Both chambers of
Nevada’s legislature have passed SB 420, the newest
iteration of the Silver State’s public-option bill. Now it moves to the
governor’s desk, where it is expected to be signed into law. This will make
Nevada the second state to officially pass what they refer to as a public
option.
While it is being
referred to as a public option, the measure that passed is similar to that of
Washington State, instituting a standardized plan that would be offered by
private insurers. These plans would resemble existing qualified health plans
certified by the state exchange and would be available for purchase through the
exchange. The bill would also make some changes to Medicaid eligibility,
increasing eligibility for pregnant women up to 200 percent of the FPL. The
plans would be required to provide silver-level and gold-level coverage, but
cost at least five percent less than a “benchmark” plan from private insurance
carriers already sold on the marketplace. Price increases would be limited to
the increase in the Medicare Economic Index for that year, with the goal of
reducing premiums 15 percent lower than the “benchmark.”
SB 420 would compel
all Medicaid managed care organizations to provide the public option plan by
requiring all companies that bid to be a MCO to also submit a bid to be a
public-option plan. Insurers that don’t apply to be a Medicaid MCO could bid to
become a public-option plan as well, but it is unclear how many public-option
bids the state would approve. Development and implementation of the public
option would fall to the director of the Department of Health and Human
Services, in consultation with the head of the Silver State Health Insurance
Exchange and the commissioner of the Division of Insurance, with the first
coverage year slated for 2025. Providers that accept the state’s Medicaid
patients or the state employees’ health insurance plan would be required to
accept patients on the public-option plan as well.
While the intention of the bill is to lower health spending
and cover more uninsured residents, the Nevada Association of Health
Underwriters does not believe this bill will achieve its goal. “This public
option is not necessary and does nothing to improve access or address the
increasing costs of health insurance for the majority of Nevadans,” the Nevada
Association of Health Underwriters stated in their letter to
lawmakers last month. NVAHU emphasized the public option’s potential to create
market instability, shift costs onto employer plans and decrease provider
access, in addition to stressing how many affordable coverage options are
already available to Nevadans.
Democratic Governor Steve Sisolak says he doesn't know
"how [the bill] is going to work out" but "anytime there's an
opportunity to get health care coverage available for more Nevadans is
certainly something that I'm interested in.” Sisolak’s predecessor vetoed the
state legislature’s previous attempt to pass a public option in 2017. That
measure was closer to a “pure” public option, a Medicaid buy-in bill that
proposed selling a Medicaid-style insurance option on the Silver State Health
Insurance Exchange sold alongside private insurance options.
|