California health insurance costs rise after tax credits expired – NBC Los Angeles

nbclosangeles.com · September 8, 2026

California health insurance costs rise after tax credits expired – NBC Los Angeles

## Californians on Obamacare are left without affordable options and forced to shape their budgets around healthcare after tax credits expired this year.

#### By Annetta Stogniew and Katharine Lee Published 47 minutes ago • Updated 47 minutes ago

#### By Annetta Stogniew and Katharine Lee Published 47 minutes ago • Updated 47 minutes ago

Rising health insurance costs are pushing some Americans to drop coverage, experts say. But as healthier people leave the insurance pool, premiums can continue to rise, creating a cycle that affects everyone.

Los Angeles resident Marc Silverman, 57, saw his health insurance premiums double this year. Now he’s paying $800 a month for “a fairly minimal plan.”

Silverman and his wife purchase insurance coverage through the Affordable Care Act, commonly known as Obamacare. In a first, Silverman said, his and his wife’s premiums rose twofold. His wife was recently diagnosed with breast cancer, so she needs a better plan, which now costs her $2,000 a month.

Insurance prices became unmanageable for thousands of Californians after Congress failed to extend federal subsidies this year. The subsidies, known as enhanced premium tax credits, had increased financial aid across the marketplace.

The tax credits expired in January after months of debate in Congress that resulted in the country’s longest-ever government shutdown. Now, fewer people qualify for federal assistance with their monthly premiums, and those who do may receive smaller tax credits than in the past.

Under these conditions, California’s Obamacare marketplace, Covered California, lost 50,000 enrollees. The exodus comes after major gains were made in Obamacare enrollment in California over the four years the tax credits were active.

Covered California enrollment drops after enhanced federal subsidies expire this year

Source: CMS • Chart: Annetta Stogniew

Silverman and his wife used to be covered by insurance paid for by Warner Music, Silverman’s employer for 30 years. But once he left the company and their COBRA coverage expired, “it was really the marketplace, and that's it.”

He has no complaints about his coverage — except the price. As he points out, “it's not covering everything… every time you go, you pay just to see the doctor.”

His wife needs biannual breast exams after her cancer diagnosis, but Silverman says insurance will cover only one exam per year. So the other exam is paid for out of pocket.

Now that their premiums are double what they used to be, Silverman is even more frustrated. His situation is not unique.

Covered California premiums skyrocket, highest monthly cost in years

California open enrollment average premiums before and after tax credits

*In 2026, 81% of California enrollees elected to receive their tax credits during open enrollment rather than throughout the year. This number reflects the average premium for that group. Source: KFF • Chart: Annetta Stogniew

Most Californians, 81%, who sign up for Obamacare during open enrollment receive their tax credits then. For them, average premiums rose $77 a month, from $187 to $264, according to data from the Center for Medicaid and Medicare Services.

That’s an additional $924 a year spent on premiums alone.

Steven Ramos of Amador County has felt the pinch of the skyrocketing premiums. Ramos, who was previously on Medi-Cal, became eligible for Covered California this year but decided to go uninsured when he was quoted $400 a month.

Ramos said he would have settled for the premiums he saw from Covered California in 2025, but the jump this year was too much.

“If I was able to increase my income just as what the American dream was originally supposed to be… but still being able to afford healthcare, I absolutely would,” Ramos said.

But that wasn’t an option for him this year. So for two months, he was uninsured and paid for his ADHD and sleep apnea medications out of pocket. The two medications cost $500 and $2,000 respectively for a one-month supply.

Ramos received a full-time job offer that required company health insurance, but he had to turn it down when he saw the plans offered would have consumed anywhere from 5% to 21% of his income, without covering his medications.

California residents who are uninsured for a whole year must pay a penalty when filing taxes. Ramos limited his income as a part-time health aide so he could again qualify for Medi-Cal, which covers the cost of his medications. He says he’s “basically being nickeled and dimed.”

Although he’s saving money on healthcare, he needs to make sacrifices with his remaining income. Earlier this year, Ramos couldn’t afford veterinary care for his dog, which he’d had for 14 years. After multiple seizures his dog died, and he said he “didn't even have $300 to humanely euthanize her at a veterinarian clinic.”

"It was so heartbreaking to think that because I needed to keep my healthcare, I had to turn down a better paying job that could have made me a little more financially stable and potentially would have been able take care of my dog better," Ramos said in an email.

Before the enhanced tax credits expired, they increased federal aid for everyone, and made it available to more enrollees. Last year, households with incomes above $63,840 for a single person, or $132,000 for a family of four — 400% of the federal poverty level — received federal subsidies for Affordable Care Act coverage. Now, Americans who make just a single dollar above that benchmark are ineligible for aid, marking the return of the Affordable Care Act's infamous “subsidy cliff.”

Premiums will continue to rise next year, according to initial rate filings from insurance companies. Last year insurers anticipated a decline in enrollment when tax credits expired, so they upped premiums at rates ranging from 7.1% to 21%.

Rate hikes for next will likely fall into a similar range. In 2025 before the tax credits expired, rate increases were generally smaller, ranging from 1.8% to 15.4%.

Insurers across the country attributed these increases to mounting healthcare costs and federal policy changes, along with the expired tax credits The loss in federal subsidies has made healthcare less affordable for consumers and more expensive for insurers.

Megan Hanson, 55, of San Bernardino County, had to downgrade from a silver plan to a bronze plan this year after losing federal enhanced tax credits. The Affordable Care Act marketplace offers three tiers of coverage – gold, silver and bronze. Gold and silver plans typically require higher premiums with lower out-of-pocket costs.

Hanson downgraded her plan to keep her monthly premium relatively stable, but a recent dermatological procedure that previously would have cost her a $90 copay was $400.

Now she’s delaying appointments to align with her budget, hoping that when she pays off her car next year she’ll be able to afford a better plan. Hanson, who is self-employed in the mental health field, says the expired federal credits made “a decent plan feel manageable” for the first time in 20 years that she has been paying for her own health insurance.

> Our benefits are being stripped away, and then they're spending money not on the people. > > Megan Hanson, 55-year-old San Bernardino County resident

After the credits expired, Hanson considered going uninsured this year. But when she saw it would cost her a $1,600 penalty, she re-enrolled with Covered California.

“It's still less than insurance would be, but… at that point it starts to feel like, may as well get insurance,” she said.

## What can states do to help lower insurance costs?

Silverman says our country’s medical system “is so poor and so not about health. It's just about profit."

He advocates for single-payer health care, where one public entity, like a government organization, pays for everyone’s medical needs. This kind of system is unlikely to be ado

Read the full story at nbclosangeles.com