Nearly 2 million people are enrolled in Covered California, the state’s version of the federal Patient Protection and Affordable Care Act health insurance, also known as Obamacare after the former president who approved the program in 2010.

That includes more than 360,000 enrollees in the Bay Area.

They could be impacted by the major policy bill that President Trump has urged Republican lawmakers to approve. The Congressional Budget Office reported Wednesday that shorter enrollment periods, formula adjustments and paperwork requirements and other changes together would result in millions more people uninsured by 2034 over previous projections.

Between 2021 and 2025, the total number of health insurance enrollments in California increased from approximately 1.63 million to nearly 1.98 million, driven by steady growth in both new enrollments and renewals, with new enrollment rising by 39% and renewals increasing by 19% over the five-year period.

Since 2021, the nine-county Bay Area has seen steady growth in Covered California enrollments through new enrollment and renewals, with total sign-ups increasing across most counties. Overall enrollment in the region rose by 5.9%, from 340,550 to 360,680.

Alameda County consistently led the region, reaching more than 82,600 total enrollments in 2025, up from 72,050 in 2022. Santa Clara County followed closely, with the most significant overall growth in the region — an increase of 15.5%, from 67,840 to over 80,700 enrollees.

New enrollment rose notably throughout the region. Santa Clara County’s new enrollments increased from 9,860 in 2022 to 15,320 in 2025, while Alameda saw a jump from 10,450 to 14,330. Smaller counties like Marin and Napa also experienced steady gains.

Renewals remained the primary driver of total enrollment, accounting for most sign-ups in each county. Alameda, Contra Costa, and Santa Clara counties recorded the highest renewal counts, with Santa Clara rising from 56,940 in 2022 to 65,390 in 2025.

While most counties experienced growth, ranging from 2.8% in Contra Costa to 14.6% in San Mateo, Solano County was the only one to see a slight decline in total enrollment, dropping by 0.6% over the same period.