Medicaid

Background:

Nevada has almost 400,000 uninsured residents residing at or below 200% of the Federal Poverty Line who have typically not been able to access health care services on a continual basis. While Nevada Check-Up has enrolled over 27,000 children in low-cost health insurance, there remains a large population in Nevada, including adults, who are “working poor” families who are unable to obtain health insurance. The barriers for this population include the high cost of coverage through employer sponsored group health insurance, restricted hours of employment to qualify for employer benefits, and the high cost of obtaining a private health insurance policy. Because of a lack of options for Nevadans, inappropriate utilization of hospital emergency rooms and other costly methods are being used or no health care is being sought. The methods are costly for providers and the state and place other Nevadans at-risk for exposure to potential diseases.

Challenges:

	The high cost of health insurance has made it virtually impossible for small business owners to purchase insurance for their employees
	Uninsured children are more likely to than insured children to have health problems
	Most uninsured people experience difficulty obtaining needed care
	Many people rely on emergency care and under-use preventative care
	Families face difficulties paying medical bills and are often subject to collections, legal action, and even bankruptcy
	Uninsured children are more likely to experience restrictions on childhood activities such as rollerblading, bike riding, or team sports, because of parental concerns about possible accidents and attendant medical care costs, as well as regulations governing school sports programs

Recent studies* indicate:

	More than 16% of Nevada residents are without insurance
	Persons of Hispanic origin are more than twice as likely to be uninsured as persons not of Hispanic origin and almost three times as likely to be part of the ‘working poor’ uninsured category than other persons
	Almost 60% of Nevadans who are in poverty are also uninsured

*Great Basin Primary Care Association 2004 Uninsured Study

Proposed Solutions:

Support national efforts to develop an insurance program that allows small business owners and employees to partner on paying health insurance premiums for themselves and their families.

Collectively purchasing health insurance allows small businesses to provide affordable health insurance to their employees. Given that large businesses provide insurance to an increased number of employees, they are able to receive significantly reduced insurance rates. This makes insurance much more affordable for both the employer and the employee. Small businesses should be able to receive similar rates by joining together and purchasing insurance for their employees. Knowing that there are affordable health care options available will encourage more businesses to do provide it.

Expand the income caps for Medicaid and Nevada Check-Up to allow more families to participate.

With almost 400,000 uninsured residents, it is imperative that the caps are expanded to reduce this rate. The ‘working poor’ often fall through gaps in insurance programs, as they cannot afford their own insurance yet they do not qualify for Medicaid. Their children are often left without insurance, as well. This leads to more missed days of work and school, and it inhibits their abilities to lean new things because they live with untreated medical problems. By allowing more residents to enroll in Medicaid and Nevada-checkup, families can receive quality health care while continuing to provide for their families.

Included Benefits:

	Increased number of Nevadans who have health insurance
	Increased access to health care services for Nevadans
	Increase preventative health service obtained
	Less missed work/school
	More accessibility to affordable health insurance coverage
	Increased revenue for Nevada safety net providers

74th Session	Great Basin Primary Care Association On-line Legislative Action