Signed by Governor Steve Sisolak

Vote Smart's Synopsis:

Vote to amend and pass a bill that establishes a state public option health care plan.

Highlights:

• Defines “health benefit plan” as a policy, contract, certificate, or agreement to provide, deliver, arrange for, pay for or reimburse any of the costs of healthcare services (Sec. 10-6.b).

• Alleges the legislature intends to commit the following actions (Sec. 2):

• Leverage the combined purchasing power of the State to lower premiums and costs relating to health insurance for residents of this State;

• Improve access to high-quality, affordable health care for residents of this State, including residents of this State who are employed by small businesses;

• Reduce disparities in access to health care and health outcomes and increase access to health care for historically marginalized communities; and

• Increase competition in the market for individual health insurance in this State to improve the availability of coverage for residents of rural areas of this State.

• Specifies “director” is the Director of the Department of Health and Human Services (Sec. 5).

• Requires the Public Option to do the following (Sec. 10-3):

• Be a qualified health plan; and

• Provide at least levels of coverage consistent with the actuarial value of one silver plan and one gold plan.

• Requires the director to do the following when establishing networks for the Public Option and reimbursing providers of health care that participate in the Public Option (Sec. 14-1):

• Ensure that care for persons who were previously covered by Medicaid or the Children’s Health Insurance Program and enroll in the Public Option is minimally disrupted;

• Encourage the use of payment models that increase value for persons enrolled in the Public Option and the State;

• Improve health outcomes for persons enrolled in the Public Option;

• Reward providers of healthcare and medical facilities for delivering high-quality services; and

• Lower the cost of care in both urban and rural areas of this State.

• Establishes in the State Treasury the Public Option Trust Fund as a nonreverting trust fund. The Trust Fund consists of (Sec. 15-1):

• Any money deposited in the Trust Fund according to sections 11 and 12 of this act;

• Any money appropriated by the Legislature to carry out the provisions of sections 2 to 15, inclusive, of this act; and

• All income and interest earned on the money in the Trust Fund.

• Requires the director to include in the State Plan for Medicaid authorization for (Sec. 24-1):

• A pregnant woman whose household income is at or below 200 % of the federally designated level signifying poverty to enroll in Medicaid; and

• A pregnant woman who is determined by a qualified provider to be presumptively eligible for Medicaid to enroll in Medicaid until the last day of the month immediately following the month of enrollment without submitting an application for enrollment in Medicaid which includes additional proof of eligibility.

• Requires the Director to include in the State Plan for Medicaid a requirement that the State pays the non federal share of expenditures incurred for (Sec. 28):

• Supplies for breastfeeding a child until the child’s first birthday. Such supplies include, without limitation, electric or hospital-grade breast pumps that:

• Have been prescribed or ordered by a qualified provider of healthcare; and

• Are medically necessary or are necessary for the mother of the child to return to work.

• Such prenatal screenings and tests as are recommended by the American College of Obstetricians and Gynecologists, or its successor organization.

Full Bill Text

Vote Smart's Synopsis:

Vote to pass a bill that establishes a state public option health care plan.

Highlights:

• Defines “health benefit plan” as a policy, contract, certificate, or agreement to provide, deliver, arrange for, pay for or reimburse any of the costs of healthcare services (Sec. 10-6.b).

• Alleges the legislature intends to commit the following actions (Sec. 2):

• Leverage the combined purchasing power of the State to lower premiums and costs relating to health insurance for residents of this State;

• Improve access to high-quality, affordable health care for residents of this State, including residents of this State who are employed by small businesses;

• Reduce disparities in access to health care and health outcomes and increase access to health care for historically marginalized communities; and

• Increase competition in the market for individual health insurance in this State to improve the availability of coverage for residents of rural areas of this State.

• Specifies “director” is the Director of the Department of Health and Human Services (Sec. 5).

• Requires the Public Option to do the following (Sec. 10-3):

• Be a qualified health plan; and

• Provide at least levels of coverage consistent with the actuarial value of one silver plan and one gold plan.

• Requires the director to do the following when establishing networks for the Public Option and reimbursing providers of health care that participate in the Public Option (Sec. 14-1):

• Ensure that care for persons who were previously covered by Medicaid or the Children’s Health Insurance Program and enroll in the Public Option is minimally disrupted;

• Encourage the use of payment models that increase value for persons enrolled in the Public Option and the State;

• Improve health outcomes for persons enrolled in the Public Option;

• Reward providers of healthcare and medical facilities for delivering high-quality services; and

• Lower the cost of care in both urban and rural areas of this State.

• Establishes in the State Treasury the Public Option Trust Fund as a nonreverting trust fund. The Trust Fund consists of (Sec. 15-1):

• Any money deposited in the Trust Fund according to sections 11 and 12 of this act;

• Any money appropriated by the Legislature to carry out the provisions of sections 2 to 15, inclusive, of this act; and

• All income and interest earned on the money in the Trust Fund.

• Requires the director to include in the State Plan for Medicaid authorization for (Sec. 24-1):

• A pregnant woman whose household income is at or below 200 % of the federally designated level signifying poverty to enroll in Medicaid; and

• A pregnant woman who is determined by a qualified provider to be presumptively eligible for Medicaid to enroll in Medicaid until the last day of the month immediately following the month of enrollment without submitting an application for enrollment in Medicaid which includes additional proof of eligibility.

• Requires the Director to include in the State Plan for Medicaid a requirement that the State pays the non federal share of expenditures incurred for (Sec. 28):

• Supplies for breastfeeding a child until the child’s first birthday. Such supplies include, without limitation, electric or hospital-grade breast pumps that:

• Have been prescribed or ordered by a qualified provider of healthcare; and

• Are medically necessary or are necessary for the mother of the child to return to work.

• Such prenatal screenings and tests as are recommended by the American College of Obstetricians and Gynecologists, or its successor organization.

Full Bill Text