GREAT BARRINGTON — With health insurance premiums skyrocketing and confusion growing over federal subsidies, Berkshire health officials are urging residents to act now, ask questions and seek free help before open enrollment ends.

While the federal boost for middle-income earners is ending, most people who get coverage through the Massachusetts Health Connector will still have access to subsidized insurance. Local programs can also help residents compare plans and understand any changes before the Jan. 23 open enrollment deadline.

The confusion stems from the ongoing government shutdown, now the longest in U.S. history, which centers on whether to keep enhanced federal subsidies, known as premium tax credits. Those subsidies, expanded during the pandemic, reduce what many Americans pay for coverage through the Affordable Care Act.

A doctor looks into the ears of a young patient at CHP Berkshire Pediatrics. Community Health Programs Berkshires CEO Bethany Kieley recommends asking questions after receiving health insurance renewal information and shopping around for cheaper premiums if necessary.

Congress is split mostly on party lines, with Democrats wanting to extend the subsidies, arguing that millions could lose affordable coverage and see premiums spike, while Republicans say it’s too expensive to extend without offsetting spending elsewhere.

A bipartisan group of 60 senators voted in favor of a bill to end the shutdown without a guaranteed extension of subsidies, but it does give federal workers who were laid off during the shutdown their jobs back and provide those who were furloughed back pay.

As the shutdown continues, the bill now goes to the House of Representatives, where many Democrats, including U.S. Rep Richard Neal, D-Springfield, have said they are not in favor of the bill as it doesn’t address the core issue of affordable health care.

“[Republicans] sprinted to extend their tax giveaways to big corporations and billionaires, and now, when it comes to keeping health care affordable for millions, the Republican record of failure is all they have to offer,” Neal said in a statement to The Eagle. “A principled deal was possible, but ignoring the reality of skyrocketing costs doesn’t earn my vote. It’s just another day in Trump’s economy for workers and their families, and for that, I cannot support it.”

Gov. Maura Healey was also critical of the Senate bill, arguing lawmakers are caving after a shutdown that included a loss of SNAP benefits and other critical federal programs for families, federal workers being laid off and major flight disruptions.

“Now we have a situation where nothing has been done to prevent people's health care costs from skyrocketing,” Healey said during a press conference on Monday. “It's total dysfunction down in Washington, D.C., and we need the president and Republicans in Congress to come back to work and make sure that there is a vote to extend those health care subsidies for at least another year.”

Gov. Maura Healey speaks at a press conference in her office on Monday about SNAP benefits and rising health care premiums.  “Frankly, this is a disaster. It's coming at a time when people can least afford it," she said.

The impact of subsidies is already being felt across the country, as residents see “skyrocketing” health care premiums for next year, Healey said.

“I don't know how Americans and people in Massachusetts are going to be able to afford these just budget-busting, skyrocketing health care costs,” Healey said. “Frankly, this is a disaster. It's coming at a time when people can least afford it.”

Jason Cuddihy, the program manager for the Berkshire Health Service Advocacy for Access Program, said it’s important that residents not get tangled up in the jargon and panic.

Massachusetts’ own system, the Health Connector, offers additional subsidies that help buffer residents from federal policy shifts — though prices are still rising, but not to the same extent.

“The majority of individuals that live here and that we assist are on one of the subsidized ConnectorCare Plans,” Cuddihy said. “So those high-cost plans that you hear about in the news really aren't applicable to us.”

Community Health Programs Berkshires CEO Bethany Kieley said premiums will be going up for most people, but the amount is unique to that individual. She recommends asking questions after receiving renewal information to see if there is a better option.

“How do you afford your health care while also covering all the other obligations life throws at us?” Kieley said. “Call the Health Connector. Really be sure there are no other options available.”

Berkshire Health Systems is reminding patients that while the federal boost for middle-income earners is ending, most people who get coverage through the Massachusetts Health Connector will still have access to subsidized insurance.

The best thing people can do is be as informed as possible and make decisions before open enrollment ends, as this is when the most options are available.

“If people are forced to choose to give up their coverage, be sure they understand what that means, knowing that there are some tax implications, and again, if they still forgo insurance, call their doctor, call CHP, be sure there aren’t some lower-cost and other options available to support them,” Kieley said.

Healey called on the federal government to “act immediately” to extend subsidies and said her administration will continue to put pressure on the government to extend tax credits for at least another year.

“This is the result of a decision and a choice that Donald Trump and Republicans in Congress have made, putting their own political agenda over the needs of their constituents," Healey said, "and at a time when the president and folks in Congress should be doing all they can to drive costs down, they are driving costs up.”

Though Kieley said everything right now is up in the air, she thinks in the future major subsidies could return.

“I still hold out hope that subsidies may come back, but I think the agreement reached makes that pretty unlikely for Jan. 1, and that would be more of a long-term hope, rather than any likelihood that it will happen for January,” Kieley said.

CHP and BHS both said they are continuing to see patients regardless of financial status.

“Berkshire Health Systems is continuing its commitment to serve anybody in the community that needs health care services, regardless of their ability to pay,” Cuddihy said. “No matter what is happening in Washington, we maintain that commitment, and that's not going to change.