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California Health Insurers: Two Years After Reform

Katherine Wilson, Wilson Analytics

California's insurance market changed dramatically as a result of health reform and the millions who became newly eligible for public insurance and private subsidies.

Click to See Data Visualization

California Health Insurers: Two Years After Reform provides a snapshot of the insurance market in California at the end of 2015. Dramatic expansion of coverage under the Affordable Care Act (ACA) in 2014 and 2015 brought more enrollment and premium dollars to California's insurers.

Over half of Californians have private health insurance — purchasing it individually or getting it through their employer. California's health insurers provide coverage for these individuals as well as those enrolled in Medicare and Medi-Cal managed care plans.

Data from the Department of Managed Health Care (DMHC), the California Department of Insurance (CDI), and other sources were used to examine market share, enrollment, financial performance, public coverage, and consumer satisfaction.

Use our interactive graphic to learn more about enrollment and revenue for private insurance carriers in California.

The complete Almanac report is available under Document Downloads. A quick reference guide, all the charts found in the report, data files, and past editions are also available. Also, see resources on the medical loss ratio.

Other key findings include:

California health insurance was a $162.5 billion business in 2015, up from $122.9 billion in 2013, a 32% increase. Six insurers accounted for more than two-thirds of the revenue, and most insurers operated in the black.

L.A. Care, the state's largest county-based insurer, more than doubled its revenues during the two-year period, and vaulted into the ranks of the six largest insurers, exemplifying the growth in Medi-Cal insurers.

All Health Insurers, by Share of Revenue, California, 2013 and 2015

Enrollment in individual and in Medi-Cal and other public managed care plans surged in 2014 and 2015 with the rollout of major ACA provisions. During this two-year period, individual enrollment increased by 58% (858,000) to 2.3 million while enrollment in Medi-Cal and other public managed care plans increased by 52% (3.5 million) to 10.3 million.

Enrollment Growth/Reduction, DMHC and CDI Combined, California, 2013 to 2015

In 2015, enrollment in Medi-Cal and other public managed care surpassed large-group enrollment, formerly the biggest health insurance market.

Enrollment Trends, by Market, DMHC and CDI Combined, California, 2012 to 2015