June 4, 2021

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NAHU Submits Comments on Upcoming Broker Transparency Regulation
NAHU Submits Comments on Forthcoming Surprise-Billing Ban Interim Final Rule
Bill to Eliminate Medicare “Observation Status” Introduced in the House
State Spotlight: Nevada Legislature Passes Standardized Plan Public-Option Bill
Healthcare Happy Hour: Surprise! NAHU Submits Comments Ahead of Balance Billing Regulations
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State Spotlight: Nevada Legislature Passes Standardized Plan Public-Option Bill

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.

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