California: Covered CA reports 1.92M enrollees, up 1.1% y/y so far...but avg. premiums are up 35% even w/state subsidies included

...and don't even get me started on the deductible hikes...

via Covered California's Open Enrollment Dashboard, as of January 3rd:

  • New enrollments: 163,023
  • Active renewals: 509.526
  • Passive Autorenewals: 1,252,350
  • Total: 1,924,899

As of the same point last year (actually 1 day more; the data from last year is as of 12/28), Covered CA was reporting:

  • New enrollments: 235,573
  • Active renewals: 425,700
  • Passive/Autorenewals: 1,241,745
  • Total: 1,903,018

Now that we're past the deadline for January coverage, I can start including auto-renewals as well. Overall...

  • New enrollments are down 31% y/y
  • Active renewals are up 19.7% y/y
  • Passive renewals are up 1% y/y
  • Overall enrollments are up 1.1% y/y

The official 2025 Open Enrollment Period enrollment tally ended up being 1,979,504 people, which means that total enrollment for 2026 is currently running about 2.8% behind last year.

On the surface, all of this may seem like good news: Total enrollment is only down 2.8%, and they still have another 4 weeks to make up the "missing" 54,604 enrollees.

HOWEVER, if you look deeper, you can see the problem, which I've been warning about for some time now.

  • Total enrollments dropped from 1,942,928 as of 12/20 to 1,939,528 as of 12/27 and to just 1,924,899 as of 01/03. In other words, more current enrollees have canceled than new enrollees signing up.
  • As I warned would likely happen last week, 1.25 million current enrollees ended up passively auto-renewing their existing plans for 2026, meaning many of them just received a very rude awakening.

Now, the good news is that California is backfilling 100% of the lost federal tax credits for enrollees who earn less than 150% FPL. However, only around ~300,000 of CA's 1.9 million current ACA enrollees fall into that category.

In terms of actual NET rate hikes, here's what it looks like so far according to the latest Covered CA data dashboard (again, the final numbers will look a bit different from these):

The ~287,000 enrollees who earn < 150% FPL are actually seeing a net reduction in their monthly premiums thanks to the state backfilling the lost federal tax credits.

However, the other ~1.6 MILLION enrollees are looking at average net premium hikes ranging from 8.7% for those who weren't receiving tax credits to begin with to a whopping 85% for ~120,000 enrollees in the 400 - 600% FPL income bracket.

Overall, net premiums are going up 35% for CoveredCA enrollees so far, and if you don't include the < 150% FPL category, they're going up an average of 48%.

It's also worth noting that those state subsidies for the < 150% crowd came at a price: Most of the funds for it actually came from an existing program which wiped out subsidies for most enrollees the past few years, which means that in 2026...

  • enrollees earning up to 150% FPL will still be eligible for $0-premium plans...but will face a modest $75 deductible
  • enrollees earning 150 - 165% FPL will receive at least some extra premium assistance...but will go back to an $800 deductible ($1,600 for families)
  • enrollees earning 165% - 200% FPL will go back to an $800 deductible ($1,600 for families), plus the other premium hikes
  • enrollees earning 200 - 250% FPL will go back to a $5,400 deductible ($10,800 for famlies), plus the other premium hikes

In other words, over 800,000 enrollees just got hit with between $800 - $10,800 more in out of pocket costs than they had last year on top of the 48% avg. premium hikes.

(If CA wasn't providing supplemental subsidies for the < 150% FPL population, as far as I can figure, their average premiums would be jumping by around 57%, and overall average net premiums would be going up by more like 50%.)

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