State Opens Up Public Comment Period On Public Health Insurance Option

A 30-day public comment period began this week on the state’s application for a federal waiver to create a public option for health insurance.

The public comment period, which started Monday and runs through Dec. 20, is the first formal step in seeking approval from the Centers for Medicare and Medicaid Services (CMS) for the waiver that would allow Nevada to create a state-managed public health insurance option by 2026.

Legislation enacted in 2021 called for creating a public health care option that would be administered by the State of Nevada through contracts that insurance companies bid for. The public option would require health care premium rates for the public option to be at least 15% lower over the next four years than plans on the state health insurance option. The public option premiums must be 5% lower than the reference Bronze, Silver and Gold plan premiums, by zip code.

However, Gov. Joe Lombardo, who opposes the public option, recently announced his intention to use federal funds made available through the waiver to also finance – and prioritize – a reinsurance program for private companies operating in the individual market.

Lombardo is also asking CMS to approve use of the federal funding to create an annual bonus payment program for insurance companies “that make strides in improving health outcomes and quality of care,” as well as a loan repayment program for providers who commit to living and practicing in the state for at least four years.

Insurance rates on the state-based health exchange have increased by 2.8% on average over the past year, while individual premiums not offered on the exchange increased by 5.9%, according to the Nevada Department of Insurance.

A 2022 state actuarial report found that the public option would have a “small negative impact on provider revenue” because the individuals who would benefit from the public option make up only about 3% to 4% of the state’s population and a small proportion of providers’ revenue.

An organization allied with the insurance and health care industries released a report early this month arguing the public option would exacerbate the state’s provider shortage and reduce access to care.

Nevadan physicians with the Committee to Protect Health Care, which disputes the industry’s report and supports the public option, “urged residents to share their health care stories as part of the public comment.”

“We’re heartened to see the Public Option continue to move forward as an innovative, unique path toward accessible, affordable health care for Nevada families. As insurance companies continue to try to undermine the Public Option, doctors continue to support it because we know it will reduce health care premiums by 16 percent over four years, make coverage more affordable for 92,500 Nevadans, and save Nevadans nearly $500 million,” Dr. Harpreet Tsui, an internist in Las Vegas and Nevada Lead for the Committee to Protect Health Care, said in a statement.

Nevadans can view the draft of the bill, public notices, meetings, the economic analysis by the state, and comment methods on the state Department of Health and Human Services website.

The state’s waiver application must be submitted to CMS by January 1, 2024.


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