In July of this year Camilo received a letter from Covered California, the state’s official health insurance marketplace. According to the notice, beginning in 2027 Camilo, who is originally from Colombia, will no longer qualify for federal health care subsidies.
That means his current monthly premium of $45 will skyrocket to around $725, a 1500% increase and a figure he says he simply can’t afford.
“I can’t make that money even if I add another job and end up having three jobs,” said Camilo, 34, who asked that we only use his first name because he fears jeopardizing his status.
Camilo is among an estimated 140,000 people in the state who have already received or will soon receive similar notices from Covered California, leaving many with few if any options to maintain coverage.
‘Drown us financially’
The cuts stem from passage of the GOP spending package HR1, otherwise known as the “One Big Beautiful Bill,” signed into law in a party line vote last year.
“I understand that what the federal government wants to do is drown us financially so that we are forced to leave this country,” said Camilo, voicing frustration over a slate of policies seemingly designed to punish hard working individuals like himself.
Camilo works full-time as a food runner at a local Italian restaurant. During his off hours he picks up gig work as a deliveryman to make ends meet. “I go out every day to work without hurting anyone, I pay taxes, I do everything right, because I don’t want to leave here,” he added.
According to Covered California, starting in 2027, federal health care subsidies will be restricted exclusively to lawful permanent residents (Green Card holders), Cuban or Haitian entrants, and migrants under the Compact of Free Association (COFA), which covers three Pacific Island nations: Micronesia, the Marshall Islands and Palau.
Those holding work or student visas, asylum (approved or pending), Temporary Protected Status (TPS), or humanitarian visas, will lose these benefits.
Adding to the pressure on immigrant families, the Trump administration recently reenacted the so-called Public Charge Rule, which took effect on September 18. The policy stipulates that green card applicants who receive public benefits including health care subsidies will be denied residency.
California has joined 21 other states in suing the administration over the rule, though it remains in effect. Immigrant rights advocates are urging those affected to contact an attorney or legal representative to determine whether they should cancel their current subsidies to protect their immigration status.
The tip of the iceberg
Diana Camacho is senior program officer at the California Health Care Foundation (CHCF). She warns that these letters announcing the new changes are just the tip of the iceberg of an impending crisis.
“Unfortunately, we are expecting significant coverage losses in California as a result of the changes in federal and state policies tied to HR1,” points out Camacho.
The policies mark a dramatic reversal for California. In recent years the state had made significant progress in lowering its rate of uninsured residents, making everyone here — regardless of immigration status — eligible for coverage under the Affordable Care Act marketplace.
An analysis by the UC Berkeley Labor Center and the UCLA Center for Health Policy Research projects that by 2030, 4.6 million Californians under the age of 65 will not have health insurance, an increase of 2.2 million uninsured people, doubling the state’s current uninsured rate.
A report by the nonpartisan Congressional Budget Office, meanwhile, suggests HR1 could force 10 to 16 million people nationwide off their health care plans.
Data show Latinos stand to be among those hardest hit, with estimates suggesting that by 2030 two out of ten Latinos in California will be left without insurance. African Americans and Asians will also likely see a doubling of their uninsured rates.
All this comes as inflation remains stubbornly high and as the war in Iran drives up costs for gas and other daily necessities.
Camilo sends a portion of his earnings back to Colombia as child support for his daughter there. Much of the rest is swallowed up by high rents. “The cost of living here only allows you to survive,” he said.
Few alternatives
As for coverage alternatives, Camacho says there are not many available.
“The reality is that there may be no public health insurance option available beyond emergency Medi-Cal,” which only covers emergency room care.
And while community health clinics and other state and county level programs — including indigent health care programs — could help fill some of the gap, many of these programs have also seen large funding cuts in recent years, leaving them ill-equipped to deal with the expected influx of uninsured patients.
The state’s $300 million Health Care Affordability Reserve Fund (HCARF), meant to offset increases in health care plans, meanwhile, won’t apply to immigrants like Camilo, explains Jules Lutaba, a senior attorney at the National Health Law Program.
“Immigrants who lose federal [subsidies] in the 2027 plan year due to HR-1 are not eligible for state subsidies,” he said.
That leaves Camilo and others in a bind.
“I know many people think the American Dream is to come and make money,” he said. “Maybe that worked some time ago. Now I feel that the American Dream is being able to sleep a little because you are just working so much.”
