Healthcare is probably the toughest issue facing Congress at the moment. The GOP’s attempt to “repeal and replace” has been widely criticized as taking coverage away from those who need it most and hitting every American hard. But while Congressmen might argue about it, and get treed like kittens trying to avoid constituents angry over the attempted changes, states have a more practical reality to tackle. Nevada just took a bold step to deal with it.
A law passed by the Nevada legislature, and currently on the desk of Governor Brian Sandoval, would allow any Nevadan access to Medicaid. Medicaid is, of course, a health program for those with few resources, which is largely administered on a state-by-state basis. It would allow anyone without insurance to buy into the state’s Medicaid program, either by using the Affordable Care Act’s tax credits if they qualify for them, or simply just writing the state a check. It’s not clear yet how much this would cost anybody who wanted to join. But as Medicaid is generally lower-cost as it pays doctors less for care, and the plan wouldn’t include options like emergency medical transportation, it’d likely be a cost-effective option.
In a way, this isn’t a surprise: Nevada is generally at the forefront of health care policy. Much like New York’s hardball approach, it informed insurers they needed to participate in state exchanges if they wanted to provide health care through state government in areas like Medicaid. And the idea has some virtues worth considering; it’d be a public option on Nevada’s exchanges, exerting a downward price pressure, and states are generally free to run Medicaid as they wish, as they usually cover the majority of its costs.
It’d also offer a method for states to ensure people are covered without having to lean on the federal government. The main question is whether Nevada will take the plunge: Sandoval, a Republican, has been keeping an eye on the bill but hasn’t signed it yet.