Six Exchange Plans Offer Coverage Through Public Health Care Programs
Nearly half of the health plans participating in the state health insurance exchange have experience offering health plans through Medi-Cal and county plans and thus might be appealing to lower-income individuals seeking coverage through the new marketplace, Payers & Providers reports (Shinkman, Payers& Providers, 5/30).
The exchange -- named Covered California -- primarily will serve individuals and small businesses.
Supporters hope that the exchange will function similarly to websites like Amazon and Expedia so that users will be able to chooseÂ among various health plans through an easily navigable online store.
The exchange is expected to open for registration in October, and an estimatedÂ five million people will purchase plans through the exchange in 2014.
Last week, California officials announced aÂ premium rate structure for health plans offered through the exchange and said that 13 insurers will participate in the marketplace (California Healthline, 5/24).
Plans Offer Public Health Program Coverage
Four of the insurers announced last week specialize in Medi-Cal managed care, including:
- Alameda Alliance for Health;
- Contra Costa Health Care;
- L.A. Care Health Plan; and
- Molina Health Care.
Medi-Cal is California's Medicaid program.
Two other health plans participating in the marketplace provide benefits to county government workers. Those plans are:
- Valley Health Plan in Santa Clara County; and
- Ventura County Health Care Plan.
Most of the six plans will be offered only in a single county.
Comments From Stakeholders
Health plan officials and health care advocates say the insurers that provide coverage through Medi-Cal and counties likely will develop a strong following among low-income residents.
Anthony Wright, executive director of Health Access, said that many of the families who might select such plans are former Medi-Cal beneficiaries who lost coverage when their income levels rose above the program's eligibility standards.
He said, "Now that they can get insurance, they may want to continue with [the] same doctors and providers they had in the past."
Howard Kahn, L.A. Care's CEO, said, "We don't think of this as going after a commercial stream of business," adding, "This is a natural extension of Medi-Cal for those who may have had coverage in the past."Kathleen O'Guin, a Molina Health Care spokesperson, said, "We are entering the (exchange) to continue serving the low-income Medicaid expansion population and to enable parents of our (Healthy Family) members to choose the same health plan as their children." Healthy Families is California's Children's Health Insurance Plan (Payers & Providers, 5/30). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.