Almost 167,000 San Joaquin Valley residents who are enrolled in health insurance plans under Covered California will see their premiums climb by an average of almost 11% or more in 2027.
Covered California, the state’s health insurance marketplace under the Affordable Care Act, announced that its enrollees statewide would face an average rate increase of 9.9% to stay with their existing health coverage plans.
But each enrollee’s rate depends on the insurance carrier from which they select for coverage, the level of coverage they choose and the county or “rating region” in which they live. The San Joaquin Valley is divided into three rating regions:
- Region 10: Mariposa, Merced, San Joaquin, Stanislaus and Tulare counties, for which the average rate increase will be 10.8%.
- Region 11: Fresno, Kings and Madera counties, with an average rate increase of 11.8%.
- Region 14: Kern County, where the average rate increase is 11.4%.
In a written statement, Covered California attributed the rate increases to a range of factors, “including the increasing cost of health care and pharmacy expenditures alongside broader industry challenges.”
But the agency also pointed a finger at the federal government under President Donald Trump for driving up costs to consumers. “Last year, federal lawmakers failed to extend enhanced federal tax credits that helped millions of Americans afford their monthly premiums,” the agency’s statement said. “This year, the Trump administration cut eligibility for lawfully present immigrants, added administrative burdens to families applying for financial help and made it more difficult for gig workers who have to recalculate their income on an annual basis.”
The enhanced tax credits, enacted in 2021 during the COVID-19 pandemic, expired at the end of 2025. They helped subsidize the cost of health insurance premiums under the Affordable Care Act and Covered California for people whose incomes amounted to between 150% and 400% of the federal poverty level.
That was in addition to credits to reduce the out-of-pocket premiums for people whose incomes were under 150% of the federal poverty level. Those credits, part of the original Affordable Care Act passed in 2010, remain in place but eligibility to qualify for them has been limited by the One Big Beautiful Fill Act passed by Congress last year and signed by President Donald Trump, and new federal regulatory changes.
Compared to California’s statewide 9.9% average increase in premiums, other parts of the country are expected to face even larger increases. The independent, nonprofit health news, policy and research organization KFF reported earlier this month that insurers selling health coverage through the Affordable Care Act across 16 states are proposing a median increase in premiums of 14% for 2027. At least 20 insurers have requested premium increases of 20%.
The Peterson-KFF Health System Tracker also reported this month that insurers described a range of factors that were affecting their rate proposals for 2027, “particularly the expiration of enhanced premium tax credits at the end of 2025 and a related increase in the risk pool’s morbidity.”
“Many healthier enrollees left the ACA Marketplaces in 2026 as their subsidies decreased – leading to an average increase in premium payments after subsidies of 58% this year – leaving behind an enrollee base that is on average somewhat sicker and more expensive to cover,” the Peterson-KFF analysis stated.
In California, to help offset the loss of those expanded tax credits for at least some residents, the state put in place its own plan for tax credits, providing assistance to lower-income Covered California customers. In 2026, that included enrollees with incomes at up to 165% of the federal poverty level. For 2027, the upper limit for the state subsidies is 200% of the federal poverty level.
For a family of four, the federal poverty level for 2026 is income of $33,000 or less per year, according to the U.S. Department of Health and Human Services.
As of March 2026, total statewide enrollment in Covered California was almost 1.8 million residents. The vast majority of those are people whose employers don’t provide health coverage to employees, self-employed business owners, freelance “gig economy” workers and people who make too much money to qualify for Medi-Cal, the state’s incarnation of the federal Medicaid program for low-income residents.
Under Covered California, people can purchase health insurance at different levels of coverage from an array of companies, from top-tier “platinum” coverage to basic “bronze” tiers with lower monthly premiums but higher deductibles.
Current Covered California enrollees who want to shop around for coverage before the renewal period opens in October may be able to save money for 2027 by signing up for a lower-cost plan with another carrier even within their existing level of coverage (platinum, gold, silver or bronze).
According to information from Covered California, the “shop and switch” option could limit the average annual increase in premiums in the Valley to 5.9% Region 10 (Mariposa, Merced, San Joaquin, Stanislaus and Tulare counties), 7.7% in Region 11 (Fresno, Kings and Madera counties) and 8.6% in Region 14 (Kern County).
For example, according to rates published by Covered California, the “gold” tier options for a 30-year-old enrollee in Fresno County range from a Blue Shield HMO plan with a premium of $862 per month to a Kaiser HMO plan for which the monthly premium is $536 per month.
Or a person could select a less-inclusive tier of coverage that has lower premiums but higher deductibles and co-payments. That same 30-year-old enrollee has choices ranging from “platinum” plans with a monthly premium costing as much as $1,000 to more rudimentary “bronze” plans with premiums as low as $434 per month.
Rising costs of health insurance premiums, coupled with the expiration of the enhanced tax credits, are at least partially responsible for a sharp increase in the number of people who enrolled in Covered California but whose coverage was terminated earlier this year for, among other reasons, failing to pay their higher premiums.
From January through March, Covered California data show that coverage was terminated for almost 27,000 San Joaquin Valley residents – and almost 279,000 enrollees statewide.
Tim Sheehan is the Health Care Reporting Fellow at the nonprofit Central Valley Journalism Collaborative. The fellowship is supported by a grant from the Fresno State Institute for Media and Public Trust. Contact Sheehan at tim@cvlocaljournalism.org.