Faced with a similar decision pre-ACA, the fact is that CA already had guaranteed issue small business health insurance. ACA roughly tripled the cost of the sam

Faced with a similar decision pre-ACA, the fact is that CA already had guaranteed issue small business health insurance. ACA roughly tripled the cost of the same plan, but made it more accessible to people by putting a web front-end on top of what was otherwise a fairly opaque process. But it's untrue to claim ACA provided benefits to any CA startup in terms of coverage, guaranteed issue or pre-existing conditions. If you wanted to start a company in CA pre-ACA and you had prior credible coverage, you could get a great plan at a competitive price (the so-called "rating adjustment factor" was capped for the guarantee issue plans) with immediate coverage for pre-existing conditions.