News Release

Date Posted

Statement from Peter V. Lee on the Administration’s Latest Effort to Undercut Broader Coverage Through the Affordable Care Act

 Statement from Peter V. Lee on the Administration’s Latest Effort to Undercut Broader Coverage Through the Affordable Care Act

SACRAMENTO, Calif. — Covered California Executive Director Peter V. Lee released the following statement on a proposed rule from the Centers for Medicare and Medicaid Services that would allow states to eliminate www.Healthcare.gov and undercut the Affordable Care Act.

Click here to see the proposed rule.

The proposed rule builds on years of actions by the outgoing administration to undercut the Affordable Care Act. Instead of marketing and promoting coverage options for millions of Americans, as they should during a pandemic, this proposed rule undermines efforts to get insurance coverage to those most in need.

The rationale for the proposed reduction of user fees is to “allow issuers to then pass on the savings to consumers,” which belies the reality that multiple policies enacted by this administration have resulted in premiums throughout much of the nation being far higher than they should be. These actions have priced millions of unsubsidized Americans out of coverage. Proclaiming that a reduction of user fees leads to a reduction of premiums flies in the face of the reality that well-spent marketing dollars by this administration would have had a five-to-one return on lowering health care costs for Americans.

Further, the policies of the outgoing administration have had nothing to do with lower premiums in the individual market. In 2020, premiums were lower in much of the nation due to a rebound from overpricing by health plans, while 2021 rates dipped across the nation because millions of Americans delayed and deferred care amidst the COVID-19 pandemic. Better profits for health plans should not be the marker of an effective marketplace. 

The user fees can and should be well spent to make sure health plans are held accountable for delivering high-quality care and addressing health disparities. This proposal serves to reduce resources for ensuring more Americans know about and secure more affordable health coverage options for themselves and their families. 

Now is a time when we should be leaning in and assuring health plans put consumers first, not running in the opposite direction. Fortunately, the new administration will have the opportunity to consider this proposal and respond in a way that best addresses the needs of Americans.” 

About Covered California

Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.

Covered California Wins National Award for Its Outreach and Education Efforts to Inform the Public About Critical Health Care Issues


  • Covered California won in the External Publications category for its work on “issue briefs” that outline the agency’s practices and the implications of federal policy changes on health care.
  • Covered California was also honored in three additional categories for its outreach and education efforts to help consumers get health insurance.


SACRAMENTO, Calif. — Covered California on Friday was honored for its public policy research, studies and reports on the Patient Protection and Affordable Care Act at the prestigious PR News Platinum Awards, a national contest recognizing outstanding public relations efforts.

“This national recognition underscores the work of our staff and community partners do to inform, educate and enroll Californians in affordable health insurance,” said Peter V. Lee, executive director of Covered California. “The main reward of our outreach is in the enrollment of thousands of Californians, but these rewards validate the good work our team is doing on consumers’ behalf.”

The 2018 PR News Platinum Award winners set industry benchmarks for excellence across all areas of communications. Entrants include U.S.-based and international public relations agencies, corporations, nonprofits, associations and government organizations.

Covered California was recognized as the top organization in the External Publications category and received honorable mention in three other categories: Media Event, Multicultural Campaign and the WOW! Award.

In the External Publications category, Covered California was honored for its “issue briefs” – a series of studies, reports and analyses – which highlighted the agency’s experiences and lessons in implementing the Affordable Care Act. These reports addressed the implications of federal policy changes, the benefits of legislative and administrative changes being considered at the state and federal level and the value of marketing and outreach.

The issue briefs and reports illustrate key elements of Covered California’s approach to creating a successful competitive marketplace in California, where the rate of the uninsured has been cut by more than half since 2013, and premiums for those who do not receive subsidies have increased by only modest amounts over the past four years.


Covered California was recognized in three additional categories. Two nominations were for the Media Event category and the WOW! Award for the agency’s outreach and education work during the "Covered in Art" bus tour and mural campaign. The statewide campaign promoted enrollment and illustrated that health care is part of the fabric of every community in California. Covered California worked in partnership with its public relations contractor, Ogilvy, on the tour, which took place between Nov. 1, 2017, and Jan. 31, 2018.

Covered California’s in-house communications team was also recognized in the category of Multicultural Campaign for its targeted outreach and media activities to reach Latinos, African Americans, Asian/Pacific Islanders and LGBTQ communities throughout the state.

Overall, Covered California competed with nationally known public relations firms that represented companies such as Intel, 21st Century Fox, HP and Kentucky Fried Chicken, among others.

“We couldn’t do this great work without the talented team of communications professionals and policy experts working in-house at Covered California,” Lee said.

About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.



Covered California for Small Business Announces Rates and Plans for 2019 with an Average Premium Increase of 4.6 Percent


  • The weighted average rate change is the lowest in the five years since Covered California for Small Business (CCSB) launched in 2014.
  • CCSB has more than 47,000 members to date, an increase of more than 30 percent over a year ago.
  • The small business program continues with five carriers offering coverage for employees around the state.
  • Covered California produced a new video, capturing the experience of one of its CCSB members: https://vimeo.com/286219647/abbf86c5b2.

SACRAMENTO, Calif. — Covered California for Small Business (CCSB) unveiled the health plan choices and rates for small-business employers and their employees for the upcoming 2019 plan year. The statewide weighted average rate change will be 4.6 percent for employers and their employees, which represents the lowest annual increase in the program’s five-year history.

“Our small-business exchange continues to grow as we offer a wide range of plan options to business owners and their employees across the state,” said Covered California Executive Director Peter V. Lee. “The modest rate change and increase in signups reflect the strides we have made as we seek to offer employers coverage options more tailored to each employee’s needs.”

This year’s rate change of 4.6 percent is lower than the most recent year-over-year trend of 6 percent that larger employers are experiencing (see Table 1) and reduces the program’s five year average increase to 5.9 percent.

“The success of Covered California for Small Business is yet another example of how this new era of health care is working for Californians,” Lee said. “The stability and competitive rates of our small business product helps put competitive market pressure on the entire small employee sector.”

Table 1: Covered California for Small Business Average Rate Change, by Year

Year
Rate Change (Percentage)
2015
5.2
2016
7.9
2017
5.9
2018
5.6
2019
4.6
CCSB 5-year Average
5.9
Avg. Large Business Rate Change in 2017 and 2018[1]
6.0


[1] Source: Willis Towers Watson, “Cost increases without plan changes are 6.0% for both 2017 and 2018.”

CCSB will be offering five plans in 2019, including two preferred provider organization (PPO) plans from Blue Shield of California and Health Net, both offering their broadest provider networks, and two health maintenance organization (HMO) plans — which are provider and hospital-based — from Kaiser Permanente and Blue Shield. Rounding out the 2019 portfolio of health plans are Chinese Community Health Plan in San Francisco and Sharp Health Plan in San Diego. Also, Health Net will be launching new offerings in the final quarter of 2018.

CCSB has experienced double-digit percentage growth in membership for four consecutive years. Currently, more than 47,000 individuals have insurance through CCSB, representing a growth of approximately 12,000 individuals, or a 33 percent gain in membership over this time last year.

The steady growth makes CCSB one of the largest small-business health options programs in the nation.

“We are seeing a growing interest from the Agent community, as they see the value in our full PPO networks for their consumers and the choices we provide for them and their employees,” said Terri Convey, director of Covered California’s Outreach and Sales Division. “This market is working for consumers, bringing the power of choice and stability to California businesses.”

One of those small business owners enrolled in CCSB is George Osorio, the owner of California Collision in Pleasanton. When George first started his business, he realized that many of his employees did not have health insurance, so he worked with CCSB to get his employees the coverage and care they needed. You can view and download George’s story here: https://vimeo.com/286219647/abbf86c5b2.

Just like in Covered California’s individual market, consumers may be able to limit increases in their rates, or perhaps even save money on their premiums, by shopping and switching to the lowest-cost plan in the same metal tier.

CCSB’s web-based enrollment and renewal portals for employers, agents and general agents will begin its second enrollment period after a successful launch in 2018. The exchange remains invested in enhancements that allow CCSB to be a leader in moving the small-group insurance market to an e-commerce industry. Additionally, as of September, CCSB has expanded its distribution channels to include two new General Agents, BenefitMall and Beere & Perves.

“We see opportunity in working with both of these organizations in expanding both our Northern California and Southern California reach,” Convey said. “Our goal remains to provide California businesses and their employees’ affordable and dependable health care coverage.”

Businesses with up to 100 employees can apply for health insurance coverage for their workers through Covered California for Small Business. Federal tax credits may be available to employers with 25 or fewer employees. Visit www.CoveredCA.com/forsmallbusiness/ for information on how to apply.

Family dental plans are optional and are provided by Delta Dental of California, Liberty Dental Plan of California, Dental Health Services,  and California Dental Network.

About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the legislature. For more information about Covered California, please visit www.CoveredCA.com.

California’s Uninsured Rate Falls to a New Historic Low as the National Rate Holds Steady

Click for Español


  • New data from the U.S. Census Bureau shows California’s uninsured rate dropped to 7.2 percent in 2017, which represents a nearly 60 percent drop since the Affordable Care Act was launched in 2014.
  • Overall, the national uninsured rate remained statistically unchanged at 8.8 percent, despite continued uncertainty and turmoil at the federal level.
  • California’s 10 point drop in the uninsured rate between 2013 and 2017 is the largest decline in the nation for any state.
  • More than 3.7 million Californians have obtained health insurance coverage since 2013, which means health care costs for those with employer coverage have also been dramatically reduced.

SACRAMENTO, Calif. — As Covered California’s open-enrollment period prepares to start in the fall, a new report from the U.S. Census Bureau shows that California continues to make historic gains in the effort to reduce the state’s uninsured rate. According to the data released on Wednesday, California’s uninsured rate fell to a new historic low of 7.2 percent in 2017, which represents a decline of 10 percentage points from the pre-Affordable Care Act rate of 17.2 percent.

“The Census figures are the gold standard and what the numbers show is that California continues to make history in reducing the rate of the uninsured,” said Covered California Executive Director Peter V. Lee. “Californians are joining the millions of Americans across the nation who continue to benefit from the coverage expansion made possible by the Affordable Care Act.”

California’s drop in the uninsured rate from 17.2 percent in 2013 to 7.2 percent, a decrease of 10 points, is the largest decrease of any state in the nation over that time period.

In addition, the report showed that 3.7 million Californians have gained health insurance coverage since 2013, which is a greater number than the next three states — Florida, New York and Texas — combined.

“California embraced the Affordable Care Act by expanding Medi-Cal and creating a competitive marketplace in Covered California that puts consumers first,” Lee said. “We know that life can change in an instant, and now millions of Californians and their families are protected and have access to the best medical care in the state.”

Lee noted that the Census report shows that Americans across the country continue to benefit from the Affordable Care Act despite continued uncertainty and turmoil at the federal level. Overall the national uninsured rate remained statistically unchanged at 8.8 percent. The report highlighted California and two other states, Louisiana and New York, as states that saw a reduction in their uninsured rate in 2017, while 34 other states had uninsured rates that remained unchanged.

A recent study shows there are an estimated 3 million Californians who remain without comprehensive health care coverage. Of those that remain uninsured, an estimated 59 percent are not eligible to enroll in health care coverage due to their immigration status. When you exclude those that are ineligible for coverage, California’s “eligible uninsured” rate drops to roughly 3 percent.

“We are getting to a point where we are nearing universal coverage in California for those who are eligible, but we cannot rest on our laurels,” Lee said. “In the coming open-enrollment period, we will again be crisscrossing the state, making sure that Californians know about their health care options and the financial help that is available to bring quality coverage within reach.”

Interested consumers should go to www.CoveredCA.com to find out if they qualify for financial help and find free local help to enroll. They can contact the Covered California service center for enrollment assistance by calling (800) 300-1506. Qualified consumers can enroll in Medi-Cal year round.

The full Census report can be viewed here: https://www.census.gov/content/dam/Census/library/publications/2018/demo/p60-264.pdf.

About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.

(1) Preliminary CalSIM v 2.0 Regional Remaining Uninsured Projections:
http://laborcenter.berkeley.edu/pdf/2016/Preliminary-CalSIM-20-Regional-Remaining-Uninsured-2017.pdf

Covered California’s Outreach and Education Efforts in the Running for Four National Awards, With Mural Bus Tour Named a Finalist for Most Innovative Overall Campaign


  • The “Covered in Art” bus tour was named a finalist in two categories for PR News’ Platinum Awards.
  • Multicultural media outreach efforts focused on target segments are in the running for Best Multicultural Campaign.
  • “Issue briefs” and reports outlining elements of Covered California’s practices and the implications of federal policy changes are finalists for Best External Publications.


SACRAMENTO, Calif. — Covered California has been named a finalist in four categories for PR News’ Platinum Awards, a national contest recognizing outstanding public relations efforts, including media events, multicultural outreach and publications.

“We are pleased to be recognized and to be in the running for these national awards,” said Peter V. Lee, executive director of Covered California. “We take pride in our robust outreach and education efforts to get the word out to everyone in California about the importance of getting health insurance. Our work to get media coverage is a core component of our broader marketing and outreach efforts, which are essential ingredients in boosting enrollment and making sure healthy people get insured.”

Platinum Award winners set industry benchmarks for excellence across all areas of communications. Entrants include U.S.-based and international public relations (PR) agencies, corporations, nonprofits, associations and government organizations worldwide.

Covered California was recognized in four categories: Best Multicultural Campaign, External Publications, Media Event and the WOW! Award, PR News’ recognition of “the most innovative, out of the box PR or marketing communications campaign.”

As finalists, Covered California is competing with nationally known public relations firms and companies such as HP, MasterCard, 21st Century Fox and KFC, among many others.
The following Covered California campaigns were named finalists Tuesday:

“Covered in Art” mural bus tour named finalist for Best Media Event and WOW! Award: These two categories were represented by Covered California’s “Covered in Art” bus tour and mural campaign illustrating that health care is part of the fabric of every community in California. To promote enrollment in health insurance during Covered California’s fifth open-enrollment period, the “Covered in Art” bus traveled throughout California visiting clinics, enrollment centers, public parks and insurance agents’ offices to unveil murals celebrating health and wellness. Covered California worked in partnership with its public relations contractor, Ogilvy, on the Covered in Art tour, which took place between Nov. 1, 2017, and Jan. 31, 2018.

Target segment media relations in the running for Best Multicultural Outreach: Covered California’s in-house communications team planned and executed successful targeted outreach and media activities to reach Latinos, African Americans, Asian/Pacific Islanders (API) and LGBTQ communities throughout the state with the goal of increasing enrollment among these often-underinsured groups. Covered California team members cultivated relationships with editors, producers and on-air personalities. Staff conducted frequent interviews with ethnic TV, radio and print media about Covered California. Staff coordinated phone banks, organized ethnic media roundtables featuring Covered California leadership and developed print-ready, in-language news articles and graphics that were published statewide. Covered California also coordinated faith-based outreach activities to promote enrollment at churches, mosques, synagogues and temples throughout the state.

Series of Covered California reports and analyses recognized for Best External Publications: Covered California regularly shares its experiences and lessons in implementing the Patient Protection and Affordable Care Act in a series of studies, reports and analyses. These reports highlight the implications of federal policy changes, the benefits of legislative and administrative changes being considered at the state and federal level, and the value of marketing and outreach. These issue briefs and reports illustrate key elements of Covered California’s approach to creating a successful competitive marketplace in California, where the rate of the uninsured has been cut by more than half since 2013, and premiums for those who do not receive subsidies have increased by only modest amounts over the past four years.

“We couldn’t do this great work without the talented team of communications professionals and policy experts working in-house at Covered California, as well as the energetic team at Ogilvy, who helped execute the Covered in Art tour,” Lee said.

Platinum Award winners will be announced Sept. 21 in New York City.

About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.

Covered California Releases 2019 Individual Market Rates: Average Rate Change Will Be 8.7 Percent, With Federal Policies Raising Costs


  • The weighted average rate change is 8.7 percent, but with robust competition, most consumers can avoid any increase if they switch to the lowest-cost plan in the same metal tier.
  • Without the federal decision to eliminate the individual mandate penalty, which added between 2.5 and 6 percentage points to the rates, consumers would be seeing a rate change closer to 5 percent.
  • California remains a strong and stable individual marketplace as it heads into its sixth year, with all 11 health insurers in Covered California returning for 2019 and 96 percent of consumers able to choose from two insurers or more.

SACRAMENTO, Calif. — Covered California on Thursday announced a modest rate change for 2019 and said many enrollees will be able to mitigate the impact if they shop and switch to the lowest-cost plan in the same metal tier. The exchange also described how the recent federal decision to eliminate the penalty for the individual mandate will raise costs for the federal government and all consumers in the individual and employer-sponsored markets.

“Covered California continues to benefit millions of people in our state by giving them access to high-quality, affordable health coverage,” said Covered California Executive Director Peter V. Lee. “It is unfortunate when a rate change of nearly 9 percent is generally viewed as good news, when the rate change could — and should — have been much lower.”

Consumers in both Covered California and off-exchange in the individual market will see an overall average statewide rate increase of 8.7 percent to their gross premiums if they renew coverage in the same plan for 2019 (see Table 1).

The proposed rates, negotiated with Covered California and filed Thursday with regulators and subject to their final review, mean those who receive a subsidy to help purchase coverage will pay an average of 6 percent more if they renew in the same plan next year, which translates to an estimated monthly premium of $123 after tax credits. Subsidized consumers account for 88 percent of Covered California’s enrollment, and those subsidies rise along with rates to help offset any increases.

Consumers, both on and off the exchange, will continue to benefit from Covered California’s competitive marketplace, which allows them to shop for the best value and save money if they switch plans. The average rate change for consumers who shop and switch to the lowest-cost plan in the same metal tier is -0.7 percent, which means that many Californians can pay the same rate as they do now in 2018, or a little less, if they shop and switch.

“Covered California’s marketplace fosters competition that puts consumers in the driver’s seat and gives them the power to shop and save,” Lee said. “Health care is local, and the price of coverage varies by health plan and region, so consumers will be encouraged to shop when they renew this fall.” (See Table 2 for a complete list of rate changes by region.)

All 11 insurers currently serving Covered California will return for the 2019 coverage year. Covered California’s competitive marketplace continues to promote choice, with 96 percent of consumers being able to choose from two insurers or more and 82 percent of consumers having three or more choices.

Table 1: Covered California’s Premiums


PLAN YEAR
5-Year Average

2015
2016
2017
2018
2019
Weighted Average Increase
4.2%
4.0%
13.2%
12.5%*
8.7%
8.4%
Lowest-Priced Bronze (unweighted)
4.4%
3.3%
3.9%
11.8%
10.2%
6.7%
Lowest-Priced Silver (unweighted)
4.8%
1.5%
8.1%
9.2%*
5.2%
5.7%
If a consumer switches to the lowest-priced plan in the same tier
-4.5%
-1.2%
3.3%
-0.7%

*  The 2018 weighted average has been adjusted to remove the cost-sharing reduction surcharge applied in 2018, since unsubsidized or off-exchange enrollees do not incur the surcharge, and tax credits help defray the costs of rate increases for those eligible for subsidies.

Impact of Federal Changes on California Rates

Lee said the elimination of the penalty for those who choose not to buy health insurance had a negative impact on rates for 2019. Carriers added between 2.5 and 6 percent to their rates, with an average of 3.5 percent, due to concerns that the removal of the penalty will lead to a less healthy and costlier consumer pool.

Covered California estimates the 3.5 percent increase added to the rates will mean Californians will be spending more than $400 million more on their health care coverage in 2019. While subsidized consumers will be protected from this increase, since the amount of financial help they receive will also increase, the federal government will end up paying an estimated $250 million more in higher tax credits. Unsubsidized consumers on- and off-exchange will bear the full brunt of the increase.

“The cost of the penalty removal will manifest for unsubsidized consumers in higher rates. While subsidized people will not bear the full costs, taxpayers will,” Lee said. “The additional losers from this policy change will be those who decide to roll the dice, go without coverage, and end up with hundreds of thousands of dollars in medical bills.”

Lee said some federal changes will affect more than just rates in 2019. The elimination of the penalty for going without health insurance will likely affect enrollment.

Covered California estimates that the elimination of the individual mandate penalty could reduce enrollment in California’s individual market by 262,000 consumers in 2019. Analysis conducted by PricewaterhouseCoopers found that the removal of the individual mandate penalty could also result in uncompensated care rising by $1,000 per newly uninsured person. If all uncompensated care costs — that are not covered elsewhere — were shifted to private insurance, the cost of employer-sponsored coverage could increase by between 2 and 4 percent, a cost that would most likely be shared between the employer and the employee.

Other factors influencing the rates include “medical trend” — or the general change in the cost and usage of medical services and products — which accounts for 7.5 percent of the rate change. In addition, the federal suspension of the health insurer tax for 2019 kept rates about 1.6 percent lower than they might have been.

“While there is a one-year reduction in rates due to the suspension of the insurer tax, the impact of removing the penalty for the individual mandate is permanent and is far larger,” Lee said.

Covered California Remains Strong and Stable

Covered California remains a strong and stable marketplace that has served more than 3.5 million Californians since it first began offering coverage in 2014. During that time, more than 5 million Californians have enrolled in the expanded Medi-Cal program. Together, these achievements have helped California reduce its uninsured rate from 17 percent at the end of 2013 to a record low of 6.8 percent at the end of 2017.

The historic gains made through steady enrollment have helped keep Covered California’s premiums at a stable level. Over the past five years, Covered California has held actual average annual rate changes for unsubsidized consumers to an estimated average of 7.9 percent and 3.8 percent for subsidized consumers (see Figure 1: California’s Individual Market Premiums).

Figure 1: California’s Individual Market Premiums [1]


The stability in Covered California’s premiums has fostered steady enrollment in California’s individual market. While the total enrollment in the nation’s individual market peaked at approximately 12.4 million in 2016, it declined by 10 percent in 2017, or roughly 1.5 million consumers. The decrease is driven primarily by a 20 percent reduction, which accounts for 1.3 million people, in the number of unsubsidized consumers in the individual market. In stark contrast, the number of unsubsidized consumers in California’s individual market has remained constant.

“In California we have 1 million unsubsidized consumers in the individual market, and while they will be protected from significant rate changes because of the positive effect of marketing and a competitive environment, we are worried that the rest of the nation is seeing millions of people at risk of being priced out of coverage,” Lee said.

Covered California’s steady enrollment further helps keep rates stable because its consumers are healthier than average, as measured by risk scores. A recent analysis published in the Health Affairs Blog, “National vs. California Comparison: Detailed Data Help Explain the Risk Differences Which Drive Covered California’s Success,” found that Covered California’s risk scores were lower than the national average from 2015 to 2017.

“Covered California’s strong enrollment, low premiums and healthy consumers are the result of promoting competition that focuses on lowering costs,” Lee said. “We will continue to put consumers first by providing them with high-quality coverage that ensures they can get the right care at the right time.”

Consumers can find out what they will pay for their 2019 coverage starting during the renewal period in October, when they can visit Covered California’s website at www.CoveredCA.com and begin using the Shop and Compare Tool for 2019.

Consumers who do not have health insurance will be able to begin signing up for 2019 coverage on Oct. 15. Others with special qualifying life events, like losing their coverage or moving, can enroll year round. Medi-Cal enrollment is also year round.

Interested consumers should go to www.CoveredCA.com to find out if they qualify for financial help and find free local help to enroll. They can contact the Covered California service center for enrollment assistance by calling (800) 300-1506.

Table 2: Covered California Rate Changes by Region

Pricing Region
Total enrollment*
Avg. rate change
Shop and save
Region 1
Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Nevada, Plumas, Shasta, Sierra, Siskiyou, Sutter, Tehama, Trinity, Tuolumne and Yuba counties
53,772
9.0%
5.3%
Region 2
Marin, Napa, Solano and Sonoma counties
51,193
9.1%
3.1%
Region 3
Sacramento, Placer, El Dorado and Yolo counties
79,158
8.8%
3.5%
Region 4
San Francisco County
36,099
9.4%
1.5%
Region 5
Contra Costa County
44,114
8.4%
1.7%
Region 6
Alameda County
63,554
9.4%
4.4%
Region 7
Santa Clara County
58,435
6.3%
-12.2%
Region 8
San Mateo County
24,283
9.3%
2.7%
Region 9
Monterey, San Benito and Santa Cruz counties
27,283
16.0%
11.4%
Region 10
San Joaquin, Stanislaus, Merced, Mariposa and Tulare counties
68,817
6.8%
0.5%
Region 11
Fresno, Kings and Madera counties
32,674
3.2%
0.4%
Region 12
San Luis Obispo, Santa Barbara and Ventura counties
65,829
8.7%
1.4%
Region 13
Mono, Inyo and Imperial counties
13,329
-0.5%
-3.5%
Region 14
Kern County
17,715
8.3%
6.9%
Region 15
Los Angeles County (northeast)
173,381
10.0%
-1.1%
Region 16
Los Angeles County (southwest)
213,126
8.6%
-5.2%
Region 17
San Bernardino and Riverside counties
123,025
9.0%
0.7%
Region 18
Orange County
133,166
9.0%
-2.2%
Region 19
San Diego County
116,149
9.0%
-3.8%
TOTAL
1,395,102
8.7%
-0.7%

*  Effectuated Enrollment for April 2018.

About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.

[1] Premiums shown are the actual observed average premiums in Covered California administrative data for renewal and open-enrollment plan selections for plan years 2014 through 2018, and the percentage change is the change to the average observed premiums. Year over year, the average premiums shown may be influenced by changes in the population distributions (such as for region, age, metal tier, etc.). Average premiums for the off-exchange market as a whole could differ from the Covered California unsubsidized premiums to the extent that the off-exchange population and plan-choice profiles differ from the on-exchange, unsubsidized profile. Additionally, the 2018 unsubsidized premiums have been adjusted to remove the cost-sharing reduction “surcharge” in Silver, since off-exchange enrollees do not incur the surcharge, and Covered California encouraged its unsubsidized Silver enrollees to move off-exchange to avoid the surcharge in 2018. For coverage year 2019 premiums, this chart shows an estimate of what premiums would be if all consumers enrolled in their same 2018 plan for 2019. The chart applies the global weighted Covered California average increase of 8.7 percent to produce the estimated average unsubsidized premium, which is an estimate of what off-exchange enrollees may pay in 2019 (the actual 2019 amount will depend on enrollee take-up and plan choice during renewal and open enrollment).