“When Covered California unveiled its initial slate of 13 carriers last year, their low rates got some attention — but so did their mix.
While Covered California couldn’t boast Aetna or UnitedHealthcare, which instead elected to leave the state’s individual market, four major insurers were on board: Anthem Blue Cross, Blue Shield of California, Health Net and Kaiser Permanente.
And the exchange also had drawn in several smaller health plans, like Ventura County Health Plan, which were going to compete for share on the individual market for the first time.
“For me, the story is [these] new participants,” Micah Weinberg of the Bay Area Council told California Healthline last summer. “Who exactly they are, and how they are being offered in these marketplaces, is worth watching.”
But Ventura County quietly pulled out. A second small carrier, Alameda Alliance, was kicked out. And earlier this summer, a third carrier — Contra Costa Health Plan — was forced to drop out, citing state rules around offering on- and off-exchange plans.
That’s left Covered California with 10 plans — which would be a bounty for nearly any other state. Not so across California’s vast, 164,000-square-mile expanse, where many regions are essentially dependent on a lone insurer.
As “Road to Reform” tracked throughout last year’s enrollment period, the seven small insurers ended up splitting just a fraction of Covered California’s customers, while the “big four” insurers were responsible for almost 95% of all sign-ups across the state.
“It’s not just an issue of market concentration,” California Insurance Commissioner Dave Jones (D) told California Healthline. “It’s the absence of choice that exists for some consumers in some parts of California.””