Public option likely all but a done deal after Assembly approves bill on party lines

[Greenbeard]

Can't say I know enough about Nevada politics to be able to evaluate the conclusion here that this bill is a done deal but it's certainly an intriguing prospect.

Colorado has been flirting with creating a public option for a few years now (perhaps this is the year), but thus far only Washington state has a public option and in its first year of operation it hasn't quite been a game-changer yet: in most geographies in Washington where a public option plan is being sold (and that isn't everywhere), it's not the price leader. And a public option is the benchmark plan (i.e., second cheapest silver offering) in only two of the state's nine rating areas this year. But Washington capped aggregate public option payments to health care providers at 160% of Medicare, which is only a little below what marketplace health plans in Washington tend to pay providers anyway.

Nevada's legislation puts a floor of Medicare payment rates in place for its public option plans, but doesn't cap what they would pay providers. But Nevada is more explicitly linking its public option to health plans that participate in its Medicaid program. Perhaps not all that surprising since Nevada has leveraged its Medicaid managed care program to encourage marketplace participation by insurers in the past; requiring insurers who want a piece of Medicaid business to offer a marketplace public option is somewhat of a natural extension of that approach.

Of course, all this doesn't really happen until the back half of the 2020s, which puts Nevada behind not only Washington but perhaps other states that are willing to stand up a public option more quickly.

Public option likely all but a done deal after Assembly approves bill on party lines

Nevada’s bid to establish a state-managed public health insurance option appeared all but certain to become a reality late Sunday evening after the Assembly voted on party lines to approve legislation setting the process for establishing such a plan in motion.

Sisolak has not taken a public position on the legislation, though it would be unlikely for the Democratic governor to veto the bill. Gov. Brian Sandoval, a Republican, vetoed a different public option proposal in 2017 that would have allowed anyone in the state to buy into a Medicaid-like system of health insurance. At the time, Sandoval said the proposal was “moving too soon, without factual foundation or adequate understanding of the possible consequences.”

Since then, the Legislature has continued to consider establishing a public option, including approving an interim study in the waning days of the 2019 legislative session to look into the possibility of allowing Nevadans to buy into the state Public Employees’ Benefits Program.

SB420, now the third iteration of the public option proposal in Nevada, will require insurers that bid to provide coverage to the state’s Medicaid population to also offer a public option plan. The plans will resemble existing qualified health plans certified by the state’s health insurance exchange, though the legislation requires them to be offered at a 5 percent markdown, with the goal of reducing average premium costs in the state by 15 percent over four years. The public option will be available for purchase starting in plan year 2026.

 

[Glitch]

I cannot say I am surprised. At least States have the constitutional authority to establish their own state-wide healthcare system. Which is more than can be said about the federal government. Considering all 50 States are required by law to balance their budgets, it will be interesting to see how long such a program lasts and how the fixed government pricing will effect the quality of care.

 

[Greenbeard]

And it's done, the governor signed this legislation today. Signed, sealed, delivered, Nevada will have a public option. Several years from now.

With governor’s signature, Nevada becomes 2nd state with public health insurance option

Nevada Democratic Gov. Steve Sisolak signed a law Wednesday, creating a new state health insurance plan to compete with private insurers.

With the governor’s signature, Nevada became just the second state with a public option. The other is Washington.

The Nevada Public Option essentially allows the state to work with private insurers to craft low-cost policies. The policies will not become available until at least 2026, the law said.