Health Insurance Oversight in California: Observations on the Post-ACA Environment

By: Deborah Reidy Kelch , Kelch Policy Group

The regulatory and market changes associated with California’s implementation of the Affordable Care Act (ACA) call for a renewed focus on how best to empower state regulators with the appropriate legal authority, resources, and responsibility to hold the health insurance industry accountable in a meaningful and practical way.

To achieve such accountability, California should consider whether to continue its substantial efforts to synchronize and reconcile features of the two state entities that regulate the health insurance industry — the Department of Managed Health Care (DMHC) and the California Department of Insurance (CDI).

Alternatively, the ACA presents policymakers with an opportunity to empower and hold accountable a single regulator with a mandate to make consumer protection the centerpiece of health insurance regulation in California. Post-ACA shifts in health insurance products and enrollment offer fresh options for improved coordination of health insurance oversight.

CHCF commissioned Deborah Reidy Kelch to consider these options. Her full report is available on the Kelch Policy Group website.