insurer

In a typical election year, the interest in the down-ballot race for California insurance commissioner musters modest interest at best.

That all changed on Jan. 7, 2025, when wildfires swept through L.A. County, damaging or destroying more than 18,000 homes and killing at least 31 people.

The resulting anger directed at the insurance industry over how it has handled claims has helped draw four Democrats into the race, who will be vying this weekend for a critical endorsement at the party’s annual convention in San Francisco ahead of the June 2 primary election.

“We haven’t seen this level of competition and, frankly, choice on the Democratic side since it first became an elected office in 1990,” said Jamie Court, president of Consumer Watchdog, a Los Angeles insurance advocacy group. “They represent wide-ranging views and a broad diversity of candidates.”

Up for endorsement are state Sen. Benjamin Allen (D-Santa Monica), whose district includes the Palisades fire zone; former San Francisco Supervisor Jane Kim; former state Sen. Steven Bradford; and San Francisco businessman Patrick Wolff, who has not held elective office.

Three Republicans have declared their candidacies, but that party’s convention isn’t until April. The filing deadline to file for the race is March 6.

The GOP field includes businessman Robert Howell, who lost by 20 points in the 2022 general election to current Insurance Commissioner Ricardo Lara. Also running are insurance agent Stacy Korsgaden from Grover Beach, and attorney Merritt Farren, whose Pacific Palisades home burned down.

Peace and Freedom Party candidate Eduardo Vargas, a Los Angeles school teacher, is on the ballot too.

The race also follows Lara’s two troubled terms in office, during which he has been accused of cozying up to and receiving money from the insurance industry for his first campaign and conferences abroad.

Lara has denied any wrongdoing, and all the Democratic candidates have vowed not to accept insurance industry donations.

“For me and maybe for many survivors, it’s not a position that we ever thought much about, but now with many of our lives devastated by our dealings with insurers I think many survivors will be watching much more closely this time around,” said Joy Chen, executive director of the Eaton Fire Survivors Network, a community group that has accused Lara of being soft on insurers and has called for his resignation.

Allen was perceived by some as the leading candidate for the party’s nomination when he announced his candidacy in September. He has held his seat for more than a decade and is the only sitting legislator in the race. He said he would not be running if not for the wildfire that struck his district.

“The fire certainly was a searing experience, helping hundreds of people get their claims paid right, but it kind of begs the question of why should you have to call your state senator to get treated right,” he said.

Allen’s platform includes a number of ideas to ensure policyholders are treated better, including requiring insurers to clearly explain claim denials. But also key to his campaign is stabilizing an insurance market that over the last several years has seen insurers drop policyholders by the hundreds of thousands, especially in fire-prone neighborhoods.

That forced them onto the California FAIR Plan, the insurer of last resort. It’s rolls grew even more since the January fires and the insurer has been sued by fire victims over its claims practices. Allen wants to build insurer confidence in the market by having insurer requests for rate hikes reviewed in months, rather than the year or more they can drag out now.

He also points to his legislative record, especially his authorship of Proposition 4, which was approved by voters in 2024 and set aside $10 billion in general obligation bonds to fund climate resiliency and environmental protection projects — an important part, he said, of lowering insurance risks.

Allen has drawn a key endorsement from California Sen. Adam Schiff and as of Dec. 31 had about $1 million in the bank, more than any other candidate. But the race was shook up last month when progressive politician Kim declared her candidacy. She boasted an endorsement from U.S. Sen. Bernie Sanders (I-Vt.), for whom she worked as his California political director during the 2020 presidential campaign.

She also has drawn attention for a plan to create a state-run disaster insurance policy for Californians.

Residents would continue to buy regular home insurance from the commercial market but would buy coverage for wildfires and other disasters from the state, similar to plans in some other countries.

The idea has come under sharp criticism from Court, who said it will shift the risk of costly disasters to taxpayers while allowing insurers to make profits from more predictable perils such as water and roof damage.

“We have to explore some different models, because the current system is not working. It’s too expensive and a market failure,” said Kim, adding that the plan could evolve.

Bradford, who represented communities in south L.A County and the South Bay in the Legislature, has been endorsed by L.A. Mayor Karen Bass. He said he’s running as a pragmatist and unifier.

“What we’ve been doing for far too long has been a whole lot of finger pointing and doing the blame game,” he said.

Bradford wants insurers to open their pricing books and give homeowners “real, guaranteed” premium discounts for upgrading their property.

He also is proposing a public–private partnership that shares the risk for insurers who write policies in fire-prone neighborhoods.

Wolff, a political newcomer, is a Chartered Financial Analyst, real estate investor and former hedge manager who cites his experience building a home and auto insurance brokerage for financial services firm Capital One.

“I spent the first half of 2025 really deeply studying the commissioner’s role and the history, and the race — the politics of everything. And after really doing that deep dive, I decided to step forward,” said Wolff, who wrote his campaign a $500,000 check and loaned it another $100,000.

He also thinks rate hikes sought by insurers need to be reviewed more quickly but wants the insurance department to publish annual reports on how specific companies handled claims.

“The insurance industry has basically lobbied to keep that data anonymous at the company level, and I think it’s really important to make that information public,” Wolff said.

Under California’s open primary system, the top two candidates will move on to the Nov. 3 general election, which means two Democrats could run up against each other if a Republican isn’t able to consolidate the GOP vote.

Steve Maviglio, a longtime political consultant currently working for State Treasure Fiona Ma, who is seeking the office of lieutenant governor, said that the race is wide open.

“This is a statewide election with millions of people with candidates they’ve never heard of,” he said.

With multiple candidates seeking the endorsement, it may be hard for any single one to reach the 60% threshold of delegate votes needed.

“If no one is endorsed, somebody is going to have to be the breakout candidate, and the way you do that is with money or organization,” Maviglio said. “Until I see that happen, it’s totally up in the air.”

The Trump administration has unveiled a sweeping set of regulatory proposals that would substantially change health plan offerings on the Affordable Care Act marketplace next year, aiming, it says, to provide more choice and lower premiums.

But it also proposes sharply raising some annual out-of-pocket costs — to more than $27,600 for one type of coverage — and could cause up to 2 million people to drop insurance.

The changes come as affordability is a key concern for many Americans, some of whom are struggling to pay their ACA premiums since the Republican-led Congress allowed enhanced subsidies expired at the end of last year. Initial enrollment numbers for this year fell by more than 1 million.

Healthcare coverage and affordability have become politically potent issues in the run-up to November’s midterm elections.

The proposed changes are part of a 577-page rule that addresses a broad swath of standards, including benefit packages, out-of-pocket costs and healthcare provider networks. Insurers refer to these standards when setting premium rates for the coming year.

After a comment period, the rule will be finalized this spring.

It “puts patients, taxpayers, and states first by lowering costs and reinforcing accountability for taxpayer dollars,” Mehmet Oz, the Centers for Medicare & Medicaid Services administrator, said in a news release Monday.

One way it would do so focuses heavily on a type of coverage — catastrophic plans — that last year attracted about only 20,000 policyholders, according to the proposal, although other estimates put it closer to 54,000.

“This proposal reads like the administration has found their next big thing in the catastrophic plans,” said Katie Keith, director of the Health Policy and the Law Initiative at the O’Neill Institute for National and Global Health Law at Georgetown University Law Center.

Such plans have very high annual out-of-pocket costs for the policyholder but often lower premiums than other ACA coverage options. Formerly restricted to those under age 30 or facing certain hardships, the Trump administration allowed older people who lost subsidy eligibility to enroll in them this year. It is not known how many people did so.

The payment rule cements this move by making anyone eligible if their income is below the poverty line ($15,650 for 2026) or if they’re earning more than 2½ times that amount but lost access to an ACA subsidy that lowered their out-of-pocket costs. It also notes that a person meeting these standards would be eligible in any state — an important point because this coverage is now available in only 36 states and the District of Columbia.

In addition, the proposal would require out-of-pocket maximums on such plans to hit $15,600 a year for an individual and $27,600 for a family, Keith wrote this week in Health Affairs. (The current out-of-pocket max for catastrophic plans is $10,600 for an individual plan and $21,200 for family coverage.) Not counting preventive care and three covered primary care doctor visits, that spending target must be met before a policy’s other coverage kicks in.

In the rule, the administration wrote that the proposed changes would help differentiate catastrophic from “bronze” plans, the next level up, and, possibly, spur more enrollment in the former. Currently, the proposal said, there may not be a significant difference if premiums are similar. Raising the out-of-pocket maximum for catastrophic plans to those levels would create that difference, the proposal said.

“When there is such a clear difference, the healthier consumers that are generally eligible and best suited to enroll in catastrophic plans are more motivated to select a catastrophic plan in lieu of a bronze plan,” the proposal noted.

However, ACA subsidies cannot be used toward catastrophic premiums, which could limit shoppers’ interest.

Enrollment in bronze plans, which have an average annual deductible of $7,500, has doubled since 2018 to about 5.4 million last year. This year, that number likely will be higher. Some states’ sign-up data indicate a shift toward bronze as consumers left higher-premium “silver,” “gold” or “platinum” plans following the expiration of more generous subsidies at the end of last year.

The proposal also would allow insurers to offer bronze plans with cost-sharing rates that exceed what the ACA law currently allows, but only if that insurer also sells other bronze plans with lower cost-sharing levels.

In what it calls a “novel” approach, the proposal would allow insurers to offer multiyear catastrophic plans, in which people could stay enrolled for up to 10 years, and their out-of-pocket maximums would vary over that time. Costs might be higher, for example, in the early years, then fall the longer the policy is in place. The proposal specifically asks for comments on how such a plan could be structured and what effect multiyear plans might have on the overall market.

“As we understand it thus far, insurers could offer the policy for one year or for consecutive years, up to 10 years,” said Zach Sherman, managing director for coverage policy and program design at Health Management Associates, a health policy consulting firm that does work for states and insurance plans. “But the details on how that would work, we are still unpacking.”

Matthew Fiedler, senior fellow with the Center on Health Policy at the Brookings Institution, said the proposed rule included a lot of provisions that could “expose enrollees to much higher out-of-pocket costs.”

In addition to the planned changes to bronze and catastrophic plans, he points to another provision that would allow plans to be sold on the ACA exchange that have no set healthcare provider networks. In other words, the insurer has not contracted with specific doctors and hospitals to accept their coverage. Instead, such plans would pay medical providers a set amount toward medical services, possibly a flat fee or a percentage of what Medicare pays, for example.

The rule says insurers would need to ensure “access to a range of providers” willing to accept such amounts as payment in full. Policyholders might be on the hook for unexpected expenses, however, if a clinician or facility doesn’t agree and charges the patient the difference.

Because the rule is so sweeping — with many other parts — it is expected to draw hundreds if not thousands of comments between now and early March.

Pennsylvania insurance broker Joshua Brooker said one change he would like to see is requiring insurers that sell the very high out-of-pocket catastrophic plans to offer other catastrophic plans with lower annual maximums.

Overall, though, a wider range of options might appeal to people on both ends of the income scale, he said.

Some wealthier enrollees, especially those who no longer qualify for any ACA premium subsidies, would prefer a lower premium like those expected in catastrophic plans, and could just pay the bills up to that max, he said.

“They’re more worried about the half-million-dollar heart attack,” Brooker said. It’s tougher for people below the poverty level, who don’t qualify for ACA subsidies and, in 10 states, often don’t qualify for Medicaid. So they’re likely to go uninsured. At least a catastrophic plan, he said, might let them get some preventive care coverage and cap their exposure if they end up in a hospital. From there, they might qualify for charity care at the hospital to cover out-of-pocket costs.

Overall, “putting more options on the market doesn’t hurt, as long as it is disclosed properly and the consumer understands it,” he said.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.