SB420 public option would hurt Nevada patients, worsen state’s doctor shortage

In a recent Nevada Independent article interviewing Sabrina Corlette about the pros and cons of SB420, she stated that the “devil is in the details.” The emergency medicine community that has tirelessly served Nevada 24/7/365 on the front lines of the COVID-19 pandemic could not agree more. 

The new state government health insurance program currently under consideration – often known as the “state government option” or “state public option” – is simply not the right prescription for what ails the health insurance market and is poised to create many more problems than lawmakers believe it will solve. 

The emergency medicine community believes that ensuring Nevadans have access to the health care they need at an affordable price is essential to the mission of population health. Unfortunately, the public option will likely worsen our state’s healthcare challenges, and the unintended consequences of SB420 need to be fully considered by all stakeholders at this critical juncture.

Reimbursing physicians and other health care providers at artificially low rates that don’t cover the cost of providing care will lead to some of these providers choosing to not accept the public option — and stop taking Medicare and Medicaid patients. This will lead to physician recruitment challenges, narrower networks and reduced access to care for patients statewide. (As written, SB420 mandates that if you accept Medicare or Medicaid, you MUST accept the public option.)

Some providers – particularly in underserved or rural areas – struggle already to keep their practices or critical access facilities open. SB420 has the potential to make it financially unfeasible to provide care in our state, and would likely worsen Nevada’s growing shortage of physicians, positioning the market for collapse at a time when stability is essential. We need policies that incentivize providers to accept patients on Medicare, Medicaid and the health care exchange. We need to help the uninsured sign up for the programs already available and well subsidized by the state and federal government.

As an emergency physician, I understand firsthand the importance of strong health care policy to help providers like myself deliver high-quality care to our community. I am deeply concerned that under the proposed state government option, the safety net of emergency care would be placed in peril and caring for patients would become more difficult as resources and specialty care diminish. 

As a Nevadan, I consider it part of the Legislature’s job to encourage more Nevadans to sign up for health care instead of making it harder and more expensive for my neighbors and friends to access health care.  

The focus should be placed on moving more currently eligible patients on to the Medicaid rolls and taking full advantage of the ACA’s menu of existing options.  More than half of the uninsured population is eligible for Medicaid or exchange subsidies. I believe Nevada should leave the politics behind and focus on helping patients become enrolled. 

Nevadans deserve to fully understand the potential for SB420 to limit access to care, increase our physician shortage and raise premiums for hardworking Nevadans covered by employer’s plans. On behalf of the emergency medical community, I’m urging lawmakers to pause their push for a state government option and consider the impacts it could have on Nevada patients and health care providers, rather than rushing to enact this complex legislation with just two weeks remaining in the 2021 legislative session.

Meg Jack, M.D., grew up in Reno, and graduated from Vanderbilt in Emergency Medicine in 2007. She has been working at Carson Tahoe Regional Medical Center since 2009 and serves as the medical director of the emergency department.