February 3, 2025
The Orange County Board of Supervisors unanimously approved a regulatory ordinance change that paves the way for CalOptima Health, Orange County’s public health insurer, to pursue participation in Covered California, the state’s health insurance marketplace established by the Affordable Care Act. This step is intended to provide continuity of care and expand access to affordable health coverage for more than 15,000 Orange County residents who fall in and out of Medi-Cal eligibility annually.
CalOptima Health CEO Michael Hunn emphasized the importance of this initiative in meeting the needs of individuals who may lose Medi-Cal coverage due to eligibility changes. “CalOptima Health’s effort to join Covered California reflects our unwavering commitment to ensuring continuity of care for our members,” Hunn said. “By offering a Covered California plan, we aim to provide ongoing coverage to members so they can continue to receive services from their trusted providers at affordable premiums.”
The ability to join a CalOptima Health Covered California plan will better serve individuals who often transition in and out of Medi-Cal. Without this option, they may face challenges that lead to gaps in care and unexpected medical expenses. Additionally, a CalOptima Health Covered California plan can help households that have both Medi-Cal and other coverage to have access to the same provider network for all family members.
“CalOptima Health’s participation in Covered California would allow seamless continuity of care for many of our members,” said Isabel Becerra, Chair of the CalOptima Health Board of Directors and CEO of the Coalition of Orange County Community Health Centers. “This initiative aligns with our mission to serve our community with excellence and dignity by promoting access to high-quality, affordable care.”
To promote transparency regarding this initiative, CalOptima Health has engaged stakeholders through public listening sessions, provider forums and a steering committee of health industry leaders over the past six months. This comprehensive approach to community engagement ensures that the plan will address the diverse needs of Orange County residents and providers.
“Too often, individuals lose their insurance coverage simply because they worked an extra shift or took on additional hours,” said Supervisor Vicente Sarmiento, Vice Chair of the CalOptima Health Board of Directors and Orange County Supervisor for the Second District. “This change ensures they now have the option to maintain their insurance, providing stability and peace of mind in managing their health care needs, without impacting the service delivery or quality of care to our members.”
“By pursuing participation in Covered California, CalOptima Health is strengthening its role as Orange County’s safety net provider,” said Supervisor Doug Chaffee, CalOptima Health Board Member and Chairman of the Orange County Board of Supervisors. “This initiative will create opportunities for continuity of care and greater access to affordable options for those who need it most.”
With the Board of Supervisors’ approval of the ordinance change, CalOptima Health will now proceed with the next steps in the regulatory process, including securing approval to participate from Covered California and the California Department of Managed Health Care. Pending these approvals, CalOptima Health aims to launch its new plan on January 1, 2027.
