But middle-income consumers face an estimated 30% rate increase, on average, in California due to several factors tied to the healthcare law.
Some may elect to go without coverage if they feel prices are too high. Penalties for opting out are very small initially. Defections could cause rates to skyrocket if a diverse mix of people don't sign up for health insurance.
Pam Kehaly, president of Anthem Blue Cross in California, said she received a recent letter from a young woman complaining about a 50% rate hike related to the healthcare law.
"She said, 'I was all for Obamacare until I found out I was paying for it,'" Kehaly said.
Nearly 2 million Californians have individual insurance, and several hundred thousand of them are losing their health plans in a matter of weeks.
Blue Shield of California sent termination letters to 119,000 customers last month whose plans don't meet the new federal requirements. About two-thirds of those people will experience a rate increase from switching to a new health plan, according to the company.
HMO giant Kaiser Permanente is canceling coverage for about half of its individual customers, or 160,000 people, and offering to automatically enroll them in the most comparable health plan available.
The 16 million Californians who get health insurance through their employers aren't affected. Neither are individuals who have "grandfathered" policies bought before March 2010, when the healthcare law was enacted. It's estimated that about half of policyholders in the individual market have those older plans.
All these cancellations were prompted by a requirement from Covered California, the state's new insurance exchange. The state didn't want to give insurance companies the opportunity to hold on to the healthiest patients for up to a year, keeping them out of the larger risk pool that will influence future rates.
Peter Lee, executive director of Covered California, said the state and insurers agreed that clearing the decks by Jan. 1 was best for consumers in the long run despite the initial disruption. Lee has heard the complaints — even from his sister-in-law, who recently groused about her 50% rate increase.