Covered California Enrollment Grows Amid 2026 Policy Uncertainties

Covered California, the state's health benefit exchange, continues to see growth with nearly 2 million individuals enrolled in qualified health plans in 2025, marking the fourth consecutive year of increased enrollment. This growth comes amid uncertainty about the future of Enhanced Premium Tax Credits, which play a significant role in making health coverage affordable for many. Physician practices are advised to carefully review their participation status and product offerings within their geographic regions as they prepare for changes anticipated in 2026. The California Medical Association (CMA) has responded by releasing a detailed tip sheet titled “Navigating Covered California: Preparing for Changes in 2026.” This resource is designed to help physician practices understand evolving participation requirements, plan options, and administrative details that could impact service delivery and reimbursement. The tip sheet is provided free to CMA members, emphasizing the organization's commitment to supporting practice management amid policy shifts. In addition to the tip sheet, CMA provides various resources including a mobile app for real-time updates, webinars on clinical and administrative topics, and dedicated practice management and reimbursement assistance. These initiatives are vital for physician practices to stay compliant with rapidly changing healthcare regulations, payer demands, and reimbursement structures in the California market. Looking ahead, key federal subsidies such as the Enhanced Premium Tax Credits are set to expire at the end of 2025, introducing potential volatility in patient enrollment and plan affordability. Physician practices should proactively verify patient eligibility, benefits, and anticipate payer policy evolutions to mitigate claim denials and ensure continuity of care. Overall, continued expansion in Covered California enrollment reflects broader trends toward increased health plan participation despite regulatory uncertainties. Stakeholders within the physician and payer sectors must stay informed and agile to adapt to upcoming policy changes and maintain access and affordability for California consumers.