Connecting state and local government leaders

Nevada Lawmakers Approve ‘Medicaid for All’ Plan

The Nevada State Capitol.

The Nevada State Capitol.


Connecting state and local government leaders

In direct response to talk of Medicaid cuts from Washington D.C., lawmakers in Carson City approved a bill that would give every single Nevada resident access to a public health insurance option.

Nevada is drawing closer to a massive expansion of health insurance coverage—one that would give every last resident of the state access to a public plan.

The bill, which would allow Nevadans to enroll in Medicaid coverage regardless of income eligibility and health status, was introduced in March by Democratic state Assembly member Michael Sprinkle, approved by the state Senate on Friday and is now awaiting a final decision from Republican Gov. Brian Sandoval.

The public option, Nevada Care Plan, would likely be sold alongside private health insurance plans on the state’s health insurance marketplace—the Silver State Health Insurance Exchange. And, Nevadans who qualify for tax credits under the Affordable Care Act would be able to use those credits towards the purchase of Medicaid coverage.

The benefits under the Nevada Care Plan would be nearly identical to the traditional Medicaid plan, but the plan would not cover non-emergency transportation services that are otherwise provided for those with income or health-related Medicaid eligibility.

Lawmakers haven’t yet estimated how many people are likely to sign up for such a plan, or how much enrollment would cost individuals who wouldn’t normally be eligible. And the text of the bill does not indicate whether or not the public option plan would involve traditional deductibles and copayments for those new enrollees.

“Once the bill gets through the governor, we’re going to have a very active working group that will build off this framework to determine these things through regulation,” Sprinkle clarified, in a conversation with Sarah Kliff from Vox.

It should be noted that the timing of this bill wasn’t an accident. In an opinion piece for the Reno Gazette Journal, Sprinkle described the measure as a direct response to the ongoing debate over health care in the nation’s capital.

After the 2016 election and under the new administration, the state of the ACA is unknown. The repeal of the ACA will undoubtedly leave millions of Americans uninsured—including some of the most infirm and poverty stricken, but not in Nevada if we pass this plan.

Sandoval hasn’t indicated whether or not he intends to sign the bill or veto it, however, the governor does have a track record of supporting increases in health insurance coverage. Sandoval was the first Republican governor to approve his state’s Medicaid expansion under the Affordable Care Act.   

The bill—which some have taken to calling “Sprinklecare”—if signed by the governor, would also require approval from the Trump Administration in the form of a waiver. It’s unclear how much of hurdle that waiver might prove to be.

On the one hand, the administration is attempting to cut federal funding to Medicaid by anywhere from $800 billion to $1.3 trillion. But, on the other hand, the bill as it’s currently structured would not alter the federal government’s spending on the program as the new enrollees would be paying their own way in.

Quinn Libson is a Staff Correspondent for Government Executive’s Route Fifty based in Washington, D.C.

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