The California Health Benefit Exchange ("Exchange") was created by the legislature in response to the Federal Health Reform passed by Congress to increase the number of insured Californians, improve health care quality, and lower costs. The Exchange will cover 2.8 million currently uninsured individuals that currently do not qualify for medi-cal in 2014 and 4.4 million people by 2016.

The Exchange will offer coverage directly and through health plans to the general public in addition to just offering coverage to the uninsured. The Exchange is in the process of developing the health benefits to be offered and deciding which HMOs will currently participate with the Exchange to market the health plans to the public. In order to assist Californians with coverage, subsidies will be offered based on an individual federal poverty level. However, in order to receive the subsidy, the individual will have to purchase their health care coverage through the Exchange.

An upcoming Supreme Court ruling will determine if Californians will be required to have health care coverage starting in 2014. If health reform moves forward, individuals will have more options for obtaining healthcare. The Exchange is currently developing the mechanisms needed to assist the public with understanding what care will be available, how to obtain, and at what cost.

For more information on healthcare reform, please contact Mark Wright, Director of our healthcare management practice at mwright@intellibridgepartners.com or 916-642-7115. Mark is the former Chief of Financial Oversight for the State Department of Managed Healthcare.

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