With just three days left in the session, a Senate bill to establish a state-managed public health insurance option finally received its first hearing in the Assembly on Friday.
Because the bill does not require two-thirds support, the Democratic-controlled Assembly could quickly process the proposal, which was sponsored by Senate Majority Leader Nicole Cannizzaro (D-Las Vegas), and send it to Gov. Steve Sisolak, also a Democrat, for his signature. But Assemblywoman Maggie Carlton (D-Las Vegas), who chairs the Assembly Ways and Means Committee where the bill sits, has indicated her chamber isn’t in any rush to get the bill out and said there would be no action on the bill, SB420, on Friday.
Sisolak has not yet taken a position on the public option bill.
Carlton, in an interview, said her committee needed time to vet a new amendment to the bill — which would make a minor change in coverage requirements for the state Public Employee Benefit’s Program unrelated to the legislation’s public option or Medicaid service expansion sections — and consider how to cover $600,000 in fiscal impact from the legislation on the Silver State Health Insurance Exchange that cannot be taken from the exchange’s reserves.
She added that she wanted to take the time to get interested parties “all in the corral together,” saying they “may not all agree with each other” but “you don’t pass something this big without making sure you’ve got everybody” together.
“We’re not moving it today because it’s significant, and we want to make sure that everybody’s comfortable, that everybody’s got all their comments on the record and members have time to address their concerns,” Carlton said.
Health care industry representatives have voiced concerns since the first hearing on the bill about being left out of the bill drafting process and this week proposed their own amendment to the legislation, which would remove the portion of the bill actually establishing a public option and leave the legislation at just an actuarial study of the latest concept. That amendment would, essentially, leave it up to the 2023 Legislature to decide whether to move forward with the proposal, based on the outcome of the actuarial study.
Cannizzaro, however, has said she isn’t open to considering the industry’s proposed amendment.
“I’m not interested in gutting the bill and replacing it with a study when that is exactly the reason why we’re here is having done a lot of studies, and I think the actuarial analysis that goes with the bill is what’s needed to get this implemented, but now is the time to start implementing it, not just studying it,” Cannizzaro said in an interview on Thursday. “People are fine to propose their own ideas but I’m not interested in accepting that one.”
The bill, at its core, would require insurers that bid to provide coverage to the state’s Medicaid population to also offer a public option plan. While the plans would resemble existing qualified health plans certified by the state’s health insurance exchange, the legislation would require them to be offered at a 5 percent markdown, with the goal of reducing average premium costs in the state by 15 percent over four years.
The bill passed the Senate on party lines earlier this week.