Covered California deadline nears. How much more will Merced County residents pay?
Time is running out for Merced County residents to apply for uninterrupted health insurance during Covered California’s open enrollment. But changes to the cost of plans make some enrollees think twice about the coverage they want moving into the new year.
In 2021, the Biden administration approved the American Rescue Plan Act, which provided more tax credits to those enrolled in the Affordable Care Act.
Under the plan, no one paid more than 8.5% of their household income for their medical coverage and people who made between $24,000 and $60,000 a year saw additional tax credits. It also extended new tax credits to people making between $60,000 and $75,000 a year. Those tax credits are set to expire Dec. 31.
Jessica Altman, executive director of Covered California, said there is uncertainty about the affordability of insurance plans going into 2026. The largest impact will be the expiration of enhanced premium tax credits, which significantly decreased the cost of insurance for people all over the country.
Kristen Corrales, a Central Valley insurance agent and local enroller for Covered California, said some of her clients who are at the higher income level were used to getting the extra tax credit.
“What we’re actually seeing with people is panic,” Corrales said. “If your income is $60,000 and over and you’re over 60 years old, it’s crushing you right now.”
Merced County has around 18,000 residents enrolled in Covered California. More than 90% receive federal subsidies for their benefits.
Some of Corrales’ clients who are in the “Silver Plan,” paying $600 a month, are now expected to pay more than double that amount at $1,300.
Congress has so far declined to extend the tax credits through 2026.
How California is ‘softening the blow’
California has softened the blow for people on the lowest end of the financial spectrum by shoring up $190 million in state funds, but it’s not enough for everyone. The state is set to lose $2.5 billion with the tax credits expiring.
“We’re putting it to really good use to protect the lowest income, just above Medi-Cal eligibility enrollees in Covered California, so I think that’s at least a little bit of good news for the few 100,000 people that we cover,” Altman said. “California is stepping in and helping in a way they wouldn’t see if they live in another state.”
Altman has seen some early warning signs in enrollment numbers: People who would normally be signing up for the first time during open enrollment are hanging back.
“The easiest thing to cut out is health insurance,” Corrales said. “So we’ve been asked several times about what the penalty will be.”
The penalty for cutting out health insurance is a yearly $900 fine per adult and $450 per child, but getting caught out in an emergency without insurance could be devastating.
Including people who are renewing their plans, enrollment in the Central Valley is up by 9% as of the end of November. This is on par with an increase of 19% enrollment since 2021, when the enhanced premium tax credits began.
Coverage should remain the same
Despite the increase in costs for some, what is covered under insurance will stay the same. Essential health benefits like emergency care, primary care, drugs, behavioral health and preventative services will still be in place.
“So no matter what plan you choose, your primary care visits, cancer screenings, vaccines, all are at no cost,” Altman said.
Open enrollment runs from now until Jan. 31, but to keep coverage without a gap in January, the deadline is Dec. 31.
“It’s a chaotic holiday season for many so now is the time to really think about your health insurance, especially with so much to consider this year,” Altman said.
