California Health Insurers: 2024 Edition provides a snapshot of the insurance market in California at the end of 2022. Data from the state’s two insurance regulators, the Department of Managed Health Care (DMHC) and the California Department of Insurance (CDI), and other sources were used to examine market share, enrollment, financial performance, and consumer satisfaction.

Key Findings

• California health insurers had $241 billion in revenue in 2022, up from $222 billion in 2020.
• In 2022, margins for the largest health insurers under DMHC regulation ranged from -4.9% to 5.9%, with four of seven insurers losing money. In contrast, all the largest health insurers regulated by CDI had positive margins, ranging from 4.8% to 10.3%.
• At the end of 2022, California’s insurers covered 35.9 million people — 14.1 million commercial enrollees, 16.1 million public managed care enrollees, and 5.8 million people enrolled through administrative services only arrangements for self-insured employers.
• Health insurance enrollment in California grew by 1.6 million (4.7%) in 2022, largely due to the increase of nearly 1.3 million (10.7%) in Medi-Cal managed care enrollment.
• At the end of 2022, 95% of individual, 95% of small group, and 94% of large group enrollees were in plans regulated by the DMHC.
•  In California, Medicare Advantage enrollment accounted for 49% of Medicare enrollment in 2022, up from 40% in 2014.
• The Affordable Care Act requires insurers to spend a minimum percentage of premium dollars on medical care or to issue rebates to policyholders. In 2022, eight California insurers owed $94 million in rebates to about 944,000 people. The average amount per recipient was $100.

The full report, all the charts, and the data file found in the report are available for download below.

These materials are part of CHCF’s California Health Care Almanac, an online clearinghouse for key data and analyses describing the state’s health care landscape. To see past editions of this almanac, contact us.

Resources about the medical loss ratio are also available.