California Health Insurers: 2026 Edition provides a snapshot of the insurance market in California at the end of 2024. Data from the state’s two insurance regulators, the Department of Managed Health Care (DMHC) and the California Department of Insurance (CDI), along with other sources were used to examine market share, enrollment, financial performance, and consumer satisfaction.
Key Findings
- California’s health insurers regulated by the DMHC had $281 billion in revenue in 2024, up from $218 billion in 2022.
- In 2024, margins for the six largest health insurers under DMHC regulation ranged from 0.4% to 10.8%.
- At the end of 2024, California’s insurers covered 36.5 million people: 13.7 million commercial enrollees, 16.8 million public managed care enrollees, and 5.9 million people enrolled through administrative services only arrangements for self-insured employers.
- Overall, health insurance enrollment in California grew by 325,000 (0.9%) in 2024, largely due to an increase of 380,000 (2.9%) in Medi-Cal managed care enrollment.
- At the end of 2024, 99% of individual, 97% of small group, and 93% of large group enrollees were in plans regulated by the DMHC.
- Medicare Advantage enrollment in California accounted for 51% of Medicare enrollment in 2024, 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 2024, six California insurers owed $31 million in rebates to about 506,000 people. The average rebate per recipient was $62.
The full report, quick reference guide, charts, and data file on California health insurers 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 California’s health care landscape. To explore previous editions of this Almanac, contact us.
