California Puts Tentative Price on Health Policies Under New Law California, widely seen as a model for how individuals will buy health insurance under the new health care law, announced Thursday that 13 insurers had been chosen to sell policies through the insurance marketplace - or exchange - being created under the law. State officials said that rate increases for individuals who already had insurance would not be as high as some had feared. Blue Shield of California, for example, estimated its current customers would see rate increases of about 13 percent. Some estimates had suggested rate increases could be 30 percent. The increases are largely the result of higher prices and the need to cover people who now have no insurance and are likely to have expensive medical problems. The new rates for individuals will be about the same - or lower - than the current rates for small businesses, according to officials from Covered California, the group operating the exchange. "The changes in the market are really making individuals much more like employer groups," Paul Markovich, the chief executive of Blue Shield, said. Like people who now receive health insurance through their employers, individuals buying policies on their own will be able to enroll next year even if they have a potentially expensive medical condition, and the policies" benefits and premiums will be more standardized. "We held insurers" feet to the fire," said Peter V. Lee, the executive director of Covered California, who said that the exchange had received interest from 33 insurers and actively negotiated with them over their proposed rates and the kind of network of doctors and hospitals they would offer. Covered California estimates that the plans offered will allow consumers access to about 80 percent of the state's practicing physicians and hospitals. While Washington, Vermont and several other states have also announced the details of their respective exchanges, California's size and previous support for the health care law made it an important test of the law, said Paul B. Ginsburg, the president of the Center for Studying Health System Change, a nonpartisan research group in Washington. "A lot of people will be watching California to see how well it succeeds," he added. California chose to behave more like Massachusetts in aggressively negotiating with insurers on behalf of its residents. But other states are, at least initially, taking a more passive approach, in which they do not try to bargain over rates. The 13 plans selected represent a range of insurers, from WellPoint, one of the nation's largest commercial players, to plans like Alameda Alliance for Health and Molina Healthcare that in the past have specialized in providing coverage to low-income patients through the state's version of Medicaid. Other entrants include health systems like Sharp HealthCare, a San Diego group of hospitals and doctors that also operates a health plan. The four largest companies providing coverage to people who are not covered through an employer but buy a policy on their own will all be selling plans in the marketplace. They are Blue Shield; Anthem Blue Cross of California, owned by WellPoint; Kaiser Permanente, the health maintenance organization giant; and Health Net, a commercial insurer based in Los Angeles. Several other large companies will be absent from the exchange, including the UnitedHealth Group, Aetna and Cigna. Unlike WellPoint, which operates a number of commercial Blue Cross plans that tend to have a sizable business offering individual coverage, the other companies have concentrated on employer coverage and have signaled that they will be cautious about which markets they will enter through the newly created exchanges. "Aetna is taking a prudent and balanced approach to exchange participation in the first year," the company said in a statement. Our decisions about which exchanges to participate on are based on a careful review of key attributes, such as our current market presence, our ability to offer strong networks and competitively priced products and the regulatory environment in each state. Under the law, however, some insurers who sit out the first year could decide to enter the marketplace the second or third year. "As the economics, sustainability and dynamics of the exchange continue to become clearer over time, the exchange has the potential to be a growth market with much to offer UnitedHealthcare, other insurers and consumers," a spokesman for UnitedHealthcare said. The rates, which still require approval by state regulators, are not final, and officials on Thursday provided a small sampling of rates in areas around the country. In southern Los Angeles, for example, a 40-year-old individual would pay anywhere from $242 a month for a plan from HealthNet to $259 for plans from Molina or Anthem. The comparable plan for a small employer costs $362. California took the step for 2014 to make sure the plans being offered had standard benefits so the pricing for plans does not vary widely, although there are differences. And some plans, like Anthem, boasted of their affiliation with well-known providers like the University of California hospitals and doctors. While low-income individuals may still find paying $300 or more a month for a plan to be prohibitively expensive, consumer advocates praised the exchange's ability to keep premiums in line with what employers pay and say it is a promising first step in the effort to force plans and providers to work harder to offer more affordable insurance. "Health insurance isn't cheap but this seems to provide individuals and families the group rate that large employers get," said Anthony Wright, the executive director of Health Access California, a state consumer advocacy coalition.