Aug 22, 2018
In 2017, group coverage rose while individual coverage declined in California, according to a report by the California Healthcare Foundation. Strong employment growth contributed to rising enrollment in group plans and Administrative Services only (ASO) arrangements for self-insured employers. California’s employed population rose 1.9%, or about 350,000 jobs. Group and ASO enrollment rose by more than 150,000, or 0.9%, to 17.6 million. Enrollment in group plans grew 0.8%, to 11.9 million. This included growth of 1.8% in small groups and 0.6%, in large groups. In addition, self-insured employers increased ASO enrollment by 1.1%.
Troubling Trends in the Individual Market
Enrollment in the individual market declined 3.8%, marking a second straight year of losses. Individual enrollment fell 1.7% in 2016. In 2017, individual off-exchange enrollment fell 7% while Covered California only posted a 1% enrollment decline. The CHFC finds a warning sign in the downward trend of consumers choosing off-exchange plans. Some individual market declines could be attributed to people moving from the individual market to employer-sponsored insurance. But the concentration of losses in the off-exchange (all unsubsidized) market suggests that some of the decline may simply be driven by affordability challenges. Affordability, especially in the individual market, and federal actions related to the individual mandate and insurance coverage standards are likely to shape enrollment dynamics going forward. The state’s response will also influence events.
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