New Health Insurance Option for Nevadans This Fall
This fall, residents of Nevada seeking health insurance through the state’s Affordable Care Act Marketplace will have a new budget-friendly alternative called the Battle Born State Plan.
This initiative stems from legislation passed in 2021 which aimed to lower premiums and create more affordable public health insurance choices. It’s a version of a concept that was initially proposed 15 years ago but didn’t make it into the final Obamacare framework: a public option designed to compete with private insurers.
About 35,000 residents are predicted to enroll in the Battle Born plans, although this figure might fluctuate due to rising health care costs and the expiration of certain federal subsidies.
Senate Majority Leader Nicole Cannizzaro (D-Las Vegas), the driving force behind the bill that established the public option, believes the Battle Born State Plans (BBSP) are crucial for decreasing health care expenses and widening access.
However, the launch hasn’t been universally welcomed.
Republican Gov. Joe Lombardo, during his campaign, criticized the public option as “political theater” and expressed strong opposition, calling it “BS.” Critics argue that this initiative might exacerbate health care shortages in Nevada and potentially push insurance companies out of the market.
In response, Lombardo’s administration has introduced a reinsurance program aimed at stabilizing the marketplace.
Nevada joins Washington and Colorado as the third state to roll out a public health insurance option.
What is the Battle Born State Plan?
The Battle Born State Plan was introduced during the 2021 legislative session. It qualifies as health insurance under the ACA, covering the ten essential health benefits defined by the law and ensuring those with pre-existing conditions are not charged extra or denied coverage.
One distinguishing feature of the Battle Born plans is the requirement to meet premium reduction goals, aimed at lowering health insurance costs overall.
To ensure competitive bidding, managed care organizations involved in the state’s Children’s Health Insurance Program and Medicaid were asked to submit proposals for administering the public option.
During this open enrollment period, three out of eight carriers are offering state plans:
- Anthem (Nevada Community Care Health Plan)
- SilverSummit Health Plan (Ambetter)
- Health Plan of Nevada (HPN)
Insurance providers need to align their networks with Medicaid managed care to guarantee sufficient access to care.
How Do Premium Reduction Goals Work?
New state plans must meet specific premium reduction targets over the next four years, aiming to ultimately offer premiums 15% lower than the average market rate.
What Steps Were Taken to Lower Premiums?
Nevada health officials highlighted two main strategies for achieving these targets: cutting administrative costs and reducing healthcare expenses, like provider reimbursements.
Actuaries noted that the primary cost-cutting measure for the Battle Born Airlines in 2026 was slashing brokerage commissions, which reduced costs significantly.
What Happens if Plans Don’t Meet Targets?
If carriers fail to comply with the premium reduction goals, the state can impose corrective measures and fines. Continued violations could result in the state terminating contracts, preventing the carriers from participating in significant public programs like Medicaid.
Officials plan to evaluate the trends after four years to determine whether carriers maintain the reductions achieved.
Who Will Enroll in the Plan?
Most enrollees in the Nevada Health Link are individuals without employer-sponsored insurance or those ineligible for Medicaid or Medicare. This includes self-employed individuals and small business owners.
Purchasing through the Marketplace allows consumers to utilize federal subsidies, which can drastically reduce insurance costs.
Battle Born plans are targeted at individuals with moderate to high incomes purchasing insurance through Nevada Health Link. There’s no cap on enrollment for Nevadans in these plans.
This comes at a time when health insurance prices are increasing across the nation, with enhanced ACA subsidies set to expire soon. These subsidies extend financial assistance and eligibility to middle-income individuals earning around $130,000 for a family of four.
Officials from Nevada Health Link indicated that those losing eligibility for subsidies or facing reduced subsidies might find the Battle Born plan advantageous, as it aims to lower costs through its premium reduction strategies.
Residents can seek assistance from navigators or brokers for free enrollment help and to find plans that suit their needs, which is particularly beneficial for those in rural areas.
What is the Reinsurance Program?
The reinsurance program, introduced with the public option, functions as a safety net for insurance companies. It enables them to lower premiums for individual health insurance plans by covering a portion of high costs.
These programs reduce the federal spending on ACA tax credits since the federal government reallocates some funds to states for financing reinsurance, helping maintain lower premiums and stability.
State officials believe that this program will benefit all licensed carriers in each market and will assist the insurers offering state plans in meeting their premium reduction goals.
Set to launch in 2026, the reinsurance program is crucial for maintaining stability for insurers while easing pressures caused by public options.
There is an ongoing lawsuit challenging Nevada’s public health insurance options, but state officials have not provided comments on the pending litigation.
Projected Savings from Public Option and Reinsurance Programs
State authorities estimate that by the end of 2029, the combination of the reinsurance and public option will yield between $290 million and $322 million in federal savings for Nevada.
Most of these funds will be directed towards implementing the reinsurance program, with some future funding allocated for health care provider loan retention and quality incentive programs for carriers and networks.
The reinsurance initiative is expected to begin in 2026, with insurer payments starting in early to mid-2027 and approved by federal authorities for five years.
How to Choose the Right Insurance?
Medicaid, Nevada Health Link, and state plans operate under the Nevada Department of Health, simplifying the process for residents. This allows for efficient enrollment transitions between different programs.
Director Stacey Weeks pointed out that if someone applies for a plan through Nevada Health Link but qualifies for Medicaid, the agency can assist in enrollments and vice versa. This approach enhances communication and access to insurance, even when individuals’ eligibility changes.
