What policymakers need to know: Learn about consumer affordability challenges in California's individual health insurance market. In this resource center, you'll find background information, definitions of key terms, an explanation of key Affordable Care Act provisions, data, and real-life scenarios faced by consumers in the individual market.
People who buy their own health insurance bear higher costs of coverage and care than those who are insured through employers. Under the Affordable Care Act, premium subsidies and cost-sharing assistance help make health insurance much more affordable for many Californians who purchase their own coverage. Still, many Californians in the individual market struggle to afford health insurance premiums as well as their out-of-pocket costs for health care services. Others choose to forgo coverage altogether due to cost. Understanding the factors that affect affordability can set the stage for policy discussions about how to help all Californians stay covered.
Need a terminology refresher? We’ve spelled out some basic health insurance cost vocabulary for you.
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About the Authors
Marian Mulkey, MPH, MPP, principal of Mulkey Consulting, offers strategic guidance, impact assessment, and health policy expertise for philanthropic, public sector, and nonprofit organizations. Katherine Wilson, MPH, of Wilson Analytics, is an independent consultant specializing in health insurance markets and health care costs. The authors wish to acknowledge CHCF Senior Communications Officer Anne Sunderland, MPH, for her substantial contribution to this paper.