Covered California and the New Marketplaces

2014 brought a new way for individuals and small business owners to compare and buy health insurance. Under the Affordable Care Act (ACA), every state was required to have a health insurance marketplace, also called an exchange, open by October 2013.

States had the option to use the federal Health Insurance Marketplace instead of building their own. California was the first state in the nation to enact legislation to create a health care marketplace – Covered California.

Covered California began enrolling eligible Californians in October 2013 for health insurance coverage beginning January 1, 2014.

The initial enrollment period runs through March 31, 2014, to give consumers more time to learn about their choices and enroll. For 2015, open enrollment is set to start on November 15, 2014 and go through January 15, 2015.

All health insurance plans purchased through Covered California must cover certain services called essential health benefits. These include doctor visits, hospital stays, emergency care, maternity care, children’s care, prescriptions, medical tests and mental health care. Health insurance plans also must cover preventive care services, like mammograms and colonoscopies, for free. All plans being sold in the Covered California marketplace, as well as those sold outside it, are required to include these benefits.

The state estimates that about 2.6 million Californians will qualify for financial assistance through Covered California to pay for their health insurance, and 1.4 million will be newly eligible for Medi-Cal. An additional 2.7 million will benefit from coverage that is guaranteed whether they buy an insurance plan through Covered California or on their own.