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Nevada & The Affordable Care Act

What The Affordable Care Act Means For Nevadans
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For more information about the Affordable Care Act, visit CBSLasVegas.com/ACA.

In 2007, slightly more than 14 percent of Nevada residents reported they were unable to see a doctor when necessary due to cost. Nevada’s families saw the price of their health insurance rise 44 percent between 2003 and 2009. Insurance premiums for single policyholders increased 29 percent over the same period. [1] Of the Nevadans that do have health insurance, 48 percent are covered through their employment. Public programs such as Medicaid and Medicare insure another 25 percent of the population, and 5 percent purchase individual private policies. This leaves nearly 600,000 residents, 22 percent of Nevada’s citizens, uninsured.[2]

Who are the uninsured in Nevada?

Children age 18 and younger are uninsured at a rate of 19 percent in Nevada. This figure rises to 30 percent for children living in households with annual incomes less than 139 percent of the Federal Poverty Level. The uninsured rate for non-elderly adults, those younger than 65, across all income levels, is 27 percent. Of the adults living in households with incomes less than 139 percent of the federal poverty level, 53 percent lack health insurance. [3] The non-elderly Hispanic population is uninsured at a rate of 36 percent, 29 percent of Nevada’s non-elderly Black population is uninsured, and 19 percent of non-elderly Whites in Nevada do not have health insurance. [4]

How does the Affordable Care Act affect Nevada residents?

The Affordable Care Act (ACA) requires states provide access to an online marketplace, also called an exchange, where individuals and small businesses may compare, select and purchase private health insurance policies that offer a minimum level of coverage. States have the option of establishing their own exchange, operating an exchange in cooperation with the federal government, or turning all administration of the health care marketplace over to the federal government. On January 3, 2013, Nevada received conditional approval from the U.S. Department of Health and Human Services to operate its own exchange.

Under ACA, all new policies, and in-force policies upon renewal, must cover a package of essential health benefits, including hospitalization, emergency services, and mental health treatments. Annual wellness checkups and other preventative screenings must be covered with no co-payments or deductibles. Residents may not be denied health insurance for pre-existing health conditions, and insurers may not place a lifetime cap on benefits. Households with incomes at or below 400 percent of the Federal Poverty Level may be eligible for tax credits to offset premium costs.

Nevada’s health insurance exchange

In June 2011, Nevada Governor Brian Sandoval signed legislation creating the Silver State Health Insurance Exchange. A 10-member Board of Directors governs the exchange, which operates as a clearinghouse for all qualified health plans. Nevada residents can access the exchange at Nevada Health Link to purchase health insurance policies. Plans offered through Nevada Health Link cover essential health benefits based on Nevada’s Point Of Service Group 1 C XV 500 HCR plan.

As required by the ACA, four categories of health plans with varying levels of coverage will be available. The least expensive bronze plans cover 60 percent of medical costs. Silver plans cover 70 percent. Gold plans cover 80 percent. Platinum plans, the most expensive, cover 90 percent of medical costs. Additionally, adults younger than 30 have the option of purchasing lower-cost catastrophic plans with limited coverage. Nevada residents may estimate premium costs and eligibility for tax credits and subsidies using the Nevada Health Link Premium Calculator.

Small Business Health Options Program (SHOP)

Under the ACA, small business employers with fewer than 50 full-time workers, or full-time equivalent workers, will not be required to offer health insurance to their employees. (Check here for a definition and calculator to determine who qualifies as a full-time worker.) However, the ACA encourages many small business employers to provide health insurance by offering small business health care tax credits.

Many small businesses were already offering health insurance packages to their employees before the ACA was passed and signed into law. These plans are accepted, or grandfathered in, under the ACA.

For small business owners who wish to change their coverage plans, or for those who did not offer health insurance before the new law, the ACA establishes the Small Business Health Options Program or SHOP. SHOP allows employers to compare and shop for quality insurance plans side by side for their employees. Nevada small business owners may access SHOP through the Nevada’s health insurance exchange Nevada Health Link. For more information about how the ACA affects Nevada employers, access the Nevada Employers Guide to ACA from the Nevada Division of Insurance.

Approved assistance and enrollment centers

The Nevada government has approved the health centers below to provide in-person enrollment assistance.

The U.S. Department of Health and Human Services has awarded grants to these two health centers in Nevada to provide enrollment assistance: HAWC, Inc. and Nevada Health Centers, Inc. For the most current list of health centers in Nevada awarded assistance grants, visit the U.S. Department of Health and Human Services.

External resources for Nevada residents

See the full list of external resources from CBS Las Vegas.

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[1] http://www.commonwealthfund.org/Publications/Issue-Briefs/2010/Dec/State-Trends-Premiums-and-Deductibles.aspx
[2] http://kff.org/other/state-indicator/total-population/?state=NV
[3] http://kff.org/state-category/health-coverage-uninsured/?state=NV
[4] http://kff.org/uninsured/state-indicator/rate-by-raceethnicity/?state=NV

Gillian Burdett is a freelance writer covering all things home and living. Her work can be found on Examiner.com.

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