Plan Choice for Covered California Consumers, 2017–2019

Katherine Wilson, Wilson Analytics

In 2018, for the first time, some Covered California enrollees had only one health plan choice (meaning only one insurer). Did plan choice continue to erode in 2019 or did it remain stable? Here are the key facts about Covered California plan choice in 2019:

1. California, like the rest of the US, continued to have no “bare-shelf counties,” or counties where no health plan is participating.

2. Compared to 2018, consumer plan choice remained stable.

Four percent of enrollees choosing 2019 coverage had only one plan choice, the same as 2018. (This compared favorably to the 20% of enrollees in the federal marketplace with only one choice in 2019.) Ninety-six percent of Covered California enrollees in 2019 had at least two plans to choose from, and 81% had at least three.

3. The locations where consumers had only one plan choice remained the same.

The majority of consumers with a single plan choice lived on the central coast, specifically in Santa Barbara, Monterey, and San Luis Obispo Counties. A total of 15 counties are either totally or partially single choice in 2019 — the same as the year before. (In counties that are totally single choice, such as Santa Barbara County, all zip codes in the county have only one insurer offering coverage through Covered California. Counties that are partially single choice, such as Placer County, have some zip codes with one choice of health insurer and other zip codes with more than one choice available.) As in 2018, most single-choice enrollees lived in Santa Barbara, Monterey, and San Luis Obispo Counties. These three counties, along with San Benito, Mono, and Inyo, are all totally single-choice counties and account for 80% of all single-choice enrollees in the state. Nine other counties have some single-choice enrollees: Placer, Ventura, El Dorado, Fresno, Madera, Kings, San Bernardino, Kern, and Riverside.

Methodology Notes: This analysis is built up from the zip code level. The choice of insurers by zip code for each year was evaluated using Covered California Products by Zip Code files for 2017–19. Enrollment was assigned to each zip code using the Covered California Active Member Profiles, 2017–18. The number of enrollees choosing 2019 plans reflects June 2018 enrollment, as official 2019 Covered California enrollment figures were not yet available at the time of analysis.