Covered California Rates Are Rising Again: What California Families Need to Know Before November 1

Two different things are being measured, and almost nobody explains the difference.
The 9.9 percent figure you are hearing about is a weighted average increase in the base premium, meaning what the insurance company charges before any financial assistance is applied. That is a before-subsidy number. What you actually pay every month is the after-subsidy number, and those two figures can move in completely different directions depending on what happened to your financial assistance.

Here is what actually happened to many California families this year. The enhanced federal premium tax credits that were put in place during the pandemic expired at the end of 2025. Those credits had been reducing monthly premiums significantly for millions of Covered California enrollees for several years. When they expired, the base premium might have gone up 9.9 percent, but the subsidy supporting it dropped dramatically at the same time. The net effect for many families was not a 10 percent increase. It was a 50 to 60 percent increase in what came out of their bank account each month.
Enrollment statewide has already dropped by 170,000 people to approximately 1.785 million. That is not a coincidence. Those are people whose after-subsidy bill became unsustainable and who made a decision to go without coverage rather than continue paying.

The reason the headline number and your actual bill feel so disconnected is that the headline describes what insurers are charging. Your bill describes what you are personally left holding after every layer of financial help is applied, and that layer changed significantly last year.

When you call me, the first thing I do is separate those two numbers for your specific situation and tell you what your 2027 bill is actually likely to be, before Open Enrollment opens.

Call (800) 590-7279 before November 1. Knowing your actual number changes the decision entirely.

This is the question I am getting more than any other right now, and the honest answer is: it depends on which change affected you, and you need someone to check your specific situation before Open Enrollment opens.
Several things changed at once, and they did not all move in the same direction.

The bad changes: Enhanced federal premium tax credits that had reduced premiums for millions of Californians expired at the end of 2025. Under H.R.1, the Trump administration also cut eligibility for approximately 130,000 Californians who hold lawfully present immigration status, including refugees and asylum seekers. Gig workers, freelancers, and the self-employed now face stricter annual income recalculation requirements that can reduce or eliminate their subsidy if income reporting is not done precisely. These changes removed help from people who had previously qualified.

The good changes: California’s state stepped in. Governor Newsom and the Legislature expanded the Health Care Affordability Reserve Fund to $300 million for 2027, up from $190 million. That expansion extended state subsidy eligibility to households earning up to 200 percent of the federal poverty level, approximately $31,920 for a single individual and $66,000 for a family of four. More than 500,000 Californians are projected to receive a state subsidy in 2027. CalOptima Health is also entering Orange County as a new carrier, which adds a competitive option for Region 18 residents who lost Molina.

The reason I cannot give you a yes or no without talking to you is that your eligibility sits at the intersection of all of these changes at once. The federal change may have eliminated something you had. The state expansion may have given you something you did not have before. The two might roughly cancel out for you, or one might dominate the other, and there is no general answer that tells you which.

A subsidy eligibility review with me takes about fifteen minutes. It is free. And it is the one call that tells you exactly where you stand before you make any decision about 2027.

Call (949) 396-1202 or (800) 590-7279. Find out your actual eligibility before you assume the worst.

I hear this question every single week right now, and I want to give you the honest answer rather than the answer that keeps you enrolled regardless of whether it makes sense.

Sometimes dropping is the right call. I will tell you when it is.

But most of the time, what looks like an unaffordable plan is actually a plan that has not been reviewed, compared against alternatives, or properly calibrated to the subsidy assistance the person actually qualifies for. And that is a very different situation from genuinely unaffordable.

Here is what I look at before I would ever suggest dropping coverage.

First, is your current plan actually the right metal tier? A significant number of Orange County families are in Gold plans paying full Gold premiums when a Silver plan with cost-sharing reductions would give them comparable real-world coverage at $150 to $200 less per month. The sticker price difference between tiers looks small until you factor in cost-sharing reductions that Silver plans uniquely offer to qualifying households. This is the most common source of overpayment I find.

Second, are you on the right carrier? Kaiser Permanente is raising rates by 6.7 percent for 2027, the lowest of the major California carriers. Valley Health Plan is raising rates by 20.4 percent. Those two people could be in plans that feel identical at enrollment and find themselves with vastly different bills next year. In Los Angeles County, consumers who shop and switch to the lowest-cost plan in their metal tier could actually see an 8.1 percent decrease rather than an increase.

Third, is dropping actually less expensive than you think? Going uninsured exposes you to uncapped medical costs. A single emergency room visit, a specialist, a prescription for a medication you take regularly: these costs do not go away because you dropped your plan. They arrive as bills instead of copayments, and there is no out-of-pocket maximum protecting you.
The question I would ask before dropping is not whether the premium feels affordable. It is whether we have looked at every alternative that could make it affordable. That conversation takes thirty minutes and costs nothing.

Before you drop, call me. (800) 590-7279. There is usually a better option than going without.