Timeline: Health Insurance in California Before the ACA

Katherine Wilson, Wilson Analytics


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CHCF offers a brief look at the health insurance market prior to passage of the Affordable Care Act (ACA). The infographics provide a breakdown of enrollment in commercial plans and public programs, as well as a visual guide to the consolidation of health plans since 1985. Also, a timeline marks key milestones in the history of health insurance in California, from the opening of the first prepaid group practice of physicians in Los Angeles, to the historic passage of national health reform in 2010.

“Insurance Plan and Public Program Enrollment, 2009” outlines enrollment in large commercial plans (more than one million members), such as Kaiser Permanente and Aetna, broken out by for-profit and nonprofit status. Detail on Medi-Cal, Medicare, and Healthy Families enrollment in the commercial plans is also provided. In addition, enrollment estimates are given for Medi-Cal and Medicare, with detail on enrollment in managed care.

“Consolidation of Health Plans, 1985 to 2011” offers a visual representation of how the key players in the health plan market have changed over time and illustrates how for-profit plans dominate the market in 2011.

“History of Health Insurance in California” is a timeline of milestones in the evolution of the market from 1929 to 2010.

A PDF containing all three graphics is provided as a Document Download; it should be printed on 11″ x 17″ paper for maximum legibility.