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With a deadline looming next week, officials at the state’s health insurance exchange are urging residents to enroll in coverage for 2018 as uncertainty around federal health care policy continues to swirl.

So far, more than 260,000 people have selected plans or have been auto-enrolled in coverage through the Massachusetts Health Connector. That’s up from about 248,000 who had enrolled as of this time a year ago, Connector officials said.

But tens of thousands of people who buy their health insurance through the state agency are at risk of being hit with huge rate increases unless they shop for a new plan — and many of them have yet to act.

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Massachusetts residents have more time to shop for coverage than residents in many other states: Dec. 23 is the deadline for Bay State resident to enroll in health plans that begin Jan. 1. And residents have until Jan. 23 to select plans that go into effect Feb. 1.

Connector officials have been contacting members through phone calls and letters, and they plan to continue outreach over the next several weeks.

“I worry that members have a hard time being caught up. ... People are busy and it’s holiday season,” said Louis Gutierrez, executive director of the Connector, a state agency that sells plans to individuals, including those who don’t get health insurance through employers.

“People just need to be covered, that’s what we care about,” Gutierrez said.

Massachusetts has the highest rate of health coverage in the country, with more than 97 percent of the population enrolled in public or private health plans, according to federal estimates.

But the state is not immune to national changes in health care. After pushing unsuccessfully for the repeal of the federal Affordable Care Act, the Trump administration in October took aim at a key aspect of that law: it announced that it would stop paying insurers millions of dollars in subsidies that are used to offset the costs of coverage for consumers.

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To make up for the loss of the subsidies, Massachusetts officials set unusually high premiums for popular mid-level plans sold on the Connector. The premiums for those plans will rise an average of 24 percent next year.

Most Massachusetts residents who benefit from federal subsidies also receive tax credits that help protect them from big premium increases. But some 80,000 middle-income state residents were expected to face the full price hikes because they did not qualify for tax credits.

Connector officials are encouraging these individuals to look for more affordable plans, either by shopping around on the Connector, or by leaving the Connector and buying directly from an insurance company.

Members of Congress are considering legislation to restore the federal insurance subsidies, a move that health care advocates and state officials — including Massachusetts Governor Charlie Baker — support. But it’s unclear whether Congress will approve such a measure.

The Baker administration asked federal officials for permission to create a special fund to help offset the loss of insurance subsidies in Massachusetts, but that request was denied.


Priyanka Dayal McCluskey can be reached at priyanka.mccluskey@globe.com. Follow her on Twitter @priyanka_dayal.