VoxCare 5/19/2021

Joe Biden’s election brought a new optimism that a public health insurance option could become a reality. But while the public option, a government-run insurance plan that competes with private insurers, seems to be off the table at the federal level, Nevada lawmakers are pushing to pass their own version before the end of their legislative session.  
Nevada would become just the second state with a public option, after Washington implemented its own version of the proposal this year. The Democrat-controlled legislature is racing against the clock — the legislative session ends on June 1 — but the legislation is already moving through Senate committees.
“Now is the time to act,” Nevada Senate Majority Leader Nicole Cannizzaro told me. “This really is designed to be a very reasonable approach to developing another option for folks. It’s not looking to upend the entire system. There are people who are unserved by this system. How do we serve those individuals?”  
Here are the basics of the Nevada proposal, Senate Bill 420:
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• The “public option” plan would be sold on the state insurance marketplace created under the Affordable Care Act, available to the individuals and small businesses that are already eligible to purchase plans there, starting in 2026.
• Health insurers that participate in the state’s Medicaid managed care program would be required to submit a public option proposal; other insurers could also submit a bid.
• The public option plan would offer silver-level (covering 70 percent of medical costs) or gold-level (80 percent) coverage.
• Premiums for the public option would initially be set 5 percent lower than a “benchmark” plan from the private insurance plans already sold on the marketplace; over time, the goal would be to bring the premiums down to 15 percent lower than the benchmark plan.
• Health care 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.

The proposal is drawing backlash from health care providers, as Megan Messerly has covered for the Nevada Independent. And some experts contend that, considering most uninsured people already qualify for Medicaid or ACA subsidies, the public option may not be the most effective vehicle for expanding coverage — but it  could put downward pressure on health care costs.   In our interview, Cannizarro presented it as both: a chance to cover the uninsured and to use the state’s leverage to address health care affordability. A transcript of our conversation is below, edited for length and clarity.  

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