California’s private health insurance marketplace remained largely stable during the latest enrollment season, even after the end of federal subsidies that had reduced costs for millions of residents. Nearly 1.9 million Californians renewed or selected a plan for 2026. This represents a modest decline of 2.7 percent compared with enrollment levels the previous year.
Although the overall number of people enrolled in health insurance stayed close to last year’s figure, many residents adjusted their coverage choices to manage higher costs. A growing number of consumers selected bronze-level plans, which typically have lower monthly premiums but require higher deductibles and copayments. These plans generally cover about 60 percent of medical expenses, leaving enrollees responsible for the remaining costs.
Data from Covered California shows that one in three new enrollees chose bronze plans for 2026, compared with one in four the previous year. In addition, about 130,000 residents who renewed their coverage moved from silver or higher-tier plans down to bronze plans in order to reduce their monthly premiums.
State marketplace officials said the shift reflects the determination of many residents to remain insured despite financial pressure. Jessica Altman, executive director of Covered California, said many Californians still recognize the value of maintaining coverage but are forced to make compromises to keep their health insurance affordable.
Health policy experts warn that bronze plans may create new challenges for consumers. Miranda Dietz, director of the Health Care Program at the UC Berkeley Labor Center, said the higher out-of-pocket costs associated with these plans could discourage people from seeking medical care when they need it. She noted that large deductibles and copayments often influence whether individuals decide to visit a doctor or delay treatment.
The expiration of enhanced federal subsidies has been a major factor driving these changes. The subsidies, introduced in 2021 as part of the federal pandemic response, helped millions of Americans reduce the cost of coverage. They also allowed middle-income households to qualify for financial assistance for the first time by capping premiums at 8.5 percent of income.
However, Congress allowed those expanded subsidies to expire at the end of last year. As a result, individuals earning more than 400 percent of the federal poverty level — about $62,600 for a single person or $128,600 for a family of four — no longer qualify for premium assistance. Many of these households have either switched to cheaper plans or left the marketplace entirely.
Among roughly 224,000 middle-income Californians expected to renew coverage, about 22 percent canceled their plans. At the same time, new enrollments within this income group dropped sharply, declining by 59 percent compared with the previous year.
Even for those who selected plans during the enrollment period, the question remains whether they will continue paying their monthly premiums. Officials said a clearer picture of how many people maintain coverage will likely emerge by April, once payment deadlines pass and enrollment data is finalized.
Meanwhile, rising health care costs are becoming a growing concern across the state. Surveys show that seven in ten Californians report that medical expenses place financial pressure on their household budgets. Four in ten residents say they carry medical debt, and six in ten say they have delayed or skipped medical care because of costs.
Lower-income residents continue to receive federal assistance through the standard subsidies that have existed since the Affordable Care Act marketplaces began. They also benefit from additional support provided by the state. California allocated $190 million for 2026 to offer state-funded tax credits to individuals earning up to 165 percent of the federal poverty level. These credits average about $45 per month for each enrollee.
Despite these efforts, many residents say making health care more affordable remains a top priority. Surveys indicate that eight in ten Californians believe lowering health care costs should be a major focus for state leaders and lawmakers in 2026.
