This overview describes California’s individual market before the Affordable Care Act and identifies potential concerns if the ACA is repealed.
The individual (nongroup) market is an important fallback option for those who are not offered health insurance coverage through their employers and do not qualify for public programs such as Medi-Cal or Medicare. Independent contractors, part-time employees, low-wage workers at businesses that do not offer coverage, people moving between jobs, and the unemployed all fall into this category of people who will need to turn to the individual market if they want health coverage.
Prior to the ACA, fewer than 10% of Californians obtained individual health insurance at any given time. The ACA established new health insurance marketplaces, provided new financial subsidies for low- and moderate-income people to purchase individual health insurance, imposed new regulations on health plans (like guaranteed issue, banning insurers from denying coverage based on pre-existing conditions), and required individuals to maintain coverage or face penalties. By 2015, two years into ACA implementation, almost 17% of Californians received coverage through the individual market.
This overview offers historical context about California’s individual market before the ACA and identifies potential concerns in the event that the ACA’s provisions reshaping the individual market are repealed.