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Covered California Struggles to Grow, Keep Policyholders

The Golden State’s public health insurance exchange, Covered California, is struggling to keep up its enrollment as only 66% of the individuals who enrolled for 2014, re-enrolled for this year.

And overall enrollment for the 2015 policy year nudged up just 1% for Covered California, ranking the state in the bottom five on overall growth during open enrollment this year, according to an analysis by Avalere Health.

California’s re-enrollment and overall policy growth compares poorly with the rest of the country. State exchanges run by the federal government re-enrolled 78% of their policyholders, while also growing their enrollment by an average of 65%.

One problem that Covered California also faced in 2014 was that it lost many of the people who had signed up at the start of the year. By December, enrollment had fallen 10% from the beginning of the year to 1.1 million individuals.

Covered California has said that it lost more enrollees than expected to non-payment of monthly premiums.

Meanwhile, Covered California had projected enrollment of 1.7 million for the 2015 policy year. But, by the cut-off date for enrollment, Feb. 15, it had 1.4 million individuals enrolled.

California’s enrollment ranks poorly with state exchanges run by the federal government via its HealthCare.govwebsite.

Overall, enrollment on the federal exchange jumped 61% in 2015 to 8.8 million. The state-run exchanges, cumulatively, increased enrollment by 12% to 2.8 million.

The bottom five states in terms of overall growth this year are:

  • Vermont, -17%.
  • Washington, -2%.
  • California +1%.
  • Rhode Island and New York, tied at +10%.


To boost its numbers, Covered California launched a special enrollment period that ended on April 30. Through April 22, it had added an additional 22,000 people, still putting it far below its target.

To make matters worse, the poor showing may not bode well for Covered California in light of the nearly $80 million budget deficit it faces for its 2015-16 fiscal year.

Although the exchange is setting aside $200 million to cover its near-term deficit, Covered California executive director Peter Lee said in December that there are questions about the “long-term sustainability of the organization.”


Call Us About Your Group Health Needs

VMA Insurance Services works closely with the Private Insurance Benefit Trust, one of the state’s oldest private insurance exchanges. Your staff will be able to choose from a menu of plans from a variety of insurance carriers by going through VMA for your group health needs.

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