As ACA Enrollment Opens and Premium Surges Loom, Nevadans Share Their Stories

NEVADA - On Saturday, Nov. 1, open enrollment for health plans offered on the Affordable Care Act (ACA) exchanges will begin. However, it comes after Congress ended ACA tax subsidies this summer, a move expected to more than double the average premium for such plans, according to an analysis by KFF.

Facing these surging costs, four Nevadans who provide or receive health care subsidized by the now-ended ACA tax credits, shared their stories:

Katie P. LMSW, Therapist Intern, issued the following statement:

“Over the past decade, I’ve had the privilege of serving our community in a wide range of settings — from inpatient mental health and managed care, to crisis response during the Route 91 Harvest Festival, and hospital social work through the COVID-19 pandemic. For the past two years, I’ve been working as an independent contractor while completing my LCSW internship. I’m also a single mother to my *almost* 4-year-old daughter, Charlee. I’m her only provider, responsible for every expense — from daycare (which costs $240 a week), to food, clothes, activities, and, most importantly, healthcare. Currently, I purchase our health insurance through Nevada Health Link. The plan I chose with HPN costs $592.63 per month — but thanks to the Enhanced Advanced Premium Tax Credit (E/APTC), my monthly premium is reduced to $85.12. That’s a savings of $507.51 every month. Without that support, coverage for my family would simply not be possible.

Right now, the EPTC, or as we know it in Nevada, as APTC, is set to expire on December 31st. At the same time, HPN is seeking a 20% rate increase for 2026. My projected premium without the credits is $745. As a working parent on a modest income, there’s just no feasible way to absorb that increase. My budget is already tight. Like many families, I’m facing rising housing costs, climbing grocery prices, and higher childcare expenses. Losing this tax credit would push me — and thousands of other working families — into an impossible position: choosing between healthcare and basic needs.

As a social worker, mother, and community member, I see firsthand how access to affordable healthcare stabilizes families, supports workforce participation, and reduces long-term costs to our social systems. These credits are not just numbers on paper — they’re the reason families like mine can stay healthy, stay employed, and continue contributing to our communities. Lawmakers must fight to ensure families, like mine, have access to the subsidies so we can continue accessing affordable healthcare.”

John Tierney, Vice-Chair, Institutional Advisory Council, Great Basin College NSEA Legislative Ambassador issued the following statement:

“In 2016, I was the Nevada State Teacher of the Year, and in 2017, I was an NEA Global Fellow for China. I retired from the classroom in 2017 after 34 years in the classroom. Last year, my wife and I saw our health insurance rates jump from almost $7,000 per year to $20,000. I am on Medicare with a supplemental policy, but my wife is not eligible for Medicare until next year. I have changed my supplemental policy to something more affordable. My wife is currently uninsured because of the inflated cost of a policy for her. We have already made plans to divorce should anything catastrophic happen to her, so we would not incur financial ruin. This would end more than a quarter-century of marriage. This is an unimaginable choice that too many of us face in the current health care system, which rewards profits over affordability.

I urge our lawmakers to consider this as an occurrence afflicting many people of my age and financial status in the Silver State. No one should face bankruptcy or ill health because they cannot afford health insurance in the wealthiest country on earth. Our representatives in Congress have excellent policies as part of their remuneration, paid by constituents. As Gandhi stated, “It is health that is real wealth, and not pieces of gold and silver.” We would all be smart to take this quote to heart as we push for a health care system that is more equitable and accessible.”

Rana Youssef, ACA Tax Credit Recipient, issued the following statement:

“Receiving the enhanced premium tax credits has given me access not only to quality healthcare but also to a better future. I moved to Nevada to attend Roseman University, and I’m preparing to graduate. Upon graduation, I will serve our community as a frontline healthcare worker. I know firsthand how essential affordable healthcare is to families. I was raised in Tennessee, where my father owns a small mechanics shop. Over the past decade, rising insurance prices made it difficult for our family, and many others like us, to maintain coverage.

As a young first-generation immigrant and college graduate, I learned about the tax credits in 2023 after five years of going without insurance. Even though I worked in healthcare for several years as a medical assistant, I had no idea enhanced peremium tax credits existed or that I qualified for them since my employer did not provide health insurance. When I moved to Nevada, obtaining health insurance was a requirement for school, but without the enhanced premium tax credits, I wouldn’t have been able to afford it. These credits helped me get healthcare, but they also made it possible for me to pursue higher education and a career dedicated to serving others.

We all become patients at some point, and we all need access to affordable, quality health insurance, as it is critical when you receive your medical bill after a hospital stay or a procedure. Coming from a working-class family, I know how much every dollar means. I’ve seen firsthand how difficult it can be to receive care. Hardworking Nevadans should not have to choose between the rising costs of housing, electricity, and transportation, and, if you're like my family, deciding whether you can send your kids to college or afford to provide healthcare for them too. All of these are necessities, not luxuries. Affordable healthcare doesn’t just save lives, it builds futures!”

Katlin Steph, ACA Tax Credit Recipient, issued the following statement:

"Currently, I pay $340 a month for health insurance. My husband and children are on a separate plan, and we pay $64 per month for all four of them. I cannot fathom having to pay over $400 a month for all five of us. If our costs rose, we would not be able to afford health insurance. Our current prices are based on the ACA tax credit. Because of the credit, we are able to afford things to ensure our kids have a fun, good life. Without it, we would have to sacrifice health insurance or the things that allow our family to have a good life. I do not want to sacrifice either one, but we simply cannot afford both."

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