Expanded ACA Subsidies Help More Nevadans Get Health Care Coverage

Open enrollment for health insurance plans in Nevada ends on Jan 15. It’s anticipated to be the largest enrollment for plans offered under the Affordable Care Act (ACA) in the state’s history, a development that is happening nationwide.

Nearly three in four people in the U.S. enrolled through the marketplace receive health care coverage that’s subsidized — the highest rate since ACA was implemented, according to the nonprofit Kaiser Family Foundation. 

The Inflation Reduction Act (IRA), passed in 2022, reduced health care premiums for those purchasing coverage through the Silver State Health Insurance Exchange, the state’s public marketplace which enrolls individuals online through Nevada Health Link.

“Nevada Health Link had a record-setting enrollment last year and with the expanded help of the IRA, we look forward to even more Nevadans finding quality, affordable health care for 2023,” Jeffrey Reynoso, the Health and Human Services (HHS) Regional Director who oversees Nevada, said at a press conference in December.

As of Dec. 23, Nevada has over 36,000 people enrolled (11,315 new enrollees and 25,596 active new enrollees – people who had plans the year before and decided to shop around),  a 3% increase compared to last year, according to Ryan High, executive director of  Nevada Health Link.

The IRA also ensures that the expanded and enhanced marketplace subsidies enacted under the American Rescue Plan Act (ARPA), which took effect in 2021 will remain in effect until 2025.

While the federal subsidies have been extended, the state-based exchanges have been on a roller coaster ride based on who is in power in Washington,  and  is watching to ensure Nevadans continue to have access to affordable health care after two years, High said

The public health care marketplace for the state saw record enrollment in 2021 and 2022 after declines in 2020 and 2019. In 2019, U.S. enrollment dipped about 4%, partly because the individual mandate penalty was lifted as part of the federal pandemic response policy, and also because short-term plans presented as alternatives to the marketplace expanded, according to Nevada Health Link.

Enrollment increased in 2021 when more than 17,000 people got health care during the COVID/American Rescue Plan enrollment window, which continued through Aug.15, 2021.

In 2022, enrollment hit record highs nationally and in Nevada, when 101,411 people signed up for coverage during open enrollment in the state, aided by ARPA’s subsidy enhancements, according to Nevada Health Link.

In addition to expanded subsidies, the state offers more plans than in previous years.

Nevada Health Link now offers a total of 163 plans. Through 2022, there were only 127 plans offered, an increase of 100 from 2020, where Nevadans had 27 plans to choose from.

Those savings, through the ARPA/IRA subsidies, amount to an average of $4,494 for a middle-class family of four in Nevada, according to Nevada Health Link.

“The more enrolled we see, the healthier Nevada is,” said Katie Charleson, the communications officer at Silver State Health Insurance Exchange.

The marketplace subsidies not only make accessing health care coverage more affordable, but they also underscore and expand one of the key selling points of the ACA — allowing Americans to have more freedom to choose plans that aren’t tied to their job.

Jason Karsh is a photographer and marketing consultant who brought health care through Nevada Health Link for about seven years.

“Part of the reason I am able to work for myself is because I am able to get health insurance on my own, I’m not tied to a job, I’m not looking to be stuck to something that I don’t want because I have to get it through my employer,” he said during a Silver State Health Insurance Exchange press event.

Before the ACA, individuals often struggled to find insurers willing to offer them individual plans, and when they did, those plans could be prohibitively expensive.

The ACA made health care for individuals not only accessible but affordable, Karsh said.

“A Lamborghini is technically accessible if you have the money,” he said. “Health care shouldn’t only be accessible, but affordable and everyone should have the choice to have health care.”

While more people are getting access to health care than ever before, systemic barriers are still making it harder for some populations to get coverage.

Americans who have a high school education or less, are Hispanic, live in rural areas, or lack internet access at home are disproportionately underrepresented in the subsidized marketplace plans despite being eligible, according to the Kaiser Family Foundation.

A recent HHS report shows that increased funding by the Centers for Medicare & Medicaid Services (CMS) for outreach and ARP subsidies expanded coverage for populations that were historically un- and under-insured.

“We’re closing the gap but we know there’s more work to do, we’re excited to partner with Nevada Health Link, their navigators, and other leaders on the ground to spread the word out in language and culture,” Reynoso said at the press conference.

Coverage will start in February for individuals who enroll in January.


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