Agenda Item   



                                                                                                                        ASR Control  22-000427




legal entity taking action:

Board of Supervisors

board of supervisors district(s):

All Districts

SUBMITTING Agency/Department:

Health Care Agency   (Approved)

Department contact person(s):

Torhon Barnes (714) 834-5109 



Clayton Chau (714) 834-2830



Subject:  Amendments to CalOptima Ordinance


      ceo CONCUR

County Counsel Review

Clerk of the Board


Approved Ordinance to Form




3 Votes Board Majority




    Budgeted: N/A

Current Year Cost:   N/A

Annual Cost: N/A




    Staffing Impact:


# of Positions:            

Sole Source:   N/A

    Current Fiscal Year Revenue: N/A

  Funding Source:      N/A

County Audit in last 3 years: No



    Prior Board Action:         10/18/2011 #29, 10/04/2011 #38






Read title of Ordinance, "An Ordinance of the County of Orange, California amending sections 4-11-2, of the Codified Ordinances of the County of Orange Regarding the Orange County Health Authority."



Order further reading of Ordinance be waived.



Consider the matter.



Direct Ordinance be placed on the agenda for the next regularly scheduled Board of Supervisors meeting for adoption.




Consider the matter and adopt the Ordinance at the next regularly scheduled meeting.







Modifying the CalOptima Ordinance will allow the CalOptima to participate in the California Health Benefit Exchange.






The Patient Protection and Affordable Care Act (ACA) was signed into law in March of 2010.  The ACA allowed states to set up their own state-based marketplace or exchange to provide its residents with an avenue to purchase their health insurance and receive discounts in the form of federal subsidies if eligible.


California was the first state to introduce legislation to create the California Health Benefit Exchange, known as Covered California. In September of 2010, then-Governor Arnold Schwarzenegger signed Assembly Bill 1602, the California Patient Protection and Affordable Care Act and Senate Bill 900 into law.


On October 4, 2011, the Orange County Board of Supervisors amended the CalOptima ordinance that stated, “It is not intended that the Health Authority compete with private sector health plans, individually or through joint ventures, to offer insurance directly to individual or group private payers procuring their coverage in the commercial, non-governmental health care market.”


On May 5, 2022, the CalOptima Board of Directors will consider authorizing the CalOptima Chief Executive Officer to seek an amendment of the CalOptima Ordinance from the Board of Supervisors regarding allowing CalOptima to participate in Covered California.


CalOptima’s participation in Covered California would substantially benefit the County and CalOptima members for the following four core reasons:

·         Reduce churn by providing CalOptima members continuity of care for former Medi-Cal members.

·         Improve access by expanding the options to ensure more individuals are covered.

·         Extend local expertise that amplifies the impact of CalOptima’s community focus.

·         Bolster the safety net by bringing revenue that can be invested back into community health.


The proposed amendments authorize CalOptima to participate in the Covered California as a health care service plan in accordance with Title 22 of the California Government Code (commencing with Section 100500) and Title 10 of the California Code of Regulations, and aligns the current Ordinance with Welfare & Institutions Code Section 14087.54.


In the event the Board adopts the amendments, CalOptima plans to begin building internal capabilities for a plan launch in January 2024.

















Attachment A -  Proposed Amendments to Orange County Codified Ordinance, Section 4-11-2
Attachment B - Current Version of Orange County Codified Ordinance, Section 4-11-2-2
Attachment C -  Welfare & Institutions Code Section 14087.54