Nevadans have until Dec. 31 to shop for health coverage through the Affordable Care Act open enrollment period.

Katie Charleson, communications director for the state's online insurance marketplace, Nevada Health Link,

Katie Charleson with the state's online insurance marketplace, Nevada Health Link, said if people enroll by the end of the year, their coverage will start Jan. 1. If Nevadans are unable to meet the deadline and enroll between Jan. 1 and Jan. 15, their coverage will begin Feb. 1.

Charleson added eligible Nevadans will be able to continue to save thousands of dollars on health care because of the Inflation Reduction Act's enhanced premium tax credits. Nearly 97,000 Nevadans are currently enrolled in health insurance through Nevada Health Link.

"Time to get enrolled is now," Charleson urged. "Open enrollment is happening now through January 15. Check us out. It's a lot more affordable than it has been in the past. Extended subsidies are still happening."

Charleson pointed out subsidized plans are ideal for those who do not qualify for Medicare or Medicaid benefits, do not have employer-sponsored coverage or are independent contractors. She added those under DACA, asylum-seekers and other noncitizens with work authorization permits may also qualify.

Nevada Health Link is not considered a public charge, which means all personal information is protected and will not be shared with law enforcement. The program has assisters, offering free help in multiple languages over the phone, online or in-person.

Dr. Jeffrey Reynoso, Region 9 director for the U.S. Department of Health and Human Services, said approximately 86% of Nevadans currently covered are paying an average of $3.50 a day for coverage. He contended the small expense is worth the peace of mind it can bring Nevada families.

"When you really think about it, I know for me, that is less than my cup of coffee this morning," Reynoso noted. "Thanks to the Biden-Harris administration and the Inflation Reduction Act, the financial help still exists for all of you in 2025 but the clock is ticking to get covered and take advantage."

If Congress does not take action to extend the savings, an estimated nine in 10 Nevadans who obtained coverage through Nevada Health Link will see their premiums increase by $700 per year, according to a report from the Center on Budget and Policy Priorities.


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A coalition of Montana groups will rally at the Capitol Wednesday to advocate for the protection of Medicaid expansion, which legislators will debate this session before the program's scheduled expiration in June.

The state's 10-year-old Medicaid expansion program covers 75,000 low-income Montanans at an annual cost of about $1 billion, according to KFF Health News. The state picks up about 10% of the tab.

Kristen Stewart of Billings is a caregiver for her 90-year-old grandmother, and enrolled in Medicaid herself. As an organizer with the advocacy group Big Sky 55+, she noted many Medicaid enrollees work but the work is often undervalued.

"Medicaid supports a lot of people who are doing unpaid work," Stewart pointed out. "Things that were we to monetize, you would see an economic boost from their production level, often more than the cost of their care."

The Gianforte administration already tightened eligibility for the program, cutting the number of enrollees by nearly 40% between May 2023 and October 2024. The program currently covers nondisabled adults ages 19 to 64 who make less than $21,000 a year.

Jeannie Brown, a bus driver for the Belgrade Public School District and a full-time caregiver and legal guardian for her teenage granddaughter, said if Medicaid expansion does not get reauthorized, she will be on a "slippery slope."

"Because I'm 60 years old and I'm having my own health issues after being a caregiver, it's hard work and it takes a toll on you physically, financially and emotionally," Brown explained. "I'm hoping these legislators really take all of these things into consideration and reauthorize it."

Any laws passed on the issue could also affect the state's behavioral health services, which Gov. Greg Gianforte has made a priority.

Obtaining medical records can be a costly endeavor but there is hope Washington state lawmakers could find a fix this session.

Medical providers look for compensation when producing medical records because of the work involved in the process.

Holly Brauchli, an attorney at Seattle Injury Law, said an outdated process is used to determine the cost. Federal law requires all records to be digitized and Brauchli pointed out providers charge per page as if the records were on paper.

"We download it and we get a bill for thousands of dollars and the justification of that bill is that there's a per page charge," Brauchli explained. "I get these invoices that say copying charge per page. There are no copies."

Brauchli noted there are a variety of reasons why someone would want to obtain their medical records. For instance, the records could be important to an injury lawsuit or someone might want to check if their health insurance was billing them correctly.

Brauchli argued records should no longer be charged as if they are on paper.

"This seems like a really easy fix and certainly one that would help Washington citizens," Brauchli contended. "People have a right to know what's in their medical record and they have a right to be able to see it. So, to me, it's a really simple and elegant fix."

A bill has not been filed yet but is expected from Sen. Tina Orwall, D-Des Moines, soon. The 2025 legislative session starts today.

This Wednesday is the deadline to enroll in Affordable Care Act marketplace health coverage.

Advocates say this year is even more critical for those seeking a plan, because the expanded tax credits that allowed many Kentuckians to enroll in health coverage - at little or no monthly cost - are set to expire at the end of this year.

After Jan. 15, folks will have to qualify for a special enrollment period to take advantage of Advanced Premium Tax Credits while they still exist.

Priscilla Easterling, director of outreach and enrollment with Kentucky Voices for Health, said the state's uninsured rate could potentially increase if families can't afford coverage without the credits.

"I think we should all be very concerned," said Easterling. "Without these enhanced premium tax credits being extended, we're going to see enrollment drop off, because families will no longer be able to afford that monthly premium."

According to research from the Robert Wood Johnson Foundation, the elimination of expanded tax credits would especially impact older adults - who tend to have higher health coverage costs.

In 2024, people over age 50 made up more than one-third of total ACA enrollment.

Easterling said in many cases, for low-income individuals making around $22,000 per year, the credits covered the full cost of their plan, and have saved Kentuckians thousands of dollars a year.

"They have been around for the duration of the ACA," said Easterling, "but the enhanced part that was first expanded in 2021. They have, on average, saved most households over $500 per month."

Easterling said residents can find local experts at kynect.gov to help them take advantage of tax credits and find the best plan for them.

"There are 'kynectors' available in all 120 counties," said Easterling, "who can help and provide free assistance for anyone who needs help navigating Kynect.gov or trying to get enrolled in coverage."

During 2024, more than 71,000 Kentucky residents enrolled in a plan through the marketplace, according to the health advocacy group KFF.

Nationwide, a record 24 million people have signed up for insurance coverage through the Affordable Care Act, according to federal data.