Millions of Californians could see higher health insurance premiums in 2026
The projected increase — up from a 7.9% hike in 2025 — is driven largely by rising medical and prescription drug costs.
But the looming expiration of enhanced premium tax credits, which have lowered costs for millions of Americans since 2021, could trigger a far steeper jump in what consumers pay.
If lawmakers fail to act, the average Covered California enrollee could see monthly premiums rise by 66% from the loss of federal aid alone, affecting 1.7 million people statewide.
'Skyrocketing health insurance premiums are the last thing Americans need right now,' said Jessica Altman, Covered California's executive director, in a statement. 'There is still time for Congress to act and protect the health care of millions.'
Covered California is the state's Affordable Care Act marketplace, where residents can compare and purchase health plans, often with financial assistance.
California is taking steps to soften the impact, allocating $190 million in state subsidies for 2026 to help its lowest-income residents.
Still, officials say that will cover only a fraction of the $2.1 billion gap left by expiring federal assistance.
Despite the uncertainty, Covered California says its marketplace remains strong, with 11 insurers offering plans statewide and most residents having multiple carrier options. Aetna will exit in 2026, affecting about 21,000 enrollees who will need to switch plans.
The state's 10.3% average increase is about half the projected national average of 20%, which officials credit to aggressive rate negotiations and a healthier risk pool.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Associated Press
2 hours ago
- Associated Press
Covered California health insurance will cost more in 2026. Here's what's behind the increase
Californians who get their health insurance through the state's marketplace will see premiums increase by an average of 10.3% next year. Covered California officials on Thursday announced the first double-digit rate increase since 2018, saying it represents a 'confluence' of factors putting upward pressure on the market. Rising health care costs, the expiration of enhanced federal subsidies and policy-driven market uncertainty together are fueling the hike, Covered California Director Jessica Altman said. Insurers in recent years have expected health care costs to increase by about 8% each year. That makes up the bulk of next year's increase. But Altman said about 2% of the rate increase in the state's version of the Affordable Care Act marketplace is based on federal financial assistance that expires at the end of the year. President Donald Trump's signature spending and tax reform bill — the 'One Big Beautiful Bill Act' — left out funding for enhanced premium tax credits used by more than 90% of Affordable Care Act enrollees nationwide. Congress enacted these subsidies during the COVID-19 pandemic to ensure people had health insurance. Since then, Affordable Care Act enrollment has nearly doubled nationwide from 12 million to 24 million people. 'We've never been through a loss in affordability like the expiration of the enhanced tax credits,' Altman said. Congress could still decide to re-up the subsidies in September. If it doesn't, California will lose about $2.1 billion in enhanced tax credits for consumers. Double whammy for consumers Ariana Brill, a certified health insurance agent who helps people enroll in Covered California, said if the enhanced subsidies aren't renewed, consumers' pocketbooks will be hit twice next year. 'We'll see rates go up. We'll see assistance go down. And the net premium, the consumer's take home price, is going to go up considerably,' Brill said. Open enrollment typically starts on Nov. 1, but Brill said clients are already calling her with concerns about increases. A majority of her clients, about 2,600 of them, will have to pay significantly more for health care if Congress doesn't extend the enhanced subsidies, she said. If that happens, Brill said she expects some people to switch to less comprehensive, lower-cost plans to make ends meet. Others will drop coverage altogether. 'For most people, affordability is a huge part of their decision making. Very few of us have the luxury of buying things without looking at the price,' Brill said. State officials recently took steps to ease the potential loss of federal subsidies for the lowest-income Covered California members. The state will spend $190 million to maintain subsidies for people earning up to 150% of the federal poverty level (individuals earning about $23,000 or families of four earning about $48,000). Still, that investment is far short of the $2.1 billion the state stands to lose. Covered California's previous estimates indicate that 600,000 people could drop coverage as a result of lost subsidies and rising costs. That, in turn, could make health care even more expensive, experts say. That's because younger and healthier people tend to forego coverage first, leaving sicker and more costly people behind. To meet their needs, insurers have to charge more. 'With those lower utilization people leaving the marketplace, which leaves only the high cost users in the pool, it drives up premiums for those who are left,' said Matthew McGough, a policy analyst for KFF's Affordable Care Act program who co-authored a recent study looking at 2026 premium increases. More people seeking health care and higher prices are already the primary factor driving annual rate increases, McGough said. Some of that can be attributed to the aging population and widespread use of costly pharmaceuticals like Ozempic and Wegovy to treat diabetes and other chronic health conditions. But insurers nationally and in California have pointed out other factors contributing significantly to increased costs. These include tariffs on drugs and medical devices, enrollment and eligibility changes included in Trump's budget package, and inflation. Most insurers are assuming Congress won't extend the enhanced premium tax credits. Nationally, the median premium increase for next year is 18%, according to the KFF analysis. Loss of subsidies accounts for 4%, McGough said. 'It's definitely a significant factor this year and that along with the general environment of uncertainty are what is pushing these rates above what we've seen in the past few years,' McGough said. ___ This story was originally published by CalMatters and distributed through a partnership with The Associated Press.
Boston Globe
3 hours ago
- Boston Globe
Draft of major MAHA report calls for more education, less regulation — and offers few policies
While the document, titled 'Make Our Children Healthy Again Strategy,' retreads key MAHA ground like the need to cut artificial food dyes and encourage physical activity, it also offers a more expansive view of where Kennedy plans to steer his agency. Details of the report, which was delivered to the White House on Tuesday but not made public, were first published by The New York Times. They have yet to be authenticated by White House officials. Childhood vaccine schedule reform is on the agenda, though the report offers no details on how Kennedy will change the list of recommended childhood vaccines, if at all. He has for years cast suspicion on vaccines, often citing flawed research, and promoted the idea that early shots are harming children. The report similarly calls for 'addressing vaccine injuries.' Advertisement 'Together, this strategy will translate the work of the MAHA movement to policies that make a transformative and lasting impact for Americans and end the childhood chronic disease crisis,' says a draft document, dated Aug. 11 and published by Politico. Advertisement The strategy notably avoids mention of the 'This report has one overriding implied message: More research needed,' Marion Nestle, a leading nutrition researcher and professor emeritus at New York University, said via email. But, she said, 'we already know the problems. It's way past time to start addressing them.' Perhaps the most forceful regulatory proposals in the report have to do with marketing. One recommends the Health and Human Services Department work with other federal agencies to enforce direct-to-consumer advertising of prescription drugs, including among social media influencers and telehealth companies. The move falls short of the full ban Kennedy previously talked about. A separate recommendation would create new industry guidelines to 'limit the direct marketing of certain unhealthy foods to children,' though it seems those rules would still be voluntary. (Some of the largest food and beverage companies currently self-regulate under a 'Though still light on specifics, these draft recommendations are a bit of a mixed bag,' said Andrew Binovi, director of government affairs for the Physicians Committee for Responsible Medicine. Advertisement Among the ideas is Nestle says the first Trump administration tried to implement a similar plan with pre-packed food boxes distributed through food banks and other organizations, which was 'a disaster for small farmers initially recruited to do these labor intensive and perishable boxes. It makes much more sense to make sure people have enough money to buy food.' Trump's recent tax cut bill The report also suggests the government should incentivize more breastfeeding, either through the WIC program or other routes. There is little mention of ultra-processed foods, or UPFs, which are expected to be a focus of the Dietary Guidelines for Americans, due later this year. HHS is also crafting a definition of what constitutes a UPF.'It appears that big food lobbyists have been busy and successful,' said Jerold Mande, CEO of the nutrition nonprofit Nourish Science, who previously held senior policymaking roles at the FDA and USDA under the George H.W. Bush, Clinton, and Obama administrations. 'Who expected the MAHA report to do more to get whole milk in schools than to get UPF out?'The report also says that the USDA will 'prioritize precision nutrition research,' a line of research that aims to provide people with more personalized recommendations by taking into account their body's individual needs and responses to certain foods. Former NIH nutrition researcher Kevin Hall Advertisement The draft report is 'the most ambitious federal plan yet to confront childhood chronic disease,' said Marty Irby, president and CEO at Capitol South and Competitive Markets Action, who previously lobbied for ranchers and farmers. 'Still, there are gaps: the USDA school lunch program continues to force dairy on many children — particularly kids of color — who are lactose intolerant, with little to no alternatives, and the plan offers little to promote local, farm-to-table food in schools.' Aviva Musicus, science director for the Center for Science in the Public Interest, criticized the report as embodying 'the idiosyncratic beliefs' of one person, Kennedy. 'He might be right about food dyes, but the report's recommendations to alter our vaccine framework, restructure government agencies, and promote meat and whole milk are going to promote disease, not health,' Musicus said. While the draft report is not a budget document, it is unclear how much funding would be needed for the various efforts or where it would come from. Already, Congress Advertisement Many of the proposals involve Medicaid, WIC, Instead of regulation, the administration plans to run public awareness and education campaigns aimed at adolescents about physical fitness, screen time, substance use, vaping and 'root cause issues that impact adult infertility.' Another initiative aims to train school and library workers on how to handle overdoses, and expand their access to the overdose-reversal medication Narcan, per the report. States will be encouraged to re-adopt the Presidential Fitness Test, which grades students on their ability to do things such as complete a mile run. HHS will also establish an 'infertility training center,' though the report offers limited details on precisely what services would be offered at such a facility. (Kennedy allies have been pushing for widespread use of what's called Medical schools, which have already been pushed by the administration to Advertisement Elsewhere in the department, National Institutes of Health officials plan to launch two new offices, one focused on developing alternatives to animal testing, such as organ-on-a-chip technologies, and another to organize chronic disease research. NIH will also start a new task force on children's health, and create a database of researchers' funding sources, similar to the OpenPayments system run by the Centers for Medicare and Medicaid Services, per the draft report. The commission's recommendations, while largely centered at Kennedy's HHS, also affect the USDA and the Environmental Protection Agency — though not as severely as some in the food and agriculture industries feared. Unlike While calling for more 'innovative growing solutions,' the report also says the government ought to 'ensure that the public has awareness and confidence in EPA's robust pesticide review procedures.' When it comes to air quality — a 'The commission has a historic opportunity to protect America's kids, but only if it resists corporate influence and turns bold ideas into real, accountable action,' Irby told STAT. Here are other highlights from the document: Mental health: More prior authorization Pediatric mental health remains a key focus for Kennedy and his MAHA allies. In February, a White House executive order called mood stabilizers and antipsychotic drugs a ' The draft echoes this language, highlighting the overmedicalization of children as a key challenge to overcome and calling for HHS to form a working group that will evaluate prescription patterns for SSRIs, antipsychotics, stimulants, and other drugs that children take. They also ask the Centers for Medicare and Medicaid Services to work with states to increase prior authorization requirements and tighten prescribing safeguards particularly for ADHD. The draft says the Veterans Administration will provide NIH with de-identifiable data on ADHD, diabetes, and pharmaceutical usage among spouses, dependents and survivors of veterans under 18. It's true that kids can be overmedicalized, said Jennifer Mathis, deputy director for the Bazelon Center for Mental Health Law. But it was 'disheartening, however, that the leaked draft strategy makes no mention of well-established services that are critical for children with significant mental health needs, such as intensive care coordination, intensive behavior support, and mobile crisis services,' Mathis said. Rates of anxiety, depression and ADHD in the U.S. are increasing, but the scientific explanation for their rise is Although the scientific literature on screen use offers Notably absent from the report, however, was the startling rise of youth suicide over the last two decades. Suicide is one of the leading causes of deaths in this demographic and is particularly pronounced among Black teenagers. One in five high school students Fluoride: New scrutiny of water standards In discussing the importance of water quality, the document focuses on one element: fluoride. The document does not directly name other contaminants, like PFAS or lead. The report states that the CDC and USDA will 'educate Americans on the appropriate levels of fluoride, clarify the role of EPA in drinking water standards for fluoride under the Safe Drinking Water Act, and increase awareness of the ability to obtain fluoride topically through toothpaste,' Experts largely agree that fluoridation at the level currently recommended by the CDC is safe, despite some growing concern that higher levels of fluoride intake could be The draft of the report also states the FDA will evaluate liquid drops and tablets. This process has already begun, with a Electromagnetic radiation: Studies ahead The report also says HHS plans to study electromagnetic radiation and health research 'to identify gaps in knowledge, including on new technologies to ensure safety and efficacy.' The report doesn't explain what sources of electromagnetic radiation its authors consider possible cause for concern. But Kennedy has claimed — contrary to scientific consensus — on The But while there's not evidence of a link between cell phones and cancer, it's true that the devices have changed dramatically since the advent of smartphones and that kids' usage has skyrocketed, said Emanuela Taioli, director of the Institute for Translational Epidemiology at Mount Sinai's Icahn School of Medicine, via email. 'Perhaps a new study on kids specifically is worth doing.' Daniel Payne and Chelsea Cirruzzo contributed reporting. If you or someone you know may be considering suicide, contact the 988 Suicide & Crisis Lifeline: Call or text 988 or chat . For TTY users: Use your preferred relay service or dial 711 then 988.
Politico
3 hours ago
- Politico
Draft MAHA report emphasizes real world data
WASHINGTON WATCH The federal government wants to use real world data in health research and regulation, according to draft strategy documents obtained by POLITICO. The draft strategy discusses how the Department of Health and Human Services would address a variety of health concerns, including chronic disease. As part of that work, the report discusses updating how the National Institutes of Health does research by using real world data, or information gathered outside of traditional clinical trials. To do that, the report calls on the NIH to build a platform for housing this information. The draft report is not finalized and therefore subject to change. However, if this new platform remains part of the agenda, it would pull in claims information from electronic health records and wearables, among more traditional kinds of data, according to the document. Researchers would be tasked with analyzing the information to understand the causes of chronic disease along with potential treatments. The report highlights a concern of Kennedy's and his supporters that Americans are overmedicated. 'There is a concerning trend of overprescribing medications to children, often driven by conflicts of interest in medical research, regulation, and practice. This has led to unnecessary treatments and long-term health risks,' the report says. The proposed NIH research platform would likely be aimed at finding alternative methods of reversing chronic conditions, like diabetes and hypertension, through diet and exercise. The report also calls for the Food and Drug Administration to incorporate real world evidence to track the impacts of regulated medical products post authorization or approval. More AI: The report says HHS would research how artificial intelligence could be deployed to assist with chronic disease care — including how it can be used to diagnose people earlier, personalize treatment and monitor patients as well as use predictive models to prevent hospitalizations. What else: Health influencers beware: According to the draft report, HHS would increase oversight on direct-to-consumer pharma advertising. In particular, the department, the Federal Trade Commission and the Department of Justice would crackdown on social media influencers and direct-to-consumer telehealth companies that mislead consumers about pharmaceutical products they promote. WELCOME TO FUTURE PULSE This is where we explore the ideas and innovators shaping health care. Former Surgeon General Jerome Adams, who served during the first Trump administration, took to X Friday to call out NIH's cancellation of $500 million for mRNA research as 'dangerous.' 'His misleading claims threaten public health and undermine President Trump's greatest and most life saving contribution to humanity,' he wrote of NIH director Jay Bhattacharya. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@ Ruth Reader at rreader@ or Erin Schumaker at eschumaker@ Want to share a tip securely? Message us on Signal: CarmenP.82, RuthReader.02 or ErinSchumaker.01. AROUND THE NATION The battle over children's online safety laws intensified Thursday as the U.S. Supreme Court allowed a so-called age-gating law in Mississippi to stay in effect, POLITICO's Gabby Miller reports. On Thursday, the justices blocked an emergency appeal while NetChoice's challenge to Mississippi's ID law plays out in a federal trial court. The trade group, which represents Meta, YouTube and X,claims the law violates its members' free speech rights. The 2023 law requires online platforms with a substantial portion of pornographic content to verify that users are 18 or older. Why it matters: A growing number of parents have concerns over how social media — and now entertainment-based chatbots — are affecting youth mental health. States are increasingly restricting access to social media platforms and sites with explicit content. For example, the Mississippi law asks social media sites to make 'reasonable effort' to shield minors from harmful content. However, laws and policies that require sites to verify their users' ages haven't fared well in court. Justice Brett Kavanaugh wrote in his concurrence that NetChoice would likely succeed in demonstrating that the Mississippi law would violate its members' First Amendment rights under the court's precedents. Part of the problem is that some age-verification laws interfere with minors' lawful access to protected speech. Netchoice has won several lawsuits against age-verification laws on that basis. But, but, but: That's not to say all age-verification laws are moot. Another policy approach is app store age verification. Those laws require mobile app stores to verify their users' ages and obtain parental consent before minors can download apps. This practice might be able to withstand legal scrutiny because app stores require users to sign contracts to download apps, and contracts signed by minors aren't legally enforceable. This approach might not bump up against First Amendment rights because it doesn't seek to restrict certain content. What's next: The Mississippi law is just one among nearly a dozen other similar state regulations, and First Amendment experts, state leaders and the tech industry are anxiously awaiting Supreme Court rulings that will determine their fates.
