Open enrollment has begun for people looking to change their health insurance plans.
But with the Affordable Care Act's individual mandate gone, it's no longer necessary to carry health coverage.
If the pool of insured people shrinks, what does that mean for health insurance in Nevada?
"It's a tough question to answer," Heather Korbulic, executive director of the Silver State Health Insurance Exchange, told State of Nevada.
Korbulic said they don't anticipate too many people choosing not to get coverage because they no longer face a tax penalty.
"We don't think it will be a really big impact -- that's because most people are accessing insurance now because they actually need it," she said.
Korbulic said the exchange has spent a lot of time in their advertising targeting people who are the most likely to forgo insurance because they are younger and relatively healthy.
She said they're trying to highlight how much health care costs if you don't have insurance.
It is not just the elimination of the individual mandate that has Korbulic and others in health insurance worried. The Trump administration now allows people to sign up for short-term, limited health care plans.
Nevada law prevents people from using those kinds of short-term options, and Korbulic's team is trying to get the word out.
"We want to make sure that Nevadans know that you need to get qualified health plan on the exchange for long-term coverage," she said.
Nevada's rural counties have had particular trouble when it comes to health insurance, but Korbulic sees signs that things are improving.
"Now that we are seeing some stability, I think there is a likelihood in the years after that we would see some increased competition across the state -- not just in the rural areas," she said.
The problem in areas with a smaller population is that insurance works on volume. A large and diverse population of people is needed to cover everyone.
Rural counties just don't have that kind of population.
Korbulic said the exchange and the governor's office are looking for more options for those rural areas.
One of the most frustrating parts about getting people to sign up for health insurance is some of the rhetoric coming out of Washington, D.C., Korbulic said.
She said people feel like their benefits have gone away or they can't sign up for health insurance, both of which are not true.
Korbulic would like to see changes made to the Affordable Care Act to address some of the problems it has.
"The ACA is not perfect and we need to do improving policy work on it, and it is time that we start having those conversations," she said.
Until that happens, the Silver State Health Insurance Exchange will continue to manage the health care options for people.
To see those options, go to nevadahealthlink.com.
Heather Korbulic, executive director, Silver State Health Insurance Exchange
