What's New This Year
The changes that actually affect what you pay and which plan is the right buy, with what we suggest you do about each one.
What Changed, and What It Means for You
Health insurance rules move every year. Most years the changes are small. This year several of them are large enough to change which plan is the right buy, and one of them can change whether you get any help with your premium at all.
Here is what is different, in plain terms, with what we suggest you do about each one. If you have not looked at your plan since you first enrolled, this is the page to read before renewal.
The subsidy income ceiling is back
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There is a hard income limit on the premium subsidy again. A household whose final income for the year lands above that limit gets no premium help at all, no matter how expensive the plan is.
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The temporary rules that removed the limit expired at the end of December 2025, and the limit returned on January 1, 2026.
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If your income comes in above the limit after you have been taking the credit in advance, the entire year's credit is repaid when you file, and there is no cap on that repayment amount.
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If you were told in an earlier year that you qualified, that answer may no longer hold. Have us run your numbers again before you count on any help.
Any Bronze or Catastrophic plan can now fund an HSA
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Since January 1, 2026, any Bronze or Catastrophic marketplace plan lets you fund a Health Savings Account. It no longer has to be the plan labeled HDHP.
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The HDHP version is still worth asking for. Its integrated deductible and lower out of pocket maximum usually make it the better buy. The Health Savings Account is simply no longer the reason to insist on it.
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This widens the set of plans a healthy household can pair with an HSA, so it is worth re-pricing your options rather than renewing out of habit.
Two things about HSA plans people get wrong
What makes a plan HSA-qualified is set by IRS rules, not by the absence of copays. The plan has to carry at least a minimum deductible and it has to cap your out of pocket costs at or below a maximum the IRS sets each year. A plan with no copays is not automatically qualified, and a qualified plan is not disqualified merely by having one.
California does not follow the federal Health Savings Account rules. Contributions are not deductible on your California return, and the account's earnings are taxable by the state. The federal treatment is unchanged. Ask your tax preparer how the two sit together for you.
Do not treat a Covered California renewal as automatic
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Covered California will send a renewal notice each fall. Read it rather than letting the plan roll over on its own, because the federal rules changed on January 1, 2026 and more changes are scheduled.
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Tell Covered California, or tell us, whenever your income or household size changes during the year, so the credit stays accurate and there is no surprise at tax time.
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Open enrollment still runs November 1 to January 31. Apply between November 1 and December 31 and your plan starts January 1. Apply in January and coverage starts February 1.
Balance billing protections, and where they stop
It is worth knowing exactly how far the surprise billing rules reach, because that is what an out of network mistake costs you.
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The federal No Surprises Act bars balance billing for emergency care, for air ambulance, and for out of network providers who treat you at an in network facility.
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California adds protections of its own. AB 72 limits what an out of network provider can bill a patient who is treated at an in network facility under a state regulated plan.
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Outside those situations you are exposed. A planned visit to an out of network doctor or surgery center is not protected, and a single one can undo years of premium savings.
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So the annual network check still matters. Re-verify your doctors, labs, imaging centers, and hospital at each renewal, because networks change.
Not Sure How This Year's Rules Affect You?
Bring us your household and we will tell you what changed for your situation. There is never a charge for the review.