The Nevada State Legislative Building, in Carson City.
In Nevada, Republican Gov. Brian Sandoval and Democratic legislators have often cooperated in innovative ways to address healthcare issues, whatever the fiercely partisan standoff in Washington, D.C.
But the governor wouldn’t go along when the Democratic-controlled legislature passed a bill to let anyone — regardless of income — sign up for Medicaid on the Affordable Care Act’s insurance marketplace — in a cousin of the universal-healthcare/Medicare-for-all proposals getting increasing attention as the red tape-bound and vastly expensive U.S. healthcare “system” looks worse and worse — including its lowly outcomes.
Mr. Sandoval vetoed the Medicaid-available-for-all bill on Friday night, hours before the deadline, saying that the legislation “could introduce more uncertainty to an already fragile health-care market and ultimately affect patient health care” and that it was being rushed “without factual foundation or adequate understanding of the possible consequences.”
But supporters of Medicaid access-for-all, including the bill’s sponsor, Assemblyman Mike Sprinkle, have argued that it cost less than a single-payer plan and that it was needed because “There is an absolute need for states to become more reliant on providing insurance options to its citizens.”
“It’s an innovative approach that might also be of interest to other states,” says Jessica Schubel, senior policy analyst with the Center on Budget and Policy Priorities, told Governing magazine. “but it clearly rests on the base of a strong Medicaid program and robust marketplace subsidies — both of which are in danger.”
The state is pushing hard to shore up its health-insurance offerings. For instance, Governing reports, it has told private insurers that their “applications for state Medicaid contracts would get preferential treatment if they also sold plans on the marketplace — and it’s already paying off.
“Nevada is the only state where Aetna is still going to offer coverage in 2018. This fall, Nevadans shopping on the exchanges will have five insurance options. In addition, premiums are expected to be lower than the national average.”