Covered California Premium Costs Will Likely Have Double-Digit Increases Next Year

Health insurance premium prices will increase an average of 11.6% next year for Santa Barbara County residents who use the Covered California marketplace.

Healthcare and pharmacy costs are increasing and "actions taken by the federal government have driven up prices for consumers," Covered California officials said Tuesday.

Federal legislators did not extend enhanced premium tax credits, which ended on Dec. 31. Those credits helped people with health insurance marketplace premium costs.

The California legislature funded $300 million for subsidies that are expected to help people who previously had federal subsidies, according to Covered California, but this will not be enough to fill the gap.

Residents with incomes up to 200% of the federal poverty level ($31,920 for an individual or $66,000 for a family of four) will be eligible for financial help paying premium costs, according to the state.

Covered California had 1.785 million people enrolled for health insurance as of March, including 78,110 in the Central Coast region. Across the state, plan premium costs are expected to increase 9.9% for 2027.

Across the United States, Affordable Care Act marketplace plan premium costs are expected to have a median 14% increase for 2027, which is a likely second consecutive year of double-digit increases, KFF reported.

"If these increases hold, typical premiums for insurers participating in the ACA marketplaces would jump by more than one-third between 2025 and 2027."

Central Coast residents who "shop and switch" — changing to the lowest-cost plan in their bronze, silver or gold tier — will see premium prices increase about 2.7% next year, according to Covered California.

Every region has access to at least two choices for plans. Open enrollment, when anyone can sign up for a plan, runs Nov. 1 to Jan. 31.

About 60% of enrollees across the state won't see an increase in their monthly premium. About 26% will be eligible for no-cost premiums with their existing plans, and others may pay less, Covered California officials said.

Medi-Cal Eligibility Changes

The expected increases come at a time when the federal government is substantially changing eligibility for Medicaid, which is low-cost or free health insurance for low-income people. Medicaid is called Medi-Cal in California and is administered by CenCal Health in Santa Barbara County.

Starting Jan. 1, 2027, some adults (19-64) will have to work, volunteer, go to school, or be in training to keep their Medi-Cal health benefits. Pregnant people, people with disabilities, parents of young children and others may be exempt from these new requirements.

The federal government also changed Medi-Cal eligibility for some immigrant adults, starting in January 2026.

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