‘We Can’t Afford to Stay’: Californians Weigh Drastic Moves as Health Premiums Rise

Carin Lenk Sloane never considered moving abroad. She’s a fourth-generation Californian and has lived in Davis for 26 years, raising three kids and building a psychotherapy practice serving local families.

“And now my husband and I are both talking about leaving the U.S. to go to a country where we are not being forced into debt just so that we can have basic health care,” she said.

Next year, her family’s health insurance bill will jump from $1,500 to $3,700 a month — that’ll cost her more than $44,000 a year for a high-deductible plan.

Sloane is one of roughly two million Californians who buy insurance through Covered California, the state’s marketplace – and one of many who could see steep price hikes now that Congress has ended the shutdown without striking a deal on health care.

The Trump administration refused to extend the enhanced federal tax credits that have kept monthly premiums affordable. Instead, GOP lawmakers have suggested replacing the subsidies with flexible spending accounts that would help people pay for health care costs directly.

“It’s remarkable that they would take half a trillion out of Medicare, millions of people out of Medicaid, and not renew the subsidies,” former House Speaker Nancy Pelosi said at a recent Covered California press conference. “Why? To give a tax break to the richest people in America.”

The enhanced tax credits, first expanded during the pandemic, made health coverage more affordable for millions of self-employed workers, freelancers and small-business owners. Without them, the cost of coverage for many Californians could more than double, according to an analysis by KFF.

Another option that Slone is considering is forgoing coverage all together — a once unthinkable step for someone who calls herself cautious and practical.

But she worries about her husband, who loves cycling and water sports. “He does dangerous things,” she said. “And I’m like, if we don’t have health insurance, you’re gonna have to really curtail your activities that keep you happy and keep you healthy.

Even if the couple gambles with their health, they will each have to pay California’s $900 penalty for not having coverage. “It’s incredibly disheartening to think that at this moment, it feels like our government and our country doesn’t care about middle-class workers, or people who are self-employed,” she said.

California has allocated $190 million from the state budget to help reduce premiums for lower-income residents, but that won’t come close to filling the gap. “That funding will make a difference,” said Jessica Altman, executive director of Covered California, “but it will not replace the $2.5 billion in annual federal funding that we are at risk of losing.”

In Los Angeles, a 38-year-old actor and writer faces a monthly premium that is about to jump 60% — from roughly $400 to $650.

Miller, who uses the pronoun they, said the new cost could upend their career. Miller has long pieced together a living through voiceover work and script adaptation, but said artificial intelligence has gutted that corner of the entertainment industry.

Out of desperation, Miller applied for a job as a mail carrier with the post office — not for the salary, but for the health benefits, mostly for their husband, who lives with a chronic autoimmune disease.

Even a federal job may not solve the problem. Miller is transgender and depends on hormone therapy, treatment that government employee health plans are expected to stop covering next year.

If the subsidies disappear, they’re considering leaving California for a cheaper state, but that option carries its own risks. “Then the issue of me being trans — where would I go?” Miller said.

The question now is whether lawmakers will return to the negotiating table. Democrats have proposed short-term extensions to keep the subsidies alive for another year or two, but Republican leaders have not backed the idea.

“There’s so much joy that’s been sucked out of our lives because we’ve needed to pay for health care,” Miller said.