Establish the SHOP Exchange, as a separate exchange to offer a choice of group health benefit plans for employer sponsored groups with up to 100 employees.
- Engage in outreach activities, including the Navigator Program to publicize the availability of coverage through the Exchange.
Exchange News
- Private Exchanges on Steroids
- Retiree Health Insurance Exchanges
- Individual Market Set to Explode Under ACA
- California Brokers Eye Possible $360 Mil Annual Exchange Market
- Legislature Should Slow Down, Be Careful - Senator Tom Harden
- Consequences of ACA Without Individual Mandate
- ACA Supreme Court Scenario 2: Mandate Alone Unconstitutional