Spurning President Obama's plan for canceled policies, California's health insurance exchange voted against any extension for about 1 million policyholders in the state.
The five-member board of the exchange voted unanimously to keep its current requirement that insurers terminate most individual policies Dec. 31 because they don't meet all the requirements of the Affordable Care Act.
The decision ends a weeklong drama over what would happen for policyholders who will lose their existing coverage at year-end and face finding replacement insurance that may cost them substantially more in many instances.
Covered California, the state exchange, considered allowing renewals into 2014 as Obama proposed or a short-term extension through March to give people more time to shop.
But state leaders ultimately rejected those options. They expressed concerns about further confusing consumers and worried that widespread renewals could keep too many healthy customers out of the broader risk pool that will shape future rates.
"We know this transition is difficult and some people will be hurt," said Covered California board member Susan Kennedy. "But delaying the transition won't solve a single problem."
The state did agree to open a special hotline for affected consumers and look into postponing the deadline to sign up for coverage starting Jan. 1.
The vote by the state exchange marks a break with the president since California has been a strong supporter of the Affordable Care Act. Some other Democrat-led states, such as Washington and Minnesota, have also rejected the president's idea on cancellations.
Obama's plan last week came in response to a public uproar over millions of consumers nationwide losing their coverage.
Also, Covered California said 79,891 people have enrolled in private health plans through Tuesday. The state has outperformed the troubled federal exchange, which has struggled with an error-prone website and meager enrollment.