Valley leaders stress vital role of health care coverage
FRESNO – With the open enrollment period coming to a close, local leaders and health advocates joined representatives from Covered California to emphasize the importance of health care coverage.
Covered California, the state’s health insurance marketplace, capped off its “connectors to coverage” open enrollment period at My Homies Kitchen in downtown Fresno on Jan. 27. Leading up to the enrollment deadline of Jan. 31, the press conference stressed the ways health insurance coverage benefits communities, even as the expiration of the enhanced premium tax credit causes costs to rise.
“As a practicing primary care doc, I know firsthand that health insurance is a critical way to protect not just physical and mental health, but financial health to prevent things like bankruptcy,” Covered California Chief Medical Officer Dr. Monica Soni said. “When my patients get the care they need, they thrive in work, in school and their life.”
Open enrollment with Covered California has a hard deadline of Jan. 31. Individuals can apply online at coveredca.com, over the phone, by mail or in person through a certified enroller in their community.
Despite the expiration of enhanced premium tax credits on Dec. 31, 2025, Soni said most Covered California enrollees will still be eligible for some type of tax credit in 2026. Half of all enrollees through Covered California are eligible for health insurance that costs $10 or less per month, and around a quarter of enrollees can receive a Silver-tier plan for that price.
Further, she said that if at any point Congress takes action to extend the tax credits, Covered California will be ready to apply those to enrollees for the 2026 coverage year.
“But I also want to stress that there’s no guarantee that Congress will take action — frankly, far from it,” Soni said. “I don’t want any Californians to miss the window for insurance for 2026 because they’re counting on something happening.”
Federal failure
The ACA enhanced premium tax credits lowered monthly insurance premium costs for millions of people across the country and state, Soni said, but that access is in jeopardy due to the federal government’s failure to expand those tax credits.
“We are already seeing the impact in California,” Soni said. “Fewer Californians are coming in to enroll, more folks are canceling … and in the end, we do estimate we might lose as many as 400,000 Californians who might drop their coverage and potentially go uninsured.”
Lower costs and an increased push to help residents understand the health insurance options available to them led to Covered California beginning the open enrollment period on Nov. 1, 2025, with a record enrollment of nearly 2 million people.
As of Jan. 24, more than 1.9 million consumers had enrolled in coverage for 2026, according to data provided to the Mid Valley Times by Covered California. A majority of those enrollees are existing consumers, however; new enrollment is down by 32% compared to the 2025 coverage year.
Approximately 96,000 consumers across Mariposa, Merced, San Joaquin, Stanislaus and Tulare counties have enrolled in coverage, and more than 51,800 consumers in Fresno, Kings and Madera counties have enrolled.
Compared to 2025, there has been a 57% increase in user-generated plan cancellations among 2026 renewing consumers. Overall, 11% of renewing enrollees cancelled their plans compared to 9% at this time last year, according to Covered California.
Additionally, the cancellation rate among middle-income consumers who have lost eligibility for financial assistance has doubled, from 9% at this time last year to 18%.
On average, the net monthly premium per member for those in the Fresno, Kings and Madera County region is $136 for active enrollees and was $339 for those who canceled or terminated their plan. In the Mariposa, Merced, San Joaquin, Stanislaus and Tulare County region, the average net monthly premium per member is $142 for active enrollees and was $256 for those who canceled.
Health care access
Soni spoke alongside Cultiva La Salud Executive Director Genoveva Islas, Fresno Building Healthy Communities CEO Sandra Celedon, Fresno Councilmember Annalisa Perea and District 21 Rep. Jim Costa.
All who spoke reflected on how the Affordable Care Act — which Costa helped to pass in 2010 — significantly expanded access to health care in the Central Valley. Costa said the ACA impacted 1.5 million constituents across the five Congressional districts that make up most of the Valley.
“But it didn’t happen in isolation,” Costa said. “It happened because we created an opportunity through the Affordable Care Act for more Americans — for millions of Americans and their families — to be able to achieve health care insurance.”
With health insurance plans available through Covered California, enrollees can access wellness programs, annual screenings and immunizations, Celedon said. Those with insurance are more likely to have a regular primary care doctor and have access to the medications they need to manage chronic conditions.
Conversely, Celedon said uninsured people delay their care, which leads to financial stress, higher medical costs and eventual medical debt. Chronic diseases that go unmanaged can lead to expensive and disabling complications.
This is why consistent access to health care that is supported by insurance, and consistent funding for the premium assistance that allows more people to have insurance, is needed, Celedon said. Steady coverage allows individuals to transition from a crisis-response model of receiving health care to a proactive well-being model, she said.
“We know that healthy people are better able to support their families, attend work or school, engage in civic life, and, of course, live longer — because we all deserve to die old, and we can only do that when we’re well cared for,” Celedon said.
Stay covered
Even with increasing costs for many, Celedon said that for enrollees in Fresno County, the average monthly cost of a Covered California plan is around $80. While that can still be a “heavy lift” for families, Celedon said she would encourage individuals to take advantage of the options that are available with Covered California to ensure they are protected for the year.
“I think it’s really important for folks to take advantage of the opportunities that are made available through very significant policy changes that many of us have fought (for) in order to make health care access available for everyone,” Celedon said. “We must take it upon ourselves to sign up for these programs that are available because that also makes it harder for them to get cut.”
Individuals who missed the open enrollment period may still be able to get coverage if they have experienced a major life change, such as losing Medi-Cal or employer-supported coverage, losing eligibility for a parent’s plan, getting married, having a child, gaining citizenship, moving to the state and many other circumstances.
For those who may go without health insurance, community-based organizations like Fresno Building Healthy Communities, Cultiva La Salud and many more can also help residents connect with clinics and federally qualified health care centers that provide care at free and reduced costs.
slas, who founded Cultiva La Salud, said community health workers with these organizations help schedule transportation, act as interpreters and reach people where they’re at, like those in rural Fresno County. She added that these organizations can only work as well as the systems that are designed to serve disadvantaged community members.
“It really is all of us working together to make sure that we keep what has been helping families access care and make sure that that doesn’t get dismantled,” Islas said. “We have to fight back to win some of the stuff that’s been taken away, but it’s going to take all of us working to make sure that everybody has access to health.”