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Covered California Upcoming Changes

Updated July 31, 2025

Did you miss our live webinar?

Check out the recording below to learn about 2026 plan changes.

 

Overview

Nearly 90% of Californians who purchase health insurance through Covered California get financial help from federal subsidies. This funding helps lower monthly premiums and other costs, like copays.

 

The One Big Beautiful Bill Act (OBBBA), signed into law by President Donald J. Trump on July 4, 2025, is expected to increase health plan premiums for Covered California enrollees due, in part, to the expiration of the financial subsidies (also called enhanced Affordable Care Act tax credits) in January 2026. 

 

In addition, the OBBBA reduces spending for Medicaid — called Medi-Cal in California — by $1 trillion over the next 10 years. These federal savings are estimated to cost the state $28.4 billion, according to reports from Gov. Gavin Newsom and state health officials. This will significantly impact the state’s health care system, including federal and state budgets, for health plans like IEHP.

 

Below are answers to some common questions we may receive from IEHP Covered members, based on current information.

Changes in federal law means an increase in the monthly premium rates starting in 2026:

  1. Extra financial help from the federal government directly reduced your monthly premiums during 2025. This extra help expired at the end of 2025 and will no longer be available
    to you in 2026.
  2. IEHP uses plan premiums to pay for covered services. To continue services for our members, IEHP needs to increase the monthly premium.

Depending on your plan, there may be changes to your copays or out-of-pocket costs.



You still have $0 copays for preventive services, like annual physicals, labs/screenings for diabetes, cancer screenings, such as mammograms and colorectal screenings.

To determine what options are best for your needs, complete the following steps:

  1. Go onto the Covered California enrollment site and update your income and
    household size.
  2. Once you complete this update, you will see any potential extra financial help that you
    will get in 2026.
  3. Consider your current health care needs and decide if you want to enroll in a lower premium plan, such as a Bronze plan. The Bronze plan offers lower premiums, but it also has higher copays. You can change your plan once you are on the Covered California enrollment site.

Please call IEHP Covered Member Services  at 1-855-433-IEHP (4347), Monday-Friday, 8 a.m.-6 p.m. TTY users should call 711.

 

You can also contact:

The notice you received explains what you need to do to continue your plan benefits from 2025 or select a new plan for next year.

 

  • Step one: To ensure that you receive any potential financial help to reduce your monthly plan costs, you need to visit the Covered California enrollment site at coveredca.com, log into your account and update your household and income information.

  • Step two: You need to pay your January 2026 plan premium no later than December 31.

Once you’ve updated your household and income information on the Covered California enrollment system and selected a plan for 2026, you can pay your 2026 plan premium at that time. If you don’t pay at that time, IEHP will send you a bill for your January 2026 plan premium amount due. To ensure that there is no gap in your health coverage, you need to make this premium payment in December. Please note that plan premiums are due on the first of each month.

Your final 2026 premium amount due depends on the amount of financial help that you are eligible for in 2026. The IEHP letter provides the 2026 monthly premium costs for your current plan. Covered California’s website will be able to confirm any potential 2026 financial help amounts starting on November 1. Financial help will still be available for 2026, but many enrollees will receive less help than you did in the past.

Yes, you can change your plan for 2026. Please login to your Covered California account to update your household and income information. You will also be able to select a new plan at this time, or you can contact your agent for assistance.

Deferred Action for Childhood Arrivals (DACA)

As of June 2025, people with Deferred Action for Childhood Arrivals (DACA) status are no longer eligible to get health insurance through Covered California due to new federal rules.

 

If you are a DACA recipient currently enrolled in a health plan through Covered California, your insurance will end on Aug. 31, 2025. You may still qualify for other health insurance options, such as private health insurance or Medi-Cal, depending on your income and household size.

Your health insurance will end on Aug. 31, 2025. DACA recipients will receive written notifications with an insert that will advise you of additional ways to get health insurance, including Medi-Cal if you are eligible.

Based on the latest information, your options for coverage may include:

  • Seeing if you qualify for Medi-Cal by visiting coveredca.com or contacting your local county social services office or county Medi-Cal office.
  • Purchasing a plan directly through a health insurance company.
  • Contacting your employer to see if there is an employer-based insurance option available.
  • The California Department of Social Services’ Immigration Services Bureau keeps a list of qualified nonprofit organizations to provide services to immigrants who reside in California. Visit cdss.ca.gov/inforesources/immigration/contractor-contact-information.
  • The Immigration and California families webpage may have resources to help you. Visit ca.gov/immigration/.
  • The Health Consumer Alliance at 1-888-804-3536 offers legal help.

Yes. If you change to an immigration status that is considered “lawfully present” for purposes of enrolling in a health plan through Covered California, you can apply for health insurance and receive financial help if you qualify.

No, unless you received too much. If you were eligible at the time you enrolled and received financial help to lower your monthly premium payment, you will not be required to repay the financial help merely due to the change in eligibility.

 

You would need to repay financial help if you mistakenly received too much. This can happen in situations such as not updating your account to note an increase in income. When filing taxes, you would find out if any excess financial help would need to be repaid. That amount is subject to APTC repayment caps.

Yes, IEHP can help you appeal this decision or file a complaint. However, if you believe your insurance should not have ended because the new rule change was applied incorrectly, you should contact Covered California for help. You can also contact legal aid or advocacy organizations like the Health Consumer Alliance if you need help understanding your rights. The number is 1-888-804-3536.

You need to transition to off-exchange health insurance. If you’re currently covered through Covered California, you can continue receiving medical services under your existing plan through August 2025. If you have an insurance agent, contact them for help.

Yes, if you paid for additional months of health insurance, IEHP can help you can request a refund.

Contact your insurance agent for help. If you don’t have one, you can try: