The open enrollment period in Nevada, and across the country, ended on January 15.
This year's period marked the first time in four years Americans have been unable to leverage the Affordable Care Act's, or ACA's, enhanced subsidies, which Congress allowed to expire at the end of 2025.
Consumer advocates hoped the pandemic-era subsidies that helped many Americans buy health insurance would be restored early in 2026. That, so far, hasn’t happened. The last bill aimed at resurrecting them died in the U.S. Senate late last month.
As a result, health insurance premiums for over 85,000 Nevadans who shop on the state’s ACA exchange, Nevada Health Link, have increased. Now, a month after the end of the open enrollment period, Nevadans are paying their first premium bills of the year.
For many, the cost has gone up substantially — about 26% on average. For some Nevadans, like local independent artist Jerry Misko, it's even more than that; his premium is 111% more than last year.
"I had heard horror stories on Facebook, on the news," Misko said. "People's rates were doubling, tripling, quadrupling — massive increases for people. And mine only doubled, plus a little bit. So, while crummy, I didn't get it as bad as some people. But doubling is a big hit for any freelancer."
He said he could have kept his premiums down by switching insurance providers, but was worried about the practicalities of a new plan.
"It would have been like an 80% increase, but it would have been through some company I've never heard of, with way less coverage, higher deductibles," he said.
Individual experiences like Misko's are indicative of a broader insurance coverage story, which is that Nevada Health Link (the state's ACA insurance marketplace) reported an enrollment decline of more than 5% this year, compared to the 2024-25 period.
"We ended at about over 104,000 Nevadans enrolled in health coverage, and last year was around 110,000. So, we did see some decrease, but it really wasn't as big as we feared," said Katie Charleston, Nevada Health Link's communications director.
"A lot of [the decrease] can be they got a job that they have insurance through now, they're on their spouse's insurance, they they went to the individual market," Charleston said. "There could be a lot of reasons that people come off the exchange."
But, she said, active enrollment, where people log into the marketplace and actively swap plans, was up 32% this year, potentially indicating movement tied to the loss of the enhanced subsidies.
"People may have seen like a hike in their existing premium, and they went back in and were able to find a plan for a better price," Charleston said.
For 10% of enrollees this year, that better price came from the new-to-the-market Battle Born State Plans, which currently boast premiums around 3% cheaper than the average ACA plan.
The Nevada Current's Deputy Editor April Corbin Girnus said these plans, which are the state's first public option offerings, helped to blunt the impact of premium price hikes.
"A state health official said that the introduction of these public option plans actually reduced [the price] of all the plans overall by about 4.6% compared to what they would be," Corbin Girnus said. "They all still raised — to make that clear — all of the plans' prices, but they're not as high as they could have been."
Corbin Girnus noted that, compared to other states, Nevada's enrollment declines are fairly small ... for now.
"North Carolina and Ohio saw drops of like 20% and above. So, huge drops. And there were a lot of states, at least a dozen, that had them in the double digits, 10% and above," she said. "Our decline is less than it could have been. So, that's good news, but it's obviously always something to watch."
