How health insurance works in California
Californians buying their own coverage have two markets: Covered California (coveredca.com), where plans from Kaiser Permanente, Anthem Blue Cross, Blue Shield of California, Health Net, and Oscar are guaranteed-issue and priced on income, and the private shared-network market, where PPO plans on Cigna, Aetna and PHCS PPO are underwritten and priced on age and health.
Medicaid is expanded (Medi-Cal) in California. California has its own individual mandate: residents without qualifying coverage owe a penalty on their state return.
What it costs
Full-price marketplace plans for a 40-year-old in Los Angeles commonly run $550–$850 a month in 2026; with a subsidy, often under $300. Private PPOs for the same healthy person run roughly $320–$480. California has the highest top state income tax rate in the country, so the self-employed health premium deduction is worth real money here.
The California picture
California regulates non-ACA coverage more tightly than most states, and the state mandate and Covered California's state subsidies change the math for many people, so private options here are narrower and the honest answer is often a careful comparison, not a promise of savings.