S1: Hey there , San Diego. I'm Andrew Bracken in for Jade Hyneman. On today's show , how newly expired health care subsidies are creating uncertainty for a lot of Californians to start the year. This is KPBS Midday Edition. Connecting our communities through conversation. Federal health care subsidies expired at the start of 2026 , leaving many Californians uncertain about their health coverage. It's been about two weeks since lawmakers returned to Capitol Hill , and a possible health care compromise is still on the table to bring those subsidies back. Last week , the House passed a bipartisan proposal to extend them. Now that bill is headed to the Senate. In the meantime , health care premiums are soaring for a lot of Americans here in California. Rising premiums could leave 400,000 people without coverage. I'm joined now by the executive director of Covered California , Jessica Altman. Jessica , welcome to Midday Edition.
S2: Thank you so much for having me.
S1: Great to have you here. So first off. I mean , I don't know , can you get a little confusing with all these terms , the ACA , these subsidies , can you just , you know , introduce us to what covered California is and how it works for Californians ? Absolutely.
S2: So covered California is the health insurance marketplace for the state of California. We were created out of the Affordable Care Act. And we are really where anyone who needs to buy health insurance for themselves or their families can go to shop for , you know , name brand health plans that , you know , have confidence that those plans are comprehensive and cover what you need. And we're also the only place that you can go to receive financial support to lower the monthly cost of that coverage. If you're someone who doesn't have an employer who is doing that for you through your health benefits , we're talking about self-employed people in the gig economy , farmers and agricultural workers , A whole lot of people that are just working in the way where they don't have that privilege of employers providing them health insurance as a stable benefit. Now , what we're talking about is what we call because we do love complicated terms. The enhanced premium tax credits. Basically , a few years ago , the federal government took the tax credits we offer and made them more generous , both giving more to lower income people and covered California and giving tax credits for the first time to middle income consumers. So with the expiration that did happen officially on December 31st , we're looking at the rollback of that. We will still have tax credits , but many people will receive less tax credits. And some people will lose their tax credits altogether and see really significant increases in their monthly payments.
S1: So , you know , there's a lot to unpack there. You mentioned that kind of , you know , economic help piece and that this isn't the only tax credit to help people. Could you talk more about some of the options and how people can access that through Covered California.
S2: So covered. California continues to be the only place you can get these tax credits if you want or need really , to buy health insurance for yourselves or your family , you can do that online on the phone. We have in-person assistance to help anyone who needs to go through this themselves. Navigate it. I really want to double down on this , this idea that we do still have tax credits. This expiration is real. It has impacts. It impacts some more than others. But most covered California enrollees will still be eligible for some level of tax credits. So my number one piece of advice for Californians in this moment is not to make assumptions. There are scary numbers and scary headlines out there. It's a moment to really be empowered by knowing how this impacts you , your family , your household , your situation so you can make an informed decision about something so fundamental , like your access to health care.
S1: And there does seem to be a fair amount of uncertainty around these subsidies and what health care looks like. we are seeing signs that , you know , sign ups for ACA plans are falling across the country.
S2: I am hearing particularly and at people probably have seen some of these stories of the group of people that are in that middle income group that are going to lose their tax credits or have lost their tax credits altogether. Unless Congress acts , this will be the only part of our health care system , really , that the federal government does not somehow support people affording their coverage. I mean , even employer based coverage , the expenses for health care by both the employer and the employee are tax exempt from the federal government , and they're supported in that way. This is a group of people that is looking at an average increase of $500 a month in their monthly costs because of this expiration. And that's an average. There are people , particularly older people in high cost regions where it's even more than that. And so those that group of people who's really shut out by this federal inaction is where I'm spending a lot of time talking to people , explaining what's happening and why. And candidly , there are not often great options for people that are in that circumstance. But helping people understand what their options are is key.
S1:
S2: About 150,000 are in San Diego. What I would also say is the nature of covered California , right. People start their own business. They're in between jobs. They drop to part time. Many people come to us for however long they need us , but a short period of time. So we've covered 1 in 6 , an estimated 1 in 6 Californians at some point since we opened our doors just over a decade ago. And so when we think about this affordability and these complex structures of the programs and the tax credits , we have to think about , yes , these 2 million people today and the decisions they're making right now , but it is also about affordability across our population into the future , and the people who may need us in the future and their ability to make economic choices that may take them out of , say , employer coverage or out of eligibility for Medicaid , called Medi-Cal here in California and still access affordable health insurance. That's what the marketplace is supposed to do.
S1: And also , I'm wondering if you can kind of break down where open enrollment is. I think it runs through the end of the month.
S2: It does run to your point until the very end of January. So midnight on January 31st. If we do see something from the federal government , because this is a very live conversation , there will be more time. We will give more time. So I want people to know that. But there's also very much no guarantee that we will see anything come out of the federal government. And there's it's a tough road ahead to to see this really come to fruition with these enhanced tax credits coming back. And so in that circumstance , it is really important. I don't want Californians to wait so long that they end up shut out and not making open enrollment. And I know these are hard decisions , but you do really need to make them in these next few weeks heading to the end of open enrollment. We are here to help. You can do everything come to covered. That's our website. You can enroll online on the phone. We do also have over 14,000 enrollment partners. These are Californians that are in your community , their agents , their community organizations who are there to help be your guide in this process. They speak dozens of languages. It is no cost to the consumer to use them. And so I really encourage people. This can be overwhelming. Health insurance is always confusing. Not to mention this year. Use our resources. They are there for you.
S1: Yeah , I want to kind of dig into this a little bit. You mentioned some of the circumstances of folks that , you know , rely on covered California , but it can be confusing. And I guess , you know , I mean , I'd put it to you this way , like , what would you say to someone that may be hesitant to sign up for coverage that may feel , you know , disturbed , discouraged , or definitely , you know , with the current financial picture , it may be too much of a financial burden at this point.
S2: I'm talking to consumers that are in , in that circumstance. And I would never , ever tell a consumer about the trade offs. Right. These are often families that are struggling with other things they need , like rent and childcare and food and gas. Right. And every family has to think through this on their own. I want people to have the facts , to have the facts of of their options , and to remember that health insurance is is really about two things. It is about investing in yourself. It is about , you know , every plan on covered California offers free preventive services , offers. You know , your annual checkups are free , your vaccines , your cancer screenings , the things that help you protect yourself and your family and stay healthy into the future. But it is also a core financial protection. I mean , the underlying problem of all of this is healthcare is really expensive in this country. One night in the hospital in California averages over $4,000. To give another example , a pregnancy , a very common health care event. We're talking about $20,000 on average , right. And so while many people are healthy , some people are not. And some people will unfortunately have healthcare needs they don't expect. And that is something to really , really think through because the financial risk is quite high.
S1: You know , we you know , you've touched on a lot of of sort of considerations and concerns I think a lot of folks have on on the health. You know , the cost of health care. I'm wondering , you know , we have about a minute or so left just to finish on this.
S2: I will say I do. I'm going to go back to where I just I just was , which is , um , people always think about the , the cost in front of them right now , that monthly premium , even people who , who really understand , you know , how a deductible works and how a copay works and how co-insurance works. Um , for worse. Our system is very opaque about the actual cost of coverage. People get these jobs , they're called explanations of benefits. They make no sense to people. I understand why , but we also see , you know , healthcare is is one of the leading causes of debt and bankruptcy in this country. And understanding what sort of is on the other side of this ? The risk that you are taking. Certainly people understand the personal. The personal risk , but the financial risk , I think that is something that that I really wish we had , um , uh , you know , better education and better opportunity to inform the public about.
S1: I've been speaking with executive director of Covered California , Jessica Altman. We'll have a link to some of the resources mentioned on our website , KPBS. Jessica , thank you so much for joining us today.
S2: Thank you. Happy New Year.
S1: That's our show for today. I'm Andrew Bracken. KPBS Midday Edition airs on KPBS FM weekdays at noon , again at 8 p.m.. You can find past episodes at KPBS or wherever you listen. Thanks again for listening. Have a great day.
