It’s one month into the sign-up period for the Affordable Care Act, and the number of Iowans who have signed up for health insurance is much higher than at this time last year.

Near the end of November 2016, about 12,099 Iowans had signed up. This year, 17,525 Iowans signed up for health insurance in the same time frame.

"We’ve seen major differences this year," says Nicole Kock, a navigator specialist with Visiting Nurse Services in central Iowa. "Our enrollment has doubled over the numbers during the same period of time last year."

Kock says that has been a pleasant surprise after budget cuts to ACA advertising and sign-up assistance programs, and multiple attempts to change the health care law earlier this year.

That uncertainty led the one insurance company left on Iowa’s Affordable Care Act marketplace to raise its premiums for 2018, but more Iowans may find they can get a health plan without paying any premium at all.

Higher health insurance premiums translate to higher subsidies for Iowans who qualify for government assistance.

Kock says it’s much more common this year for Iowans to get a zero-premium health plan through Obamacare.

"Even though it might be a high-deductible health plan and a low percentage of coverage for that bronze level plan, if it’s free, that is really helpful for families and individuals to be able to afford that," Kock says.

She adds this year has been very hard for people who don’t qualify for subsidies. The Iowa Insurance Division has estimated about 20,000 people will drop health insurance.

The open enrollment period ends Dec. 15.