Your Guide to California Health Insurance
Before we jump right into California health insurance and everything you need to know, let’s start with a little background information. In 2010, the Affordable Care Act (a.k.a “Obamacare” or ACA) was passed with the goal of getting all Americans access to affordable health insurance. To meet this goal, one measure Obamacare took was to create the ACA health insurance marketplaces, or health exchanges: one-stop shops where Americans can choose from a range of standardized, government-regulated health care plans. Health exchanges are also where eligible people can get subsidies, which lower the cost of their health plans.
States were given the option to run their own local exchange, take part in a multi-state exchange, or use the federal exchange (aka HealthCare.gov). States that run their own exchanges get to customize many elements, including the time frame during which their residents can sign up for a plan. Several states decided to operate their own state exchanges and continue to do so to this day. California is one of those states.
Want to compare health plans in California? Enter your zip code below to get started.
California’s Health Insurance Landscape: Then and Now
The California health insurance exchange is called Covered California. As of February 2021, over 1.5 million Californians had enrolled in ACA coverage. Between 2013 and 2019, the percentage of Californias who went uninsured dropped from 17.2% to 7.7%.
Most of those who are uninsured fall into four groups:
1. Ineligible due to immigration status (59 percent)
2. Eligible to buy, but don’t qualify for subsidies (18 percent)
3. Eligible to buy and qualify for subsidies (13 percent)
4. Eligible for Medi-Cal, but not enrolled (11 percent)
Covered California is one of the reasons it is considered one of the most successful state exchanges out there.
The California Health Insurance Exchange
Covered California is where eligible people throughout the state can find subsidized ACA plans. Open Enrollment for 2022 in California begins November 1, 2021 and ends January 31, 2022. Lucky you—this sign up window is significantly longer than the window given on the federal exchange.
When your coverage will begin depends on how early you sign up:
If you sign up by December 15, your coverage will start January 1.
If you sign up between December 16 and January 15, you will have to wait until February 1 to use your plan.
If you sign up from January 16 to January 31, your coverage will start March 1.
Covered California uses an active purchaser model for their exchange. This means that Covered California negotiates with health insurance carriers directly to get the best rates, networks, and benefits possible for you. Covered California is unique in that it is the only exchange that requires all plans within a metal tier to offer all the same benefits.
Like all other state exchanges, all metal tiers on Covered California covers 10 essential health benefits. These include things like prescription coverage, maternity and mental health care, and laboratory services.
In true health insurance fashion, each of these steps can be trickier than you expect. Many people need help navigating the website, estimating their income, figuring out if they are eligible for subsidies, and understanding what documents are needed for proof of income, citizenship, or identity. Oftentimes, working with Stride makes this process much faster and easier. Don’t worry, though; you’ll still enroll through Covered California with the same plan at the same price.
Covered California: What You Need to Know for 2022
1. You May Have Access to New Plans
All insurers that offered plans on Covered California for 2021 will continue to do so for 2022, and one new carrier (Bright HealthCare) will begin offering California plans. This 12 insurance companies offer plans in the state, including:
Anthem Blue Cross of California
Blue Shield of California
Bright HealthCare
Chinese Community Health Plan
Health Net
Kaiser Permanente
Health Net, Sharp Health Plan
L.A. Care Health Plan
Molina Healthcare
Oscar Health Plan of California
Sharp Health Plan
Valley Health Plan
Western Health Advantage
As of 2021, Kaiser (38%) and Blue Shield (26%) made up the majority of the California health insurance market. Californians are lucky because there is a wide variety of carriers participating in the exchange. All residents will have at least two plans to choose from and at least 94% will have three to choose from.
2. Plan Prices Are Increasing (A Little)
Last year, California plan rates increased by a record low .6% on average. This year, insurers have proposed an average increase of 1.8%, but how much costs actually increase is subject to approval by state regulators.
Inside tip: Most shoppers may be able to save an average of 7.3 percent by switching to the cheapest plan within their metal tier.
3. More People Will Qualify for Financial Aid
Thanks to the American Rescue Plan and California’s financial aid for middle-class residents, Californians are saving more on health insurance. Average savings range from $706 for low-income families and $532 for some middle-class families.
4. The Tax Penalty is Back
Any Californian uninsured in 2022 will be fined a penalty. The amount is based on your family size ($750 per adult and $375 per child).
The amount you’ll owe will depend on:
How many uninsured people are in your household
How old each uninsured person in your household is
The tax filing threshold of your household
Your household’s gross annual income
California’s Open Enrollment (the time of year when you can enroll in a new health plan) has begun. To avoid the fine, compare available plans on Stride and see if you qualify for new subsidized prices! This can unlock smarter, better savings all year long. And don’t forget—if you need help finding a subsidy or picking a plan, our experts are here to help! Enter your zip code below to get started.