Nevada may become the first state to open Medicaid to all residents.
The Democratic-led state legislature passed a bill earlier this month that would allow anyone to purchase a Medicaid-like policy, regardless of their income. Governor Brian Sandoval, a Republican, has until midnight Friday to sign or veto the bill, which was approved along party lines.
The bill calls for the state to create the Nevada Care Plan, which would be separate from the state’s Medicaid program but offer nearly all the same benefits. It could either be administered by the state’s Medicaid department or officials could contract with an insurer to run it.
The legislation contains few details on how the program would work or what the premiums would be. Instead, it’s more of a framework to help Nevadans access coverage that’s more affordable and comprehensive, particularly if Congress repeals Obamacare, said the bill’s sponsor, Assemblyman Mike Sprinkle.
“I really, truly believe and have for a long time that health care is a right and responsibility for the government to provide,” he said. “This is a way for us to do that.”
Medicaid recipients pay little or nothing for their coverage, but people who buy into the Nevada Care Plan would most likely have to pay some premiums, deductibles and co-pays. Theoretically, it would be cheaper than what’s currently available on the individual market because Medicaid pays lower rates to doctors, hospitals and other providers.
To craft the four-page Medicaid-for-all bill, Sprinkle convened a working group, which included the governor’s chief of staff and the heads of the state’s Medicaid, insurance and health departments. If Sandoval signs it, coverage would begin in 2019.
Sandoval is one of the few Republican governors to have embraced Obamacare. Nevada expanded its Medicaid program to adults who make up to $16,400 and set up its own Obamacare exchange, which extended coverage to more than 400,000 residents. The uninsured rate dropped to about 12%, from 23%, one of the worst in the nation.
Sprinkle wants the plan — already dubbed Sprinklecare by some — to be offered on the state exchange so residents who qualify for Obamacare subsidies could use them, though that would require permission from the federal Centers for Medicare and Medicaid Services. At some point in the future, he’d like the state to provide subsidies to make the coverage more affordable for even more residents.