Nevada Health Link premiums expected to rise 26 percent for 2026

By April Corbin Girnus

Nevada Current

Nevadans who get insurance through Nevada Health Link, the state’s Affordable Care Act marketplace, are facing premium rate hikes of 26 percent, the state Division of Insurance confirmed to the Nevada Current.

The average approved rate increase of 26 percent is significantly higher than the 17.5 percent average proposed increase announced by the Nevada Division of Insurance in late July.

The July estimate was based on preliminary filings, according to the division, and has been adjusted upward by carriers because of “rising medical costs and prescription drug spending, increased medical utilization and a less healthy risk pool, Medicaid unwinding and the expiration of enhanced federal premium subsidies.”

Regulatory changes related to the Centers for Medicare & Medicaid Services’ Marketplace Integrity and Affordability Rule are also driving up premium costs, according to the division. Among several revisions in the rule is one addressing how premiums are adjusted, which is expected to raise the costs of not only premiums but also out-of-pocket costs.

“These factors are not unique to Nevada,” a spokesperson for the division noted, “similar increases are being reported nationwide.”

For most ACA enrollees, the overall premium rate hike will be compounded by the loss of enhanced federal subsidies that brought down their out-of-pocket premium costs. These subsidies, according to health policy analysts at KFF, increased the amount of assistance received by enrollees already receiving subsidies and qualified middle-income people for tax credits.

The enhanced federal subsidies expire at the end this year and are a key sticking point in a political showdown between Republicans and Democrats that has resulted in a federal government shutdown.

KFF estimates the vast majority of ACA enrollees nationwide receive the advanced premium tax credit.

Nevada Health Link has said that 9 out of 10 enrollees receive a federal subsidy that brings down the cost of their premium. Approximately 110,000 Nevadans get their health insurance through Health Link.

Nationally, 24 million people get health insurance through the ACA.

Keep Americans Covered, a coalition of health care providers, insurers, and customers, has estimated 85,000 Nevadans will lose the enhanced subsidy. KFF estimates the number higher at 94,500.

Nevada Health Link in a statement to the Current acknowledged that health care premiums across the country are rising but added that “the cost of going uninsured can be devastating.”

The statement continued: “We encourage Nevadans to come to NevadaHealthLink.com to see your actual price after savings, compare plans from multiple carriers and get free, local help from licensed brokers and navigators; don’t assume that there are not affordable options just because the average plan price is increasing.”

The marketplace includes eight health insurance carriers and 140 qualified health plans, according to a news release from the organization. Thirteen qualified dental plans through four insurance carriers are also offered.

The average approved premium increase by carrier was not available on the Nevada Division of Insurance’s website as of Thursday afternoon. A spokesperson said the division was experiencing a “technical malfunction” but expected to post the information on Friday.

Heath Link will hold more than 20 community events across the state in October where Nevadans can discuss their options.

Open enrollment will begin Nov. 1 for coverage beginning Jan. 1. The open enrollment period ends Jan. 15, according to Health Link’s website.

Political battle

The federal government shutdown, which began early Wednesday, appears to be a result of a deep divide between Republicans and Democrats on health care policy.

Democrats have said Republicans refuse to negotiate on health care, which they have indicated is their priority issue. They have focused on the expiration of ACA premium subsidies.

On Tuesday, Republicans introduced a stopgap funding bill that did not include an extension of the premium credits. All but two Democrats (and one Independent who typically votes with Democrats) voted against the bill.

U.S. Sen. Catherine Cortez Masto was one of the Democrats to support the bill. (U.S. Sen. John Fetterman of Pennsylvania was the other.) In a statement defending her vote, Cortez Masto said she did not want to hurt federal government employees.

“We need a bipartisan solution to address this impending health care crisis, but we should not be swapping the pain of one group of Americans for another,” she said.

U.S. Sen. Jacky Rosen, on the Senate floor hours before the federal government shutdown began, took a markedly different stance from her colleague.

“Nevadans sent me here to fight for them, not to cave and let Washington Republicans take away their ability to go to the doctor and get your medication,” she said. “Everyone should have access to affordable, quality care.”

Rosen defended the ACA premium credits.

“This is not a handout, it isn’t welfare,” she said. “It’s just a tax cut that helps lower the cost for nearly 95,000 Nevadans so they can afford to buy an insurance policy. So they can go to the doctor when they’re sick and go to the pharmacy to get their medication for a copay. So they can just afford their insurance…”

U.S. Rep. Susie Lee in press conferences and statements has expressed similar sentiments and emphasized the importance of addressing the issue immediately because of the open enrollment timeline.

Meanwhile, the National Republican Congressional Committee is running ads accusing Democrats of shutting down the federal government “in order to give illegal immigrants free health care.”

Undocumented immigrants are not eligible for ACA marketplace plans, whether subsidized or not. Similarly, they are not eligible to enroll in Medicaid.

Medicaid does reimburse hospitals for some emergency care provided to undocumented immigrants, but that spending is less than 1 percent of overall Medicaid spending, according to KFF. Emergency services entail care that prevents death, serious harm or disability.

Nearly half of states provide prenatal and pregnancy-related care to undocumented immigrants through the Children’s Health Insurance Program, known as CHIP. Nevada is among them.

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April Corbin Girnus is an award-winning journalist and deputy editor of Nevada Current. A stickler about municipal boundary lines, April enjoys teaching people about unincorporated Clark County. She grew up in Sunrise Manor and currently resides in Paradise with her husband, three children and one mutt.