California

via Covered California:

Covered California is encouraging all uninsured Californians to sign up for health insurance by Dec. 31.

The open-enrollment period for 2026 ends on Jan. 31, but to have insurance in place for January, consumers need to enroll by the end of the year. Covered California’s over 1.9 million enrollees also have until Dec. 31 to make any changes to their coverage for next year.

It has been a unique open enrollment with the Enhanced Premium Tax Credits set to expire heading into 2026. Since their introduction in 2021, the enhanced assistance has helped double enrollment nationally under the Patient Protection and Affordable Care Act and by over 23 percent in California.

So far this open enrollment, 123,461 Californians have signed up for 2026 coverage as of Dec. 20, marking a 30 percent decrease over the same period last year.

via Covered California's Open Enrollment Dashboard, as of December 13th:

  • New enrollments: 103,627
  • Active renewals: 431,722
  • Passive Autorenewals: 1,407,579
  • Total: 1,942,928

As I've noted before: While I include the passive/auto-renewal number for completeness sake, that number won't really be relevant until after the deadline for January 1st coverage passes (which was December 15th in most states, but not until 12/23 in MA & 12/31 in CA, IL, MD, NV, NJ, NM, PA, RI & VA).

More important for the moment is the total number of active enrollments, which includes both new enrollees as well as current enrollees who log into their account and actively select a plan for 2026.

In California, those come to 535,349 combined. This also means that only 23% of current enrollees had actively re-enrolled as of 12/13.

As of the same point last year (actually 1 day more; the data from last year is as of 12/14), Covered CA was reporting:

via Covered California's Open Enrollment Dashboard, as of December 6th:

  • New enrollments: 62,247
  • Active renewals: 389,329
  • Passive Autorenewals: 1,363,264
  • Total: 1,814,840

As I've noted before: While I include the passive/auto-renewal number for completeness sake, that number won't really be relevant until after the deadline for January 1st coverage passes (which is December 15th in most states, although not until 12/23 in MA & 12/31 in MD, NV, NJ, NM & RI).

More important for the moment is the total number of active enrollments, which includes both new enrollees as well as current enrollees who log into their account and actively select a plan for 2026.

In California, those come to 451,576 combined. This also means that only 22% of current enrollees had actively re-enrolled as of 12/06.

As of the same point last year (actually 1 day more; the data from last year is as of 12/07), Covered CA was reporting:

I don't know if this is new or not, but it turns out that Covered California--the largest state-based ACA exchange in the country--has an Open Enrollment Dashboard after all!

This means that in addition to two small states regularly reporting Open Enrollment data (Maine and New Mexico), the largest one is as well!

Here's what Covered CA is reporting as of November 29th:

  • New enrollments: 45,023
  • Active renewals: 365,879
  • Passive/Autorenewals: 1,412,526
  • Total: 1,823,428

As I've noted in both my Maine and New Mexico updates, while I include the passive/auto-renewal number for completeness sake, that number won't really be relevant until after the deadline for January 1st coverage passes (which is December 15th in most states, although not until 12/23 in MA & 12/31 in MD, NV, NJ, NM & RI).4,

IMPORTANT: Premium Alignment is NOT a substitute for making the enhanced ACA tax credits permanent. It does little to help the lowest-income folks who are still better off with Silver plans thanks to robust CSR assistance, and the benefits of it will be mediocre for those over 400% FPL if the enhanced tax credits expire.

Even for those it benefits the most (primarily those who earn between 200 - 400% FPL),  it's a complement to the upgraded subsidies, not a replacement for them.

HOWEVER, it's still hugely helpful to those who know how to take advantage of it, and particularly in the states newly implementing it, it should relieve a huge portion of the pain being caused by the enhanced APTC expiring next month.

via Covered California:

SACRAMENTO, Calif. — Covered California Executive Director Jessica Altman issued the following statement on Speaker Emerita Nancy Pelosi’s announcement of her retirement on Thursday:

“After nearly four decades of unmatched public service, Speaker Emerita Pelosi leaves behind a legacy that continues to affect the lives of millions of Americans every day.

“Speaker Emerita Pelosi was one of the architects of the Patient Protection and Affordable Care Act and the driving force in making sure the landmark legislation became the law of the land in 2010.

“She was again the speaker of the House when the current Enhanced Premium Tax Credits were passed in 2021, further bringing down costs for consumers and making health insurance more affordable and accessible to more Americans than ever.

“Thanks to the speaker emerita’s tireless efforts, enrollment in Affordable Care Act marketplaces has more than doubled nationwide and currently provides health care coverage to over 24 million Americans, including nearly 2 million here in California.

via Covered California:

SACRAMENTO, Calif. — Covered California is kicking off its open-enrollment period for 2026 coverage on Nov. 1 amid uncertainty surrounding the enhanced premium tax credits that have delivered greater affordability and record enrollment across the nation.

This marks the 13th open-enrollment period under the Patient Protection and Affordable Care Act, which since its inception has helped tens of millions of Americans access health insurance, including a record nearly 2 million Californians heading into 2026. Today, more than 24 million Americans are insured through a marketplace plan.

Every year, even when the ACA is running smoothly, there are always changes in market participation, as different insurance carriers enter or exit the individual market in certain states or either expand or shrink what parts of the state they offer healthcare policies in.

2026 is no exception, and given the massive turmoil the ACA exchanges are undergoing right now (due primarily to the expiring federal tax credits as well as regulatory changes made by the Trump Regime's so-called "Integrity & Affordability Rule"), there's either 13 or 32 insurance carriers throwing in the towel in one or more states, depending on how you count a carrier operating in multiple states or under multiple subsidiary brandings.

It's important to keep in mind that the following list probably isn't comprehensive--it includes the carriers which I've confirmed are pulling out statewide (with one exception: Meridian Health Plan of Michigan is only pulling out of parts of the state). There's likely one or two that I've missed, especially given that several of these have only made their final decisions within the past week or so.

Last week I noted that six states have launched window shopping for the 2026 ACA Open Enrollment Period (OEP), allowing residents of the following states to plug their household information into their states ACA exchange website to see just how much their net health insurance premiums are going to increase starting January 1st, 2026:

Today another seven states joined them by activating 2026 window shopping as well:

Originally posted 1/21/25

California has ~1.98 MILLION residents enrolled in ACA exchange plans, over 88% of whom are currently subsidized. They also have an estimated ~470,000 off-exchange enrollees. Combined, that's over 2.4 million people, or 6.2% of their total population.

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