California announces SHOP exchange insurers and rates

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

The health benefit exchange for California’s 500,000 small employers named six health insurers last week and announced the rates those insurers will charge. Small businesses (meaning 50 or fewer workers) employ 4.5 million workers in California.

This news from California may be useful to health care journalists covering the exchanges in other states, particularly those 16 states (and Washington, D.C.) that are running their own exchanges.

With this announcement on Aug. 1, California becomes the second state to publish the names of the insurers and their rates for its Small Business Health Options Program (SHOP) exchange, following Oregon and Washington, D.C. Enrollment on the exchanges begins Oct. 1 for insurance coverage effective Jan. 1. The Golden State’s health benefit exchange is called Covered California.

In the Los Angeles Times, Marc Lifsher writes that more than 7 million Californians under age 65 are uninsured, including 25 percent of all workers and 40 percent of workers at companies with fewer than 10 employees.

Lisa Aliferis of KQED in California reports that the SHOP rates announced last week are about what insurers are charging now in the small group market or slightly lower. The advantage for small businesses buying health insurance on the SHOP exchange is that they may be eligible for subsidies of 35 percent toward the premium cost, Aliferis writes.

Within the next several weeks, the remaining 14 states are due to name the insurers and their premium rates, according to Sara R. Collins, Ph.D., and Tracy Garber, M.P.H., of The Commonwealth Fund. Collins is the fund’s vice president for Affordable Health Insurance and Garber is a senior policy associate. Premiums in states where the federal Department of Health and Human Services (HHS) is facilitating the establishment of the SHOP exchanges are expected next month, Collins and Garber say.

For journalists seeking to compare the rates in California with those of other states, Collins and Garber recommend this HHS brief. Although the brief predates the release of California’s SHOP exchange rates, it shows that initial SHOP exchange premiums in six states are 18 percent below projected premiums, Collins and Garber say.

Most of the states establishing their own SHOP exchanges are moving beyond what is required under the Affordable Care Act, Collins and Garber add. For an assessment of SHOP exchanges being developed in these 16 states and the District of Columbia, they suggest this fund brief.

Another resource that may be useful is the fund’s interactive map, showing state marketplace designs side by side.

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