Thousands of middle-class Californians who depend on the state-run health insurance marketplace face premiums that are thousands of dollars higher than last year because enhanced federal subsidies that began during the COVID-19 pandemic have expired.
Despite fears that more people would go without coverage with the end of the extra benefits, the number enrolling in Covered California has held steady so far, according to state data.
But that may change.
Jessica Altman, executive director of Covered California, said that she believes the number of people dropping their coverage could increase as they receive bills with their new higher premiums in the mail this month. She said better data on enrollment will be available in the spring.
Altman said that even though the extra benefits ended Dec. 31, 92% of enrollees continue to receive government subsidies to help pay for their health insurance. Nearly half qualify for health insurance that costs $10 or less per month. And 17% of Californians renewing their Covered California policies will pay nothing for premiums if they keep their current plan.
The deadline to sign up for 2026 benefits is Saturday.
Here’s help in sorting out what the expiration of the enhanced subsidies for insurance provided under the Affordable Care Act, often called Obamacare, means in the Golden State.
What expired?
In 2021, Congress voted to temporarily to boost the amount of subsidies Americans could receive for an ACA plan. The law also expanded the program to families who had more money. Before the vote, only Americans with incomes below 400% of the federal poverty level — currently $62,600 a year for a single person or $128,600 for a family of four — were eligible for ACA subsidies. The 2021 vote eliminated the income cap and limited the cost of premiums for those higher-earning families to no more than 8.5% of their income.
How could costs change this year for those enrolled in Covered California?
Anyone with income above 400% of the federal poverty level no longer receives subsidies. And many below that level won’t receive as much assistance as they had been receiving since 2021. At the same time, fast-rising health costs boosted the average Covered California premium this year by more than 10.3%, deepening the burden on families.
How much would the net monthly premium for a Los Angeles couple with two children and a household income of $90,000 rise?
The family’s net premium for the benchmark Silver plan would jump to $699 a month this year from $414 a month last year, according to Covered California. That’s an increase of 69%, costing the family an additional $3,420 this year.
Who else could face substantially higher health bills?
People who retired before the Medicare-qualifying age of 65, believing that the enhanced subsidies were permanent, will be especially hit hard. Those with incomes above 400% of the federal poverty level could now be facing thousands of dollars in additional health insurance costs.
How did enrollment in Covered California change after the enhanced subsidies expired on Dec. 31?
As of Jan. 17, 1,906,033 Californians had enrolled for 2026 insurance. That’s less than 1% lower than the 1,921,840 who had enrolled by this time last year.
Who depends on Covered California?
Enrollees are mostly those who don’t have access to an employer’s health insurance plan and don’t qualify for Medi-Cal, the government-paid insurance for lower-income people and those who are disabled.
An analysis by KFF, a nonprofit that provides health policy information, found that nearly half the adults enrolled in an ACA plan are small-business owners or their employees, or are self-employed. Occupations using the health insurance exchanges where they can buy an ACA plan include realtors, farmers, chiropractors and musicians, the analysis found.
What is the underlying problem?
Healthcare spending has been increasing faster than overall inflation for years. The nation now spends more than $15,000 per person on healthcare each year. Medical spending today represents about 18% of the U.S. economy, which means that almost one out of every five dollars spent in the U.S. goes toward healthcare. In 1960, health spending was just 5% of the economy.
What has California done to help people who are paying more?
The state government allocated $190 million this year to provide subsidies for those earning up to 165% of the federal poverty level. This money will help keep monthly premiums consistent with 2025 levels for those with an annual income of up to $23,475 for an individual or $48,225 for a family of four, according to Covered California.
Where can I sign up?
People can find out whether they qualify for financial help and see their coverage options at the website CoveredCA.com.
What if I decide to go without health insurance?
People without insurance could face medical bills of tens of thousands of dollars if they become sick or get injured. And under California state law, those without coverage face an annual penalty of at least $900 for each adult and $450 for each child.
