The Orange County Board of Supervisors last week held off a vote on whether to change a county law to allow CalOptima, the largest health insurer in the county, to offer private insurance plans directly to consumers.
CalOptima is California’s largest county-organized healthcare system, offering healthcare to low-income residents. The system serves about 911,000 members—about one in four county residents.
Currently, six Covered California plans are available in the county, offered by private health insurers. If approved by the board, CalOptima would become the first public agency to offer a plan.
Though the federal government has yet to announce an end to the nation’s COVID-19 state of emergency, the end of the emergency declaration will cause states to redetermine whether individuals continue to be eligible for Medicaid—a public insurance program that provides free or low-cost medical services for people with lower income.
Once it ends, up to 20 percent of Californians may find themselves without health insurance coverage.
CalOptima is seeking to expand its health coverage in anticipation of this, through Covered California—the state’s health insurance marketplace connecting over 2 million people statewide with brand-name health insurance.
In May, CalOptima CEO Michael Hunn appealed to the Board of Supervisors to make this amendment to the county ordinance.
“The goal is to provide affordable and comprehensive coverage to as many Orange County residents as possible while increasing access to quality care,” Hunn said in a July 21 statement.
The board approved May 24 the first reading of the amendment, but the final approval is not yet materialized as a second reading has been postponed several times this year.
“I really appreciate the CalOptima board partnering with the county … to provide better services and more services to our most underserved in our community,” Supervisor Katrina Foley commented at the board meeting.
Part of the organization’s goal is to support multilingual, multigenerational, and multicultural members to receive better coverage, its administrators say.
Providing a Covered California plan would allow its members to keep their health network and doctors through a CalOptima Exchange Plan—which would bridge the gap members face when they are no longer eligible for Medi-Cal and must switch to another Covered California plan.
Under CalOptima’s network, members have access to over 10,600 primary care doctors and specialists, 34 community health centers, and 41 acute and rehab hospitals.
CalOptima was founded in 1993 by the Orange County Board of Supervisors as a County Organized Health System. Managing both state and federal government programs, it is run by a board of directors made up of members, providers, business leaders, and local government representatives.
