California Health Care

Find latest news, legislation and regulations related to the California health care system. Medical coverage services in the golden state are offered through the following options:

  • Covered California: The Health Exchange Marketplace
  • Insurance Carriers: providing off-exchange medical benefits
  • Veterans Administration (VA) Health Care Coverage
  • Medi-Cal
  • Prison Health Care for California

Health care in California has gone through radical changes since the passage of the Patient Protection Affordable Care Act (PPACA) in 2010 and the implementation of Health Care Reform in 2013. Obamacare plans in California are sold through the state health insurance exchange, Covered California.

Individuals, families and businesses can enroll on a health care plan through Covered California, through Medi-Cal, through a health insurance broker, or by contacting a health insurance carrier directly. Popular carriers offering health insurance in California include Anthem Blue Cross, Blue Shield of California, Kaiser Permanente, Health Net, Molina and United Healthcare. For rates and benefits, click California Health Insurance Quotes. Open Enrollment 2017 is from November 1, 2016 to January 31, 2017. Outside of that window, you may apply during the Special Enrollment Period as long as you have a qualifying life event.

Government agencies that regulate health care in California include the California Department of Insurance, the California Department of Health Care Services, the Department of Managed Health Care (DMHC) and Ombudsman. The DMHC and Ombudsman offer protections and legal assistance for the consumers of health care in California.

 

Due to the Federal UI Supplement of the American Rescue Plan, if someone has received unemployment insurance for at least one week in 2021, then they qualify for the following:

This discount is approved for the entire year of 2021. However, Covered California is not expected to implement this until August of this year

In July or August, Covered California plans to add the question about Unemployment Insurance to the CALHEERS application. If you affirm that you have received unemployment income in 2021, then you will receive rates based on an income that is 138.1% of the Federal Poverty Level. See Covered California Income Chart.

Note: Normally at 138.1% of FPL, children ages 0-18 would end up on Medi-Cal. However, this UI Discount will not cause children to end up on Medicaid/Medi-Cal who would not have qualified otherwise. Medi-Cal eligibility will still be based on the full income and the associated Federal Poverty Level.

Details are being worked out. We anticipate it working like thi...


Due to Proposition 22, app-based drivers working for companies like Uber, Lyft, Door Dash, Grub Hubb, etc. receive money toward their health care coverage from the app-based company. They can enroll through Covered California, receive subsidies, and receive additional money from the company toward the cost of their health care. However, they do need to submit documentation to prove they have enrolled in a health insurance plan.

Covered California announced today:

Proposition 22 Proof of Coverage forms are available today for PDF download. Because some app-based network companies have strict submission windows, consumers who are app-based drivers should upload their Proof of Coverage PDFs to their network company(ies) site as soon as possible. Some companies may not pay stipends for a Proof of Coverage document received after their specified date.

Please note: For future quarters, Proof of Coverage documents will be available the first day after the close of the quarter. For example, Qua...


If you are a Californian with no health insurance in 2020, you may face a tax penalty in 2021. Though in 2019 the Trump administration rescinded the tax penalty established by the Affordable Care Act, you may still need to pay a tax penalty in 2021 if you live in California and do not have health insurance. 

Your options are either to not carry health insurance and pay a penalty at tax time or to enroll in a qualified insurance plan and avoid paying the penalty, though some exceptions may apply depending on your circumstances.

In 2014, a mandate was implemented in the United States for individuals and employers to have health insurance as part of Obamacare. Most individuals who were legal residents or U.S. citizens were required to purchase qualifying health insurance or else they would need to pay a tax penalty. While this tax penalty has been rescinded at the federal level, some states are now implementing their own penalties for individuals without health insurance.

Many indiv...

Posted: October 23rd, 2020

Mix the complicated worlds of health care and politics and you can end up with nothing but confusion. Health care in the 2020 election has been a hot topic, alongside other key issues. We’re here to help Californians and all Americans better understand the health care policies put forth by the 2020 presidential candidates: President Donald Trump and former Vice President Joe Biden. We’ll discuss the Republican vs. Democratic stance on health care and how these candidate’s policies compare.

The Democratic Party’s platform has pushed health care reform for many years. One of the most significant changes came with the Affordable Care Act (ACA), nicknamed ObamaCare after the Democratic president who signed it into law in 2010. The current Democratic nominee for the 2020 presidential race, Joe Biden, was the vice president at the time.

According to the Democratic National Committee, the Affordable Care Act brought health care to more than 20 million previously uninsured American...

Posted: October 23rd, 2020

As the cost of health care continues to rise, many consumers are concerned about how they will be able to fit health insurance into their budgets. Due to the increasing costs, consumers are looking into alternatives. One option that tends to come up is a health share plan. 

What exactly are health share plans? What can a health share plan offer you, and what do you need to know about these plans before you commit to one? As a California resident, you should understand the difference between health insurance and health share plans to make the best decision for you and your family. 

Health share plans are also referred to as health sharing ministries and health care sharing programs. A health share plan is not the same as a cheap health insurance program, nor is it a health care alternative. Instead, health share plans are cooperatives in which members agree to cover a portion of one another’s medical costs. These plans are often faith-based, and though they may sound similar to insur...

Posted: October 23rd, 2020

The Golden State is getting a pleasant surprise in 2021. Covered California rates are going up 0.6% on average and the plan benefits are not changing very much.

The out-of-pocket maximum is going up from $7,800 to $8,200 on the Bronze, Silver and Gold Plans. For Bronze and Silver, there are no other benefit changes for next year.

On the Gold Plans, there are a couple more changes beyond the out-of-pocket maximum going up $400. Doctor Visits and Urgent Care are both going up $5, from $30 per visit to $35 per visit. For Gold Plans that have a copay for Imaging (including CT, PET Scans, and MRI’s), the copay is dropping from $275 down to $150. For Gold Plans that require a percentage payment for Imaging, that amount will remain at 20%.

For the Silver 87 Plans, there is one small change. The out-of-pocket maximum is going up $150, from $2,700 up to $2,850.

In 2021, consumers can look forward to small rate changes and minimal benefit changes. Also, if Californians switch plans to the lowest p...

Posted: September 23rd, 2020 under Covered California Insurance

by Wendy Barnett

When you have lost your job, your medical insurance from your employer can end, too.  Being without work can be a stressful time, but understanding your health insurance options doesn’t have to be. There are four important things to know when you have lost your job health insurance:

Did you know that since the Affordable Care Act took effect, most people must apply for their health insurance during a particular period of time each year? This period, which is called Open Enrollment, occurs annually in the fall. Once Open Enrollment closes, a Special Enrollment Period begins in which applicants must experience a Qualifying Life Event in order to apply.

Since the beginning of the COVID-19 outbreak, there have been over 1 million reported cases and over 50,000 associated deaths in the United States. As COVID-19 continues to impact communities across the country, people need access to health care more than ever. Unfortunately, many people — including Californians —...


DOI Reminds Agents to Make Clear the Differences Between HCSM’s and Insurance

In a press release put out today, the California Department of Insurance admonished insurance agents in the state to make sure that clients know what they getting when they enroll in a Health Care Sharing Ministry. These health sharing plans have become more and more popular in the state, and the DOI is concerned that consumers may not really understand what they are getting.

The Department of Insurance put out this press release today:

NOTICE TO: All Admitted Insurers, Accident and Health Agents, and Other Interested Parties DATE: March 10, 2020 RE: Health Care Sharing Ministries Health Care Sharing Ministries (“HCSMs”) are organizations in which members often share a common set of religious or ethical beliefs and agree to make payments to, or share, the medical expenses of other members. HCSMs operate either by matching paying members with those who need funds for medical expenses or “sharing” health...

Posted: March 11th, 2020

Citing Misleading Practices, the DOI Cracks Down on This Health Care Sharing Ministry (HCSM)

Today, March 10, 2020, the California Department of Insurance issued a cease and desist order to Aliera Healthcare and Trinity. Aliera is a Health Care Sharing Ministry (HCSM). It was exempt under the Affordable Care Act, meaning those enrolled with Aliera were not issued a penalty for being uninsured. However, the DOI has cited the problem of deceptive or misleading marketing practices.

See the cease and desist order below:

News: 2020 Press Release
For Release: March 10, 2020

Media Calls Only: 916-492-3566
Email Inquiries: cdipress@insurance.ca.gov

Department Issues Cease and Desist Order to Protect California Consumers from Misleading Health Plans Known as ‘Health Care Sharing Ministries’

Deceptive marketing tactics by Aliera and Trinity could impact up to 11,000 Californians

OAKLAND, Calif. — The California Department of Insurance issued a Cease and Desist order effective immediately against A...

Posted: March 11th, 2020

Health insurance is an important investment. Without it, you would be responsible for covering 100% of the expenses if something major happens to you, such as surgery or an extended hospital stay. With health insurance, though, a large sum of the medical and hospitalization expenses would be covered if you have an illness or injury. However, there are several things to consider before you choose a plan, like the deductible amount.

Your health insurance deductible is the total amount of money you pay for a medical expense before your insurance takes over to cover the remaining balance. For example, if you have a medical bill of $5,000 and your insurance policy has a deductible of $1,000, you would pay that $1,000 out of your own pocket. Your insurance would cover the remaining $4,000, minus any coinsurance that might be written into the policy.

For certain services, such as basic health checkups, the insurance will cover the expense before you meet the deductible. All health plans cover t...

Posted: February 13th, 2020 under Covered California Insurance


Not sure how Obamacare affects your health care plans in California? Learn how the ACA works in California, including benefits, costs and enrollment.


Covered California is the Golden State’s official health exchange marketplace where individuals, families and small businesses can find high-quality, low-cost California government health insurance.


Learn about Obamacare income guidelines in California using our income limits chart, and see if you’re eligible for government assistance.


Learn about the Covered California website. Find easy online enrollment. Set up your account, log in, buy insurance and more on the California health marketplace website.