A closer look, however, shows that Californians are making concessions to afford staying insured. 

More enrollees are opting for “bronze-level” plans. These plans have lower monthly premium costs but higher deductibles and copays; they cover 60% of medical expenses — leaving enrollees to pay the rest. One in three new enrollees chose bronze plans for 2026, compared to one in four last year, according to Covered California. And 130,000 Californians renewing their coverage switched from a silver or higher-metal tier plan to bronze.

“Many Californians see the value in remaining covered, but they had to make sacrifices and shift to lower-tier plans. We see it as a commitment to health and the value that Covered California provides,” Jessica Altman, Covered California’s executive director said in a statement. 

While bronze-level plans may offer people some peace of mind, the high deductibles and copays tend to discourage people from seeking care, said Miranda Dietz, director of the Health Care Program at the UC Berkeley Labor Center.

“Those out-of-pocket costs do impact people’s decisions to get care, so that’s worrisome as well,” Dietz said. 

People earning above 400% of the federal poverty level — $62,600 for an individual and $128,600 for a family of 4 — no longer qualify for premium assistance after Congress chose not to extend the enhanced subsidies at the end of last year, pushing many to opt for plans with cheaper premiums or drop their marketplace plans entirely. 

Of the 224,000 middle-income enrollees set to renew, 22% cancelled their plans, according to Covered California. New sign ups for people in this income bracket decreased by 59% compared to last year.

Whether those who renewed coverage or newly signed up continue to pay their premiums is another question. A clearer picture of who stays enrolled will emerge around April, Covered California said. 

“Once you actually face the prospect of paying that premium and the stress that puts on your budget, it’s entirely possible that some of those folks may fall off, and the (enrollment) numbers might go down,” Dietz said.

Affording care: a growing stress point 

It’s unknown whether people who cancelled their marketplace health plans are enrolling in other types of insurance. Covered California data from the last five years show that when people terminate their marketplace plan, 10% to 14% of them report becoming uninsured. 

The Affordable Care Act’s enhanced premium subsidies, first enacted in 2021 as part of federal COVID-19 response, helped lower the insurance costs for millions of Americans. They especially helped middle-income earners by allowing them to qualify for financial assistance for the first time, capping premiums at 8.5% of income. That help is now gone, and premiums are up an average of 10%.

Lower-income enrollees remain eligible for standard federal premium aid available since ACA marketplaces launched. They also benefit from state help. California allocated $190 million in 2026 to provide state-funded tax credits for people who earn up to 165% of the federal poverty level — $25,823 for an individual or $53,048 for a family of four — averaging about $45 a month per enrollee.The end of the enhanced federal subsidies also come at a time when poll after poll shows health care costs are a growing stress point for people. Seven in 10 Californians say health care expenses place a financial strain on their household, according to a recent survey by the California Health Care Foundation. Four in 10 have medical debt and six in 10 report skipping care. Meanwhile, eight in 10 Californians say making health care affordable is an “extremely” or “very” important priority for state officials and lawmakers in 2026.

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“Californians don’t see health as a single dimension, it really is about an overall quality of life,” said Shakari Byerly, managing partner at Evitarus, the research firm that conducted the polling.

Nearly 40% of state residents surveyed said they know someone whose mental health has worsened as a result of U.S. Immigration and Customs Enforcement raids. One in five people indicated that they know someone who is afraid to seek medical care because of immigration activity.

Byerly said immigration is a more acute concern in the Latino community in Los Angeles, where 60% of people polled know someone experiencing financial hardship that is tied to immigration actions.

“People have long come to California and remain here for the California dream. Many of these issues strike at the heart of what that dream means and what people still believe is possible, despite pressures and concerns,” Byerly said.

The poll comes ahead of a Nov. 7 forum at UC Riverside where 11 philanthropic organizations, including the California Wellness Foundation, have invited gubernatorial candidates to discuss their healthcare priorities. So far, former U.S. Health and Human Services Secretary Xavier Becerra, State Superintendent of Public Instruction Tony Thurmond, former L.A. Mayor Antonio Villaraigosa and former State Controller Betty Yee say they plan to attend.

Nearly 90% of people polled statewide said they’d like to see the next governor prioritize caps on out-of-pocket health costs.

Though she wasn’t surveyed, 64-year-old San Diego resident Lisa Kaczmarczyk agrees that healthcare affordability should be a priority for the next administration.

“Medical has been one of my top expenses every single month for years,” Kaczmarczyk said, even though she’s healthy and has no chronic conditions.

Self-employed as an educational consultant, Kaczmarczyk purchases her health plan through Covered California, the state’s insurance marketplace. She pays $502 a month in premium costs for an individual gold plan after federal subsidies, plus an average of $576 a month in copays and other costs not covered by her insurance, like dental care.

The federal government shutdown and its consequences could drive those costs higher. Federal subsidies for marketplace enrollees like Kaczmarczyk may soon change. Enhanced aid introduced during the pandemic is set to expire at the end of the year, and Congress has yet to decide whether to renew that help.

“There are absolutely things that I don’t buy. I prioritize groceries and I prioritize medical bills.” The more she spends on healthcare, Kaczmarczyk said, the less she can put into her retirement savings or toward things she’d really like, such as new furniture or a vacation.

Health insurance is essential, she says. But like half of Californians, she has delayed seeking some care. Kaczmarczyk said she looks forward to being eligible to enroll in Medicare next year, hoping that will curb her health expenses.

Gov. Gavin Newsom and legislative leaders have said that the cost of living is a pressing issue, but legislative reforms to provide relief for Californians may take years to get approved or to take effect.

According to the poll, 72% of Californians said they were worried they wouldn’t be able to afford to live in California long term. It’s a matter that candidates running to be California’s next governor will have to respond to, said Richard Tate, president and CEO of the California Wellness Foundation.

Among 2,000 Californians surveyed in late August and early September, former U.S. Rep. Katie Porter led the field of potential gubernatorial candidates with support from 20% of respondents. She was followed by Riverside County Sheriff Chad Bianco at 16% and U.S. Sen. Alex Padilla at 13%. The poll’s margin of sampling error was just over 2%.

In a statement, Tate said, “What voters want from the next governor is clear: affordable housing, healthcare that doesn’t break the bank, mental health support they can count on, and the ability to care for their loved ones with dignity and peace of mind.”

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