If you’re enrolled in a Covered California plan or planning to apply soon, the Trump Covered California rules 2025 will directly impact your eligibility, premium payments, and how subsidies work. These new policies, introduced by the CMS under the Trump administration, have already been approved and are set to take effect in phases between 2025 and 2027.
At Skyline Benefit, we’re a certified Covered California agency—and we’re here to help you stay informed, stay covered, and avoid losing access to affordable health insurance during this regulatory shift.
Let’s break down the most important rule changes affecting Californians.
Trump Covered California Rules 2025: What You Need to Know Now
1. Missed Payments Must Be Repaid Before You Re-Enroll
Under the new rules, if your Covered California plan was terminated due to non-payment, you must clear those past due premiums before re-enrolling with the same carrier.
- Some insurance carriers may require you to repay up to six months of unpaid premiums.
- You will not be reimbursed for any medical care received while your plan was inactive.
Skyline Tip: If your coverage (e.g., with Anthem) was terminated—maybe due to missed payments, card issues, or simple oversight—we can help you explore fresh options with a different carrier, such as Blue Shield. While you may still need to settle past balances with your previous insurer, starting a new plan with a new provider could offer a clean path forward depending on your situation.
2. DACA Recipients Will Lose Eligibility Starting August 2025
As of August 25, 2025, individuals under Deferred Action for Childhood Arrivals (DACA) will no longer qualify for Covered California health plans or subsidies. The CMS has classified DACA recipients as not “lawfully present.”
If you’re affected, you’ll need to secure alternative private insurance before that date. Our team can help you explore non-exchange options.
3. Two Years Without Filing Taxes = No More Subsidy
Covered California will now enforce subsidy restrictions for those who haven’t filed federal taxes for two consecutive years.
- One missed year might be excused.
- Two or more years disqualifies you from receiving premium assistance.
- Applies to both returning and first-time applicants.
Skyline Insight: Behind on taxes? We’re not just insurance brokers — we’re tax experts. We’ll help you file or catch up, so your subsidy eligibility stays intact.
4. New Scrutiny for Low-Income Applicants Without Tax Records
If you report income below 100% of the Federal Poverty Level and haven’t filed taxes, you’ll now be required to:
- Complete an income attestation form
- Provide honest, good-faith income estimates
- Submit documentation (especially if self-employed)
False reporting or inconsistencies could lead to retroactive repayment of your subsidy.
5. The $5 Premium Rule: Grace Periods Now Have Consequences
Some enrollees pay $0 premiums due to high subsidies. However, starting in 2025, if you don’t actively renew your account or confirm your profile information during renewal, you may be assigned a $5 premium.
- You have 2 months to pay it.
- If unpaid by the third month, your plan is terminated.
However, this rule helps prevent inattention or abuse of zero-premium plans.
6. Shorter Enrollment Period Starts in 2027
Beginning in 2027, Covered California’s open enrollment window will be shortened to just 9 weeks.
- Miss the deadline? You’ll need to wait until the next year unless you qualify for a Special Enrollment Period.
- Timely enrollment is now critical for everyone relying on ACA coverage.
Need Help Navigating Trump Covered California rules 2025?
At Skyline Benefit, we don’t just help you choose a plan — we protect your eligibility, simplify enrollment, and make sure you stay covered no matter what’s changing behind the scenes.
We’re licensed to assist with:
- Covered California plan enrollment and renewals
- Switching carriers if you’ve been terminated
- Maximizing your subsidy eligibility
- Tax return filings for health subsidy compliance
- Private coverage options.
Schedule a consultation today. Call us at: (714) 888-5112