Obamacare enrollment dips in Bay Area after extra subsidy expires

Enrollment in Obamacare is slowing down in California after Republicans in Congress opted not to extend a policy that beefed up financial assistance for patients, a move that led to the longest federal government shutdown in U.S. history.

About 175,000 people statewide have newly enrolled in Covered California, the state’s Affordable Care Act marketplace, so far for 2026. That’s a 31% decrease from this time last year, data shows. Health experts expect bigger declines in the coming months, as more enrollees receive notice of price hikes and cancel their plans. Meanwhile, more people are opting for bronze-level plans with high deductibles and limited coverage.

“These early numbers don’t even show the extent of what’s likely to happen as people have to pay their premium bills and find they can’t afford them with all their other household expenses,” said Larry Levitt, executive vice president for health policy at KFF.

Bay Area counties are already clocking declines in new enrollees: 27% in Contra Costa County, 24% in Alameda County and 23% in Santa Clara County, according to Covered California’s data.

Health officials and advocates gathered in downtown Oakland Tuesday to urge residents to sign up for a Covered California insurance plan before the Jan. 31 deadline, or see if they’re eligible.

Even though the enhanced assistance expired at the end of 2025, spiking costs for many, Covered California plans are still more affordable than private insurance, they said. About half of Covered California enrollees are eligible for health plans that cost about $10 a month, and the vast majority qualify for reduced-price insurance, said the marketplace’s Executive Director Jessica Altman.

“If you’re on the fence — get off the fence,” said Rose Wilkerson, a caregiver and Covered California enrollee who lives in Kensington near the Berkeley Hills. Wilkerson said she pays about $150 a month for a Covered California plan, the same cost as last year.

That bucks the trend in California, after President Donald Trump and Republicans in Congress last year declined to extend tax credits used by millions nationwide to afford health insurance.

With the extra help eliminated, the average Covered California plan doubled in cost for 2026, state officials said. The biggest increases were expected for middle-income households and adults in their 50s or 60s, close to Medicare eligibility, whose monthly premiums would rise from $186 to $365, officials said.

Democrats passed the increased assistance during the height of the COVID-19 pandemic. When Republicans opted not to extend the tax credits in the fall, Democrats in the Senate withheld their votes from a budget agreement, kicking off the longest federal government shutdown in U.S. history. That strategy proved unsuccessful when a group of moderate Democrats broke ranks.

Then, earlier this month, a group of Republicans, including Central Valley Rep. David Valadao, broke with their party’s leadership to pass a bill extending the subsidies. That move may ultimately be unsuccessful. The legislation was not included in a major health policy compromise announced Tuesday between Republicans and Democrats in Congress, Politico reported. Levitt, of KFF, said negotiations to extend the subsidies are now “hanging by a thread.”

Health advocates in Oakland said they still hope politicians in Washington, D.C., revive the enhanced subsidies. If members of Congress did reach an agreement, Covered California would extend its enrollment period or reopen it, Altman said, so more patients could access financial assistance.

“We’re hoping that someone, somewhere, can save the day,” said Njeri McGee-Tyner, director of healthcare access for the Alameda Health Consortium.

In the meantime, McGee-Tyner said her organization’s health navigators are helping customers weigh their options if they’re priced out of the Covered California marketplace. Bigger monthly premiums for some families mean hard choices between medical care, rent and putting food on the table, she said.

One such option? Paying for a bronze plan, she said. Many in California are taking that route. According to Covered California’s data, more than a third of new customers are enrolling in bronze plans, compared with one-fifth at this time last year, a spokesperson said.

Customers who can’t afford even the lowest-level Covered California plans may lose their insurance. If their income drops, they may qualify for Medi-Cal, the state’s health plan for low-income residents that is also seeing cuts. Seniors may age into Medicare eligibility, and others will hunt for a job that offers health insurance. However, employer-sponsored health plans also rose in cost this year.