Policy and Regulation News

Nevada Legislature: All Residents Should Have Medicaid Access

Nevada has passed a bill to allow Medicaid enrollment by all residents regardless of income or health status.

Nevada passes Medicaid for all bill

Source: Thinkstock

By Jesse Migneault

- The Nevada State Assembly has passed a bill which would open Medicaid enrollment to all of the state’s residents, regardless of income or health status.   The Nevada Care Plan would allow every state resident without health insurance to purchase Medicaid coverage.

The plan would likely be sold on Nevada’s health insurance marketplace, making it a public option to compete against the private health insurance plans available on the exchange.

Nevada’s approach to insure its 2.8 million residents with a Medicaid-for-all program is a markedly different approach than the universal healthcare proposals currently in the legislatures of California and New York.

“It’s not going to eliminate the sky-is-falling concerns if the Affordable Care Act goes away,” said bill sponsor Assemblyman Mike Sprinkle (D) to the Nevada Independent.

“I think this is going to be trend-setting, and I think that it will set an example for the rest of the nation to at least look at what we’ve done here and make what we’ve done here work within their own states.”

Medicaid traditionally covers low-income Americans who must meet income qualifications to receive coverage.   Nevada currently limits Medicaid enrollment to individuals who earn $15,800 or less annually, or $32,319 for a family of four. 

The state currently has four Medicaid payers: Aetna Better Health, Amerigroup, Health Plan of Nevada and Silver Summit Healthplan.

The Nevada Care Plan would require enrollees to buy into the coverage by paying a premium.  This would align the plan more with private payer options, and would be a departure from traditional Medicaid where there are no premiums or copays.  The state has yet to determine what the out-of-pocket costs would be.

The bill would allow applicants who are currently eligible for advance payments of premium tax-credits or cost sharing reductions to use those funds to purchase their Nevada Care Plan.  Those without coverage whose income currently disqualifies them from subsidies, could buy into the plan with their own money.

If signed into law by Governor Brian Sandoval (R), the bill would further require federal approval and HHS waivers before it could be implemented.   

As written, the Nevada Health Plan would provide all current Medicaid benefits except for emergency medical transportation.

There have been recent attempts in the nation to establish a universal public insurance option, although the proposals have stalled since the 2016 election.

Proponents of the Nevada Medicaid-for-all bill believe the lower cost of Medicaid versus Medicare makes it a more attractive program to roll out as an open public option.

In addition, increased enrollment numbers that may arise from the Nevada Care Plan may allow for greater bargaining power for provider prices, pharmaceuticals and other services.

Studies have indicated that those able to enroll in Medicaid have received expanded preventive care and chronic disease management services, which have led to better overall health.

“Access to screening and preventive care in Medicaid translates into well-child care and earlier detection of health and developmental problems in children, earlier diagnosis of cancer, diabetes, and other chronic conditions in adults, and earlier detection of mental illness in people of all ages,” reported KFF Associate Director of the Program on Medicaid and the Uninsured Julia Paradise.

“Access to physician care, prescription drugs, emergency care, and other services improves the likelihood that Medicaid enrollees will get treatment for both their acute and chronic conditions.”