Private Practice Insights: Covered California

By Stuart A. Bussey, M.D., J.D., UAPD President

With summer on the horizon the heat will be increasing on medical providers. Last week Peter Lee, director of the new Covered California health insurance exchange, announced that 13 health plans have been selected to participate. These plans will offer coverage to millions of previously uninsured Californians. The selection of these plans is subject to a rate review by the state. The rates submitted by the plans averaged only $320/month for an individual—substantially lower than the rates for most small employer plans. The “winning” organizations, including new entrants as well as giants like Kaiser, built their bids around the expectation of high enrollment. Supposedly, even rural areas in California will have access to at least one plan in the exchange. The competition for patients in the current ACA environment is causing a rate war to attract patients. Patient loyalty to providers will be tested. Healthpocket, a website that rates and compares health plans, asked 713 consumers if they would be willing to change physicians if it meant saving money on premiums. Though 40% said they would not change doctors, 34% thought that saving between 500-1000 dollars annually would justify such a switch.