Fears of a sharp enrollment drop in Nevada’s Affordable Care Act marketplace didn’t play out. State officials said signups held mostly steady, even as premiums rose and federal subsidies expired.
After open enrollment closed Jan. 15, 2026, more than 104,200 Nevadans selected coverage through Nevada Health Link. The total marked a 5.5% decline from the prior year.
Officials described the drop as modest, given the broader pressure on household budgets.
Janel Davis, executive officer of the exchange, said enrollment trends remain durable. She pointed to steady growth since the marketplace launched in 2013 and shifted to a fully state-run model in 2019.
Nevada reached a high point in 2025, with more than 110,000 people enrolled, an 11.5% increase from 2024. This year, about 10% of signups went to the state’s new public option, branded as Battle Born State Plans.
Other states tell a rougher story. Early data from the State Marketplace Network showed disenrollments rising 83% in Colorado, 49% in Maryland, and 47% in Minnesota.
California enrollments tracked 31% below the same point last year. The report also found buyers shifting toward lower premiums with higher out-of-pocket exposure, a trade-off that often breaks once bills arrive.
Concerns about enrollment surfaced late last year as health care costs climbed and enhanced federal tax credits expired at the end of 2025. Congress, under Republican control, showed little appetite to renew them.
Those credits expanded eligibility beyond the 400% federal poverty threshold, about $130,000 for a family of four, and boosted aid for existing enrollees.
Their expiration followed a bruising budget standoff. Early figures show average marketplace premiums nationwide doubled compared with 2025.
Davis said subsidies didn’t disappear entirely. Roughly 8 in 10 Nevada enrollees still receive some form of financial help. The state’s uninsured rate now sits between 10% and 12%, roughly half the level seen before Medicaid expansion.
More shoppers engaged actively this year. Davis said active enrollment rose 32%, meaning more people compared plans rather than auto-renewing. Those who switched saved an average of more than $280 a month.
Attention now shifts to February, when first bills arrive. Davis said exchanges across the country expect some attrition as costs hit home. She said Nevada officials remain alert.
The new public option accounted for 10,762 enrollments. The plans stem from 2021 legislation building on ACA rules, requiring full essential benefits and premium reduction targets. Nevada became the third state to launch a public option, following Colorado and Washington.
Initial projections estimated 35,000 signups. Health Authority Director Stacie Weeks said those forecasts relied on outdated data and missed inflation.
She pointed to a 26% average cost increase across the individual market for 2026. Against that backdrop, she called a 10% share a solid start.
Weeks said the plans met cost-reduction goals and benefited from a new state reinsurance program cushioning the market. Combining both policies, she said, worked better than expected.
Health authority administrator Jennifer Krupp said Battle Born signups came from active shoppers competing against auto-renewals. She said those consumers tend to stick with coverage and understand their benefits.
Open enrollment closed, though access didn’t. Davis said people experiencing qualifying life events still enter special enrollment windows.
About 70% of recent signups received help from certified brokers or navigators, free of charge, both in person and online.
