Health insurance in Nevada
- Nevada transitioned to a fully state-run exchange in the fall of 2019, so residents now enroll through Nevada Health Link instead of HealthCare.gov.
- Open enrollment for 2020 coverage in Nevada has ended, but Nevada has a COVID-19 enrollment window for uninsured residents, through May 15, 2020.
- Residents with qualifying events can still enroll or make changes to their coverage for 2020. The next open enrollment period, for plans effective in 2021, will begin November 1, 2020.
- Short-term health plans can be sold in Nevada with initial plan terms up to 185 days, and cannot be renewed.
- With Anthem’s return to the exchange, three carriers are offering 2020 coverage through the Nevada exchange.
- The average premium increase in Nevada was about 1.7% in 2020.
- More than 77,000 enrolled in 2020 coverage through the Nevada exchange (the second year-over-year enrollment drop in a row).
- Nevada implemented the ACA’s Medicaid expansion in 2014.
Nevada’s health marketplace
From 2015 through 2019, Nevada Health Link was a state-run exchange that used Healthcare.gov for enrollment. But starting in the fall of 2019, Nevada residents enrolled through Nevada Health Link, as the state is no longer using HealthCare.gov.
Open enrollment for 2020 health plans has ended, although Nevada residents with qualifying events can still enroll or make changes to their coverage for 2020. The next open enrollment period, for plans effective in 2021, will begin November 1, 2020.
But to address the COVID-19 pandemic, Nevada Health Link opened a special enrollment period in mid-March for people who were uninsured and didn’t have a qualifying event. The enrollment window runs through May 15, 2020. After that, people will still be able to sign up if they experience a qualifying event, including loss of an employer’s health plan.
Nevada carriers and rate increases
Three carriers – Silver Summit, Health Plan of Nevada, and Anthem Blue Cross Blue Shield (HMO Colorado/HMO Nevada – offer 2020 plans through the state’s exchange. Anthem had exited the exchange at the end of 2017, but rejoined in the fall of 2019, for plans effective in 2020.
For Nevada’s individual market, average rates increased by about 1.7 percent for 2020 (1.6 percent for plans sold in the exchange). This came on the heels of an even smaller increase of 0.4 percent for 2019 plans.
Read more about Nevada’s marketplace, carriers and rate increases.
Exchange enrollment hit a record high for 2018, but dropped in 2019 and 2020
77,410 people enrolled in plans through the Nevada exchange during open enrollment for 2020 coverage. This was about 15 percent lower than enrollment had been two years earlier, when 91,003 people had enrolled in plans through Nevada’s exchange for 2018.
Nevada is one of only a handful of states where exchange enrollment increased every year from 2014 through 2018. In that first year, fewer than 36,000 people enrolled, and the exchange struggled with technology problems. In 2015, after switching to HealthCare.gov’s enrollment platform, Nevada’s exchange enrollment more than doubled, to above 73,000 enrollees. And the high-water mark came in 2018. Enrollment has declined since then, but the COVID-19 pandemic and Nevada Health Link’s decision to open a special enrollment period for uninsured individuals has likely resulted in a substantial increase in enrollment mid-way through 2020.
Medicaid expansion in Nevada
Nevada expanded Medicaid in 2014, and as a result, the state estimated that roughly 204,000 people became newly eligible for coverage, most of them childless adults who are working but whose employers do not offer health insurance coverage.
Nevada’s acceptance of federal funding to expand Medicaid eligibility to 138 percent of poverty has played a significant role in reducing the state’s uninsured population.
As of early 2020, average monthly enrollment for Nevada Medicaid/CHIP had grown by nearly 300,000 people since late 2013 – an 88 percent increase (enrollment had plateaued by 2017, and has remained fairly steady since then).
Short-term coverage in Nevada
Although the federal government relaxed the rules for short-term health plans in 2018, states may continue to impose tighter regulations. So short-term plans in Nevada have maximum terms of 185 days, and continue to be nonrenewable, as those are the state’s rules. (In states that don’t impose stricter limits, the new federal rules allow short-term plans to have initial terms of up to 364 days, and total duration, including renewals, of up to three years).
Read more about short-term health plans in Nevada.
How has Obamacare helped Nevada residents
In 2013, a fifth of Nevada residents (20.7 percent of the population) were uninsured. By 2018, that number had fallen by nearly 46 percent, to 11.2 percent.
Medicaid enrollment in Nevada increased by 88 percent from 2013 to early 2020 – the second-highest percentage increase in the US, second only to Kentucky. Clearly, the expansion of Medicaid has played a major role in reducing the number of Nevada residents without health insurance.
Nevada and the Affordable Care Act
In 2010, Nevada’s U.S. Senators were split on healthcare reform. Democratic Senate Majority Leader Harry Reid voted yes and was an ardent supporter of the ACA from the get-go. But Republican John Ensign voted against the ACA. In the U.S. House, two Nevada Democrats – Dina Titus and Shelley Berkley – voted yes, while one Republican – Dean Heller – voted no.
Reid did not run for reelection in 2016, and was replaced in the Senate by Democrat Catherine Cortez Masto, who supports the ACA. Jacky Rosen, also a Democrat, is now the Junior Senator from Nevada and is also a strong supporter of the ACA.
In the U.S. House, Nevada’s delegation now includes three Democrats and one Republican.
At the state level as of 2020, Nevada has a Democratic governor (who supports the ACA and is working to protect it from being overturned in the Texas v. Azar lawsuit), and a Democratic majority in both the Senate and the Assembly.
Former Governor Brian Sandoval, a Republican, was generally opposed to the ACA because of “the individual mandate it places on citizens, the increased burden on businesses and concerns about access to health care.” But in 2012, Sandoval became the first Republican governor to accept federal funding to expand Medicaid starting in 2014, and he continued to urge the Trump Administration to ensure that any changes to the ACA wouldn’t pull the rug out from under the hundreds of thousands of people who have gained coverage in Nevada as a result of the ACA — mostly via Medicaid expansion.
Nevada was also the only state with a Republican governor that opted to run its own exchange in 2014. Unfortunately, Nevada Health Link ran into crippling technical problems early in open enrollment and never fully recovered. In May 2014, shortly after the first open enrollment period ended, the Nevada exchange board unanimously agreed to switch to Healthcare.gov‘s enrollment platform but continue to exist as a supported state-based marketplace. That is the structure Nevada used until the fall of 2019, when they switched back to using the much improved Nevada Health Link platform.
Medicare enrollment in Nevada
In Nevada, there were about 540,000 Medicare enrollees as of early 2020. About 40 percent are enrolled in Medicare Advantage plans, while about 60 percent have Original Medicare.
Read more about Medicare in Nevada, including the state’s rules for Medigap plans.
State-based health reform legislation
Scroll to the bottom of this page for a summary of recent Nevada bills related to health reform.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.