Mendocino County residents could see steep health insurance hikes under Covered California

MENDOCINO CO., 10/8/25 — Hundreds of thousands of Californians, Mendocino County residents among them, who use Covered California for their health insurance could lose coverage next year. Covered California is the state's marketplace set up under the federal Affordable Care Act, also known as Obamacare, that passed in March, 2010. California set up its own marketplace with the Affordable Care Act as a guideline. In Mendocino County, an estimated 5,000 people, about 5.25% of residents, are enrolled under Covered California.

Individuals using Covered California are not provided health insurance by their employer. Many are self-employed and have no other access to health insurance. It's unclear how many Mendocino County residents could lose coverage either from insurance rates becoming unaffordable or being declared ineligible for lowered rates. Some may simply drop off when automatic renewal of eligibility is discontinued in 2028.

Premiums will go up if tax credits expire

Covered California CEO, Jessica Altman, explained that enhanced premium tax credits are the main form of financial help for those insured under Covered California. The tax credits lower premiums that private insurance companies charge those receiving coverage. Altman said that since the tax credit system was instituted in 2021, enrollment in the state program more than doubled. Those tax credits are set to expire on Dec. 31 unless Congress acts to extend them.

Altman said that 2 million people statewide will be impacted with what she described as a double whammy of decreased tax credits and premiums rising because healthcare costs in general are going up.

Altman said that Covered California enrollees would pay an average of 97% more than what they already pay for health coverage if the tax credits expire, in tandem with premiums going up due to the cost of healthcare increasing. As a result, Altman estimated that up to 400,000 current members statewide could choose to disenroll due to affordability.

Altman explained what tax credits will look like for different single-household incomes.

"$22,000 a year to $65,000 a year is where they will still receive tax credits, but they will be a lot less generous than they have been in recent years," Altman said. "$65,000 is where you're going to see people no longer eligible for tax credits at all if these expire."

"The average premium that someone in Mendocino County pays without a tax credit is $800 a month. And so if you think about someone making $65,000 a year now, having to pay $800 a month when they're paying much less than that today, that's a lot of money as a percent of your entire household income," Altman said. She estimated that group, which she described as a middle-income group, would pay on average about $500 more per month.

"The impact on Covered California enrollees and marketplace enrollees nationally can't be understated," Altman said.

The state has stepped in to help, allocating $190 million from the state budget to help those earning up to 150% of the federal poverty level, which translates to an income of $22,590 annually for a single person. This would be a change for the state—the federal government makes the payments to private insurance companies. In recent years, the state has provided regulations and oversight of marketplaces, not made payments to insurers.

"We're going to use those [state] funds to try and mitigate affordability increases for our most vulnerable enrollees," Altman said. "We simply don't have enough state funds to fill the hole the federal government would be leaving."

Legal immigrants will also be impacted

A provision from the federal reconciliation bill, known officially as H.R. 1, dubbed the "One Big Beautiful Bill," that goes into effect in 2027 limits which immigrants in the country legally continue to be eligible for financial assistance. Only green card holders and certain immigrants from Cuba and Pacific Island nations will maintain eligibility. Now excluded are those with refugee status and victims of domestic violence and trafficking. Altman said this will take away tax credits for 119,000 current enrollees in California.

Effective in 2028, another provision from H.R. 1 discontinues automatic renewal of coverage, which accounts for the annual renewal of 70% of those under Covered California.

Altman explained that every marketplace enrollee would need to go online to maintain eligibility. "[They] will have to take a proactive action … every year in order to stay enrolled," Altman said.

Another provision from H.R. 1 that takes effect in 2028 ends conditional eligibility. Those under Covered California must report their expected income of the next year for eligibility determination. Those who are unsure of their expected income or have an unstable income, such as someone looking for a job or an independent contractor whose income fluctuates, may be given coverage on the condition that within 90 days they work out their expected income. This will no longer be the case.

"In 2028 we will not be able to deliver any tax credit until all information is verified," Altman said. "So we will have to get that paperwork in [before] we can give you that tax credit."

Altman explained that this will likely create confusion.

"If someone is trying to find paperwork, or they just lost their job and don't even know what paperwork to give us — that happens all the time — they may have to choose between paying the full premium while they wait out their tax credit eligibility, which many people cannot afford to do, or forego coverage until their paperwork clears," Altman said.

Losing out on reimbursement funds could mean clinic closures

Mendocino Coast Clinics Executive Director Lucresha Renteria explained that when people who lose their health insurance come into the clinics needing care, they are offered a sliding scale to pay what they can. Renteria noted that in these cases, the clinics only are paid whatever the person can afford and lose out on reimbursement through Medicaid or insurance companies. Lacking those funds, clinics could face difficult decisions.

"Some clinics are going to have to close across California. I'm not talking about Mendocino County only, but across California, across the nation, some clinics will either close completely or they will close different services, and it will affect 100% of the population in that community," Renteria said. "It doesn't matter that you have the gold standard Blue Cross insurance if your clinic can't stay open."

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