Decline in ACA Enrollment in Nevada
Enrollment in Affordable Care Act (ACA) plans in Nevada has seen a notable drop of 12.5% since the end of the open enrollment period in January. This decrease is significant—about double what the state experienced last year—and it seems to point to rising rates and reduced subsidies pushing some consumers out.
The trend isn’t isolated to Nevada; it’s part of a larger national decrease in ACA marketplace enrollments, which dropped by 13% in February, approximately 3 million fewer individuals than the previous year. In Nevada specifically, there was a 6% decline from February 2025 to February 2026.
A late June report from the U.S. Department of Health and Human Services indicated that some of this decline might stem from efforts to eliminate fraudulent registrations. However, health analysts believe it’s more likely connected to factors such as the expiration of federal aid that caused premium hikes, making it hard for many to afford their plans.
“It’s clear that real people have lost coverage,” remarked Cynthia Cox, vice president and ACA program director at KFF. She noted the tough situation for individuals who dropped their insurance just as premiums were skyrocketing.
This year, average net premiums for those receiving subsidies increased by $82 from 2025 to 2026, according to Nevada Health Link. While officials are hesitant to identify a single reason for the decrease, they concede that rising costs play a substantial role.
“The expiration of enhanced federal tax subsidies has been the most significant change,” said Jennifer Krupp of Nevada Health Link. She pointed out that many consumers now face additional out-of-pocket expenses.
Experts attribute the initial enrollment decline to higher premiums and a subsequent drop once bills were in hand. Following the 2026 open enrollment period, the 12.5% drop stands out against the smaller 5.7% decline seen after the 2025 period.
According to data from the state market network, most state-run marketplaces are also witnessing a surge in disenrollment, showing a 24% increase compared to March 2025.
During the recent open enrollment, over 104,000 Nevadans enrolled, including more than 20,900 newcomers and over 42,600 who returned to adjust their plans. About 10% opted for the new “Battle Born Province Plan,” a public health insurance option designed to provide more affordable premiums.
This new plan aims to lower costs for all Nevadans and expand coverage options across the state, including with providers like Anthem and Silver Summit Ambetter.
In addition, the Governor’s Market Stabilization Program is set to roll out in 2026, expected to reduce overall premiums by around 7%.
“Without that, we would have faced an even larger increase,” noted Stacey Weeks, director of the state health department, which is working to streamline various health programs and mitigate costs.
“Cost hikes in health care are universal right now… Every market is being affected,” she added.
Rep. Dina Titus expressed frustration towards congressional Republicans for failing to extend important aid last year. She highlighted how the cuts to Medicaid could leave 22,000 additional individuals in her district without coverage. “Nevadans are paying more, getting less, and facing poor health outcomes,” she stated.
But rising costs aren’t the only reason for the enrollment drop; many residents transition to employer coverage, qualify for Medicaid, or relocate out of state. There are also shifts in plan preferences—Enhanced Bronze plan enrollment has increased by 20%, while Silver plans saw a 20% decrease. Catastrophic plans have seen a slight dip as well.
Despite the financial strain, health officials emphasize the importance of maintaining insurance coverage. “It’s meant to shield you and your family from devastating costs in case of a medical emergency,” Davis advised. “As burdens grow, having insurance remains crucial for unforeseen health issues.”
