By Ike Hall, Contributing Writer
On Wednesday, November 12th, about 25 media members, health executives, and San Diego community leaders gathered inside Mental Bar, a Black-owned coffee shop in Encanto. The gathering was hosted by Covered California, a state-run health insurance marketplace and one of the largest purchasers of private individual health plans in California.
Put plainly, Covered California lets Californians shop for private insurance plans offered by top insurers, and, for eligible consumers, it provides financial help to lower monthly premiums and out-of-pocket costs. It also uses its negotiating power to set strict standards for insurers that participate in the marketplace.
While very low-income residents often qualify for Medi-Cal, Covered California supports tens of thousands of middle-income families, young adults in their first jobs, and other working people whose employers do not offer affordable insurance. In San Diego County, more than 140,000 residents use Covered California plans, and the majority receive some form of financial assistance.
This “Community Conversations” event is part of a statewide outreach and media tour the agency is conducting to mark the start of the 2026 Open Enrollment period. This is the time when Californians can compare insurance plans and sign up for coverage for the coming year.
This enrollment period comes during a time of great distress for American healthcare. The nation is emerging from a government shutdown, medical costs continue to rise, and Congress has not yet decided whether federal subsidies will continue.
The panel featured Covered California Executive Director Jessica Altman, Chief Medical Officer Dr. Monica Soni, and Dr. Sharon Smith, former president of the San Diego Black Nurses Association.
With a suppressed tension in the room, much of the conversation centered on a looming challenge: the potential expiration of the federal enhanced premium tax credits. These government subsidies, enacted during the pandemic and made possible through the Affordable Care Act, have allowed many non–Medi-Cal recipients to afford private health insurance.
Without these tax credits, working families, young adults entering the job market, and the broader middle class would face sharply higher premiums. Covered California projects a 76 percent average premium increase in San Diego County if the credits expire.
Altman explained, “Enrollment in the marketplaces more than doubled for people of color because of the tax credits. They reduce disparities.” The future of these subsidies will not be known until Congress meets to determine their fate in mid-December, which leaves families and enrollment counselors in a stressful limbo.
Dr. Monica Soni expanded on the stakes if the tax credits are not renewed. “A decade of infrastructure that allowed healthcare professionals to cover uninsured folks has been wiped out,” she said. “I am in fear that we are going to be in a worse place than 10 years ago. Four hundred thousand people are at risk. I am worried about someone in the middle of chemo or specialty care who might be left in the lurch.”
Dr. Sharon Smith, who led the San Diego Black Nurses Association for more than two decades, reflected on the historical and cultural stakes for Black communities. “A lot of Black folks were not receiving the proper care,” she said. She described how expanded coverage reduced emergency-driven care and increased access to preventive treatment for chronic conditions like heart disease, which affects the Black community disproportionately. “The more people that were covered, the fewer emergency-driven cases we saw.”
As a state marketplace, Covered California not only sets quality standards for participating insurers, but also plays a direct role in enrolling uninsured people into coverage. “Health insurance has been made to be as complicated as possible,” Altman said.
Throughout the hour-long conversation, the speakers emphasized the wide gaps between the healthcare system and everyday people, especially communities of color such as Encanto. Events like this are intended to bridge those gaps by connecting Covered California directly with community leaders who can help spread information and guide residents to enrollment support.
Covered California representatives reminded attendees that free, multilingual enrollment help is available across San Diego County, offering one-on-one guidance for comparing plans, checking subsidy eligibility, and determining Medi-Cal benefits.
Open Enrollment runs through January 31, 2026. Early enrollment is encouraged to avoid gaps in coverage.
Altman closed the event with a quote from Dr. Martin Luther King Jr., “The arc of history is long, but it bends toward justice,” affirming Covered California’s commitment to helping Californians remain insured despite rising costs and the uncertainty coming from Washington.
