Fresno outreach highlights risk to Valley enrollees if subsidies expire

Covered California officials and community health leaders gathered at Clinica Sierra Vista's Elm Dental Center in south Fresno on November 13 to help residents enroll in health plans and to raise the alarm about a policy cliff that could affect thousands of San Joaquin Valley families. The enhanced premium tax credits that lowered monthly payments for many enrollees were expanded in 2021 and are scheduled to expire at the end of 2025, a deadline that advocates say could trigger widespread sticker shock and coverage losses.

On the ground at the outreach event, staff guided residents through plan options and subsidy eligibility, while officials emphasized that local enrollment numbers illustrate what is at stake. In Fresno County there are 48,340 Covered California members, of whom 43,590 receive subsidies. For subsidized members the average net monthly premium in Fresno County is $80, a level that helped make coverage affordable for many working families and people with low incomes.

Loss of the enhanced credits would likely raise premiums for subsidized enrollees and could push some to drop coverage or delay needed medical care. The San Joaquin Valley already faces higher uninsured rates than many parts of the state, and public health experts warn that increased uninsurance would worsen health disparities, strain safety net clinics and lead to more preventable hospitalizations. Clinica Sierra Vista and other community providers play a key role in enrollment outreach and connecting patients to care, but clinic capacity cannot substitute for stable, affordable coverage at the state and federal levels.

The outreach event served both as a practical enrollment clinic and as a reminder of the policy choices facing Congress. Without congressional action to extend the enhanced tax credits, many enrollees in Fresno and across the Valley could encounter much higher monthly bills in 2026. That outcome would affect not just individual households but local health systems and public health outcomes, particularly for communities already dealing with economic and access barriers.

As open enrollment continues, community organizations and clinics are urging residents to review their options and seek assistance now, while policymakers weigh whether to extend the subsidies that have helped keep premiums manageable. The decisions made in Washington will have immediate consequences in Fresno County, where tens of thousands of families rely on subsidized coverage to access care and maintain their health.