Covered California report says exchange enrollees getting needed care

California's state-run health insurance exchange, Covered California, took a look back at its first two years of operation and concluded in a new report that there are many indications its enrollees are getting the medical care they need.

Californians have greater access to medical care since coverage was made available under the Affordable Care Act, according to the report. Covered California began offering health insurance to state residents Jan. 1, 2014, and has since provided coverage to two million members.

Tens of thousands of enrollees, who obtained health insurance through the exchange, have received care in California hospitals, including organ and bone marrow transplants, brain surgeries, joint replacements, cancer treatments and emergency room care, according to the report. The data suggest "that Californians are not just getting covered; Californians are getting the healthcare they need when they need it," the report said.

Numerous studies show that expanded insurance coverage has also provided access to preventive care, wellness exams and screenings, which for some people was not an option before Covered California, the report said.

The report includes an individual breakdown for all 111 hospitals where enrollees received care. In the future, the exchange plans to launch the Covered California Healthcare Evidence Initiative, which will collect data from the health plans it contracts with to "bring into more precise focus the totality of care accessed at all care facilities," the report concludes.

California is among only a few states that actively negotiate health plan prices, and as a result can attract broad enrollment of consumers in its exchange, as FierceHealthPayer previously reported. 

While the exchange has been held up as a model of "active purchasing" success over passive marketplaces, Covered California has had its issues. The exchange came under fire last year for enrollment and tax-related issues that caused consumers to be denied coverage.

To learn more:
- read the report

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