map of United States with California highlighted


Covered California’s open enrollment period, which is for individual plans, just ended. Thinking about that reminds me of some of the differences between how our state implements the Affordable Care Act compared to how it’s done at the federal level. The differences stem from competing beliefs as to whether the ACA should be an important source of insurance for those that don’t get it through their employer.

  • California’s open enrollment period went until January 31, 2018, compared to the federal deadline of December 15, 2017 in those 39 states that did not set up their own exchanges. That’s three months for Californians to choose their health plan, instead of 45 days.
  • While Covered California spent over $100 million on marketing (including outreach and enrollment assistance) in 2017-18, the feds under the new administration cut back on their marketing of Obamacare to $10 million, a tenth of what was spent the year before (with just another $37 million for enrollment assistance).
  • People seeking individual policies from Covered California had a lot of choices – 11 health insurance companies participate in the exchange, including WHA (though the number varies within each region). In other parts of the country, many insurers have left the market, leaving consumers with one health plan and higher prices.
  • Last October, the federal government stopped paying insurers, including WHA, subsidies that help low-income consumers with their medical costs. Those cost-sharing reductions were still offered to individuals, however, and California makes sure consumers know about them.

Covered California operates for the benefit of consumers. This is done in part by selecting the health insurance companies that participate in the exchange and by negotiating rates. It’s also accomplished by designing the benefits that all health plans must offer to consumers. Individuals compare health plans and choose the one that is best for their health needs and budget.

Covered California’s objectives dovetail nicely with Western Health Advantage’s mission, which includes improving healthcare access and affordability. Businesses look to WHA for competitive health plans that take care of their employees’ needs. We value that trust and aim to cover more employees and families in our networks, which stretch from the Bay Area to the foothills of the Sierras.

California has lowered its rate of uninsured residents from 17% before the start of the ACA in 2014 to about 7% by the end of 2016 (this includes an expansion of MediCal). The national uninsured rate is dropping much more slowly. Not only that, better health outcomes, better quality and lower costs are being achieved in California.

WHA and Covered California make the marketplace more competitive, for businesses and individuals, respectively, for the benefit of all.

P.S. You can still enroll in a Covered California individual plan if you have a “qualifying life event” (e.g., if you lose your employer-sponsored coverage. Click here for more info.


garry maisel

-Garry Maisel is the President and CEO of Western Health Advantage. For more information about WHA, visit westernhealth.com.


Preteen Vaccine Week

teen getting vaccine

Preteen Vaccine Week Promotes Immunizations

To help protect adolescents against dangerous diseases, Western Health Advantage (WHA) is joining with the California Department of Public Health in recognizing February 11-17, 2018 as Preteen Vaccine Week.

Vaccination is one of the best ways parents can protect infants, children, and teens from 16 potentially harmful diseases. Vaccine-preventable diseases can be very serious, may require hospitalization, or even be deadly – especially in infants and young children.

According to the Centers for Disease Control and Prevention (CDC), immunizations have had an enormous impact on improving the health of children in the United States. Most parents today have never seen first-hand the devastating consequences that vaccine-preventable diseases have on a child, a family, or community. While these diseases are not common in the U.S., they persist around the world. It is important that Californians continue to protect their children with vaccines because outbreaks of vaccine-preventable diseases like pertussis, mumps, and measles can and do occur in the United States.

If you haven’t done so already, now is the time to ask your doctor about the three vaccines recommended for your child at their preteen visit, plus a flu shot every year.


Preteens need vaccines against whooping cough (Tdap), meningitis (MenACWY), and HPV when they are 11-12 years old. Incoming 7th graders must also provide proof of having received the whooping cough shot before starting school. A booster dose of MenACWY is recommended when teens are 16 years old. In addition, flu vaccine is recommended for everyone 6 months or older – not just preteens and teens.


HPV Vaccine Facts

mening infographic CDPH

For more information about recommended schedules for immunizations, visit mywha.org/teenIZ.


Active mature woman with headphones and smartwatch running in park

WHA is proud to participate in American Heart Month this month, in partnership with the American Heart Association. This is a great time to commit to a healthy lifestyle and make small changes that can lead to a lifetime of heart health.

Heart disease is the leading cause of death for both men and women in the United States. Every year, 1 in 4 deaths are caused by heart disease. The good news? Heart disease can often be prevented when people make healthy choices and manage their health conditions.

You can make healthy changes to lower your risk of developing heart disease. Controlling and preventing risk factors is also important for people who already have heart disease. To lower your risk:

  • Watch your weight.
  • Quit smoking and stay away from secondhand smoke.
  • Control your cholesterol and blood pressure.
  • If you drink alcohol, drink only in moderation.
  • Get active and eat healthy.

Also, if you haven’t had a physical in the last year, schedule one. If you have received a check-up recently, are you following your healthcare provider’s recommendations? Ask you family members and friends these questions too.

For more information, visit heart.org and westernhealth.com.


Female hands holding red polygonal heart shape

Join millions of women and Western Health Advantage in the fight against heart disease on Friday, February 2, 2018 for the American Heart Association’s National Wear Red Day.  Whether on the job or walking outside, illuminate your wardrobe and support women fighting heart disease.

Heart disease is the No.1 cause of death in women and it’s time to take a stand……in RED! Go Red for Women is a nationwide event that is devoted in helping women fight back against heart disease.

Alarming heart health statistics include:

  • Every 80 seconds a woman dies of heart disease or stroke.
  • Heart disease causes 1 in 3 three deaths in women each year.
  • Cardiovascular disease is the leading global cause of death.

Take charge of your heart care! Urge your mothers, sisters, and friends to get their heart checkups. Get your cholesterol screening and get regular medical care from your primary care physician.

Get healthier! Resolve, today, to make one healthy change in your life. Eat breakfast, even if it’s an apple or a high-fiber bagel you grab on your way out the door. Switch one soda a day for a glass of water. Take the stairs instead of the elevator.

Heart disease is largely preventable. Learn more about heart disease prevention and heart healthy tips at: goredforwomen.org

For more information visit Go Red for Women.

pregnant, woman, happy child

January 7-13, 2018 is Folic Acid Awareness Week. The National Birth Defects Prevention Network (nbdpn.org) promotes this week to increase awareness of the importance of consuming enough folic acid, particularly for pregnant women.

Folic acid is a B-vitamin that is necessary for proper cell growth. If taken before and during early pregnancy from a multi-vitamin or fortified foods, folic acid can prevent from 50% up to 70% of some forms of serious birth defects of the brain and spine.

Experts recommend that women who may become pregnant should take 400 micrograms of synthetic folic acid daily, by:

  • taking a daily multi-vitamin or folic acid supplement
  • eating fortified foods like grains, pastas, or breakfast cereals
  • including a variety of foods as part of a healthy diet

The easiest way to be sure to get the recommended daily amount of folic acid is to take a multi-vitamin every day.

More info at: cdc.gov/ncbddd/folicacid/index.html

WHA has more info at our Pre-Pregnancy Checklist

happy girlfriends

Many young women are missing the opportunity to be screened for cervical cancer. As January is National Cervical Cancer Awareness Month, WHA would like to remind you of the importance of cervical cancer prevention and early detection. Cervical cancer, which forms in the tissues of the cervix (the organ connecting the uterus and vagina), is almost always caused by human papilloma virus (HPV) infection, which is spread through sexual contact.

Pap Test
Women with early cervical cancers and pre-cancers usually have no symptoms. After the Pap test was introduced in the 1950s, the death rate for cervical cancer patients was greatly reduced because cervical cancer started being detected early, when it is most curable. When cervical cancer is diagnosed early, when it has not spread, the 5-year survival rate is 91%.

The U.S. Preventive Services Task Force (USPSTF) recommends that most women ages 21 to 65 get a Pap test once every three years. Women ages 30 to 65 may wait five years between Pap tests if they are tested for HPV at the same time. The HPV test isn’t advised for women under age 30.

HPV Vaccine
HPV is the cause of most cases of cervical cancer, which is why getting this vaccination is so important for young women. The American Cancer Society recommends that the vaccine be given to girls at age 11 to 12. That’s because a woman should get the HPV vaccine before she has any type of sexual contact with another person.

To protect yourself from HPV and cervical cancer:
● Have regular Pap tests
● Get the HPV vaccine
● Use condoms and limit your number of sexual partners
● Don’t smoke
● Eat a diet high in fruits and vegetables
● Maintain your proper body weight

Depression is Treatable

depression, in dark place

Depression is more than just feeling sad. It’s a serious condition that needs a good recovery plan and a good dose of understanding. With early detection, and a treatment plan that may include medication, therapy and lifestyle choices, many people can start feeling better.

Symptoms of depression may include:

  • persistent feelings of sadness and hopelessness
  • loss of interest in most normal activities
  • changes in sleep patterns
  • tiredness and lower energy level
  • anxiety, apathy, restlessness

Managing depression often requires treatment with counseling and possibly medication. If you think you are suffering from depression, it’s always a good idea to discuss with your primary care physician (PCP). You can also self-refer to see a mental health specialist. When self-referring, consider keeping your PCP in the loop so that your medical and mental health services align with your individual needs.

Medication treatment and Follow-up Care:

There are many antidepressant medications available. Screening and evaluation by your PCP or a behavioral health professional is essential prior to prescribing an antidepressant. Taking antidepressant medications as prescribed is a key to successful treatment.

If antidepressants are prescribed, keep these points in mind:

  • Most antidepressants take 4 to 6 weeks before they have an effect, and for their side effects to ease up.
  • When beginning a new medication or changing dosing, it’s important to be followed by your doctor for any unwanted behavior changes the medications may cause.
  • It’s important to continue the medication(s) and keep follow-up visits with your physician. People sometimes want to stop the medication due to feeling side effects, or due to lack of improvement in the short term. These issues should be discussed with your physician so that alternate treatment options can be discussed.

More information on depression from the National Institute of Mental Health.  For info from Western Health Advantage, go to mywha.org/bh.

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