CARSON CITY – Doctors, hospitals, insurers and business groups led opposition in a Senate committee on Tuesday to a proposal that would create a public health insurance option in Nevada, warning about impacts on the quality, accessibility and availability of health services in the state – exactly what the defenders affirm that the measure will improve.
The debate is over Senate Bill 420 Tuesday, therefore, pitted much of the state’s health facility against progressive advocates who say the existing system fails with the estimated 350,000 Nevada uninsured residents who are in need of coverage. Supporters have repeatedly noted that Nevada, despite expanding Medicaid under the 2010 Affordable Care Act, still has the seventh highest rate of uninsured residents among states, and is at or near the bottom place among states in terms of accessibility and health outcomes.
The project, which will be changed, would seek to leverage the purchasing power of the health system supported by the state’s Medicaid. Insurers vying for a portion of the state’s Medicaid managed care contracts would be required to offer a low-cost health insurance option available to individuals and small businesses. Existing health plans for large companies and employers would not change.
It would be financed by federal awards and grants, going into effect in 2026 after several years of data collection and adjustments. The project would also expand Medicaid services to more pregnant women and their families, increasing income eligibility.
Tipping the scale
But opponents said in testimony to the Senate Health and Human Services Committee that the introduction of a low-cost plan would inevitably tip the balance in the insurance market, leading to higher health costs in other segments. It can also lead providers, doctors and other health care providers to leave the state entirely, opponents said.
The proposed public option “will not work for Nevada’s unique healthcare environment,” said Connor Cain, a lobbyist who speaks for the Hospital Corporation of America and several hospitals in the Las Vegas area. He added that the plan “would almost certainly reimburse you at a much lower rate” than market-based plans.
“If we really want to expand insurance coverage, we, as a state, must ensure that everyone who would otherwise qualify for coverage is eligible for Medicaid,” said Cain.
Disregarded study idea
The hearing lasted nearly two and a half hours. Instead of the bill, opponents suggested an actuarial study to examine the target population without insurance and their needs.
The suggestion drew a slight contempt from the proponents: The issue of the public option has been one of the most studied issues in the Chamber of Deputies. A bill creating a public option was passed by the Legislature in 2017, but was vetoed by the governor, and a study authorized in 2019 and released in January gave rise to the current proposal.
“We know who the people who are not insured are, and now the question is what should we do to try to make them insured,” said Senate majority leader Nicole Cannizzaro, D-Las Vegas, the project’s main sponsor.
She noted that the proposal would reduce the costs that arise from treating uninsured people, which are borne by the entire health scenario, and said that the bill had a built-in implementation delay of almost five years to allow for adjustments, making it another. complete study the most unnecessary.
Cannizzaro added that the opposition’s concern about cost changes for those with existing insurance, and its call for more people to be covered by Medicaid instead of the new plan, seemed contradictory: the new public plan would be financed in part by premiums and pay more than Medicaid.
“If we are talking about implementing something where you get reimbursed at higher rates than Medicaid, why that is one reason to oppose this project is just one that I have a hard time understanding,” she said.
The committee took no action on the project. He faces a May 14 deadline to move forward or be considered dead.