By Tom Murphy, AP Health Writer

Higher prices, less help and a government shutdown all hang over health insurance markets as shoppers start looking for coverage this week.

The annual enrollment window for people to pick an individual plan opens Saturday in Nevada, where shoppers can use Nevada Health Link, and nearly all other states. A heavy dose of politics weighs on this year's search.

The federal government shut down earlier this month as Democrats in Congress demanded negotiations to extend enhanced tax credits that have helped people buy coverage the past few years. Republicans say they won't negotiate until Democrats vote to reopen the government.

Stuck in the middle are insurance customers, many of whom will be facing the biggest premium hikes they've seen in years and may be forced to consider changing plans.

“It seems overwhelming, but it really is important to shop and consider your choices,” said Sara Collins, an insurance expert with the Commonwealth Fund.

Here's how shoppers can respond:

The first deadline is in 6 weeks

Shoppers will have until Jan. 15 in Nevada and in most other states to find a plan for 2026, but have to make their choice by Dec. 15 if they want coverage starting New Year's Day.

This is the main chance people with individual coverage have every year to find a plan for the next year. More than 24 million people enrolled in individual plans for 2025, according to KFF, which studies health care issues.

People can buy a new plan with help from income-based tax credits through insurance marketplaces set up in every state. Former President Joe Biden's administration beefed up that help with enhanced tax credits during the COVID-19 pandemic. Those are set to expire this year unless Congress works out an extension.

Last year, nearly 95,000 Nevadans, or approximately 86 percent of people enrolled through the state marketplace, received enhanced subsidies. 

Shoppers also can find options outside these marketplaces — sometimes for a lower price — but they won't get tax credit help.

You may see price hikes

KFF has said that premiums, or the cost of coverage, will jump around 20 percent next year on average. But the expiring tax credits could cause coverage costs to more than double for some.

Rates submitted by health insurers in September indicate that premiums for the individual market in Nevada — which includes the Nevada Health Link marketplace and all non-employer health insurance coverage — will increase by an average of 26 percent, or $147 each month.

Insurance has become more expensive because care costs are rising, a big worry for Americans. Insurers also set prices assuming the extra tax credits would expire — and that healthy people who paid little for coverage in 2025 might not return because of that.

The higher prices aim to make up for that lost revenue, said Karan Rustagi, a Wakely Consulting Group health actuary who works with insurers.

The higher prices may not change even if Congress restores the enhanced tax credits before the enrollment window ends. It can take insurers weeks to complete rates with regulators and then update their systems and customer handbooks, Rustagi noted.

What you can do

Shoppers can get a sense for their options by checking their state marketplace. In Nevada, that’s nevadahealthlink.com.

Collins said people should start there, not Google. Search engine results could connect you with someone selling more limited, short-term insurance.

Fill out the application for tax credit help first, said Joshua Brooker, a Lancaster, Pennsylvania-based independent insurance agent.

That will tell you whether any help is available to you now. That assistance will automatically be updated if the enhanced tax credits are renewed.

"Doing that first application is not lost time," he said.

Then pick a plan. Look beyond the premium. Consider any deductibles you may have to pay, what doctors or hospitals are in the insurer's network and how any prescriptions would be covered.

Don't wait to see whether the extra tax credit debate is resolved. That may not happen during your enrollment window. If it does, you can revisit your choice.

“You do have a mulligan,” Brooker said.

Agents say many people procrastinate on insurance shopping. That can make it tougher to find help as sign-up deadlines approach.

“I have people every year either wait until the very last day to enroll or they miss the deadline entirely,” said Shayla Teague, an insurance agent based in Anchorage, Alaska. “Make sure you have something in place, ready to go.”

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