Legislation to create a state-run public health insurance option pushed by Senate Majority Leader Nicole Cannizzaro (D-Las Vegas) passed out of the Senate and Assembly. Once Gov. Steve Sisolak signs the bill, which he has said he will do, Nevada will become the second state in the country, after Washington, to enact a public option into law.

SB420, now the third iteration of the public option proposal in Nevada, will require insurers that bid to provide coverage to the state’s Medicaid population to also offer a public option plan. The plans will resemble existing qualified health plans certified by the state’s health insurance exchange, though the legislation requires them to be offered at a 5 percent markdown, with the goal of reducing average premium costs in the state by 15 percent over four years. 

Individuals covered under  public option would pay for premiums, though those who qualify for subsidies through the state’s health insurance exchange would be able to use those dollars to cover some or all of the costs of the public option plan. The public option will be available for purchase starting in plan year 2026.

Health care pricing transparency also continued to be a key theme this session, as lawmakers passed SB40, a bill to create an all-payer claims database, and SB380, a proposal to expand the state’s drug pricing transparency law. Supporters of the all-payer claims database hope that the data collected will help improve health care affordability and efficiency, as well as boost transparency around health care costs. A second pharmaceutical bill SB396, which authorizes nonprofit and for-profit entities to join interstate and intrastate drug purchasing coalitions with public entities, also passed through the legislative process, while three others died (SB392, SB378, SB201).

AB351, a bill that would allow terminally ill patients to self-administer life-ending medication passed out of an Assembly committee but never received a floor vote. This is the fourth session in a row the proposal has been introduced.

Lawmakers passed SB5, a telehealth bill, and continued to explore the issue of mental health, including passing AB181, a mental health parity bill.

Lawmakers also passed a bevy of proposals centered around women’s health, including, AB189, a measure making it easier for pregnant and postpartum women to get Medicaid coverage, and SB190, a bill making birth control available without a doctor’s appointment. Though many women’s health measures advanced, AB387, a bill establishing licenses for midwives, died in a 13-8 Senate floor vote.

Budget conversations took hold during the session as lawmakers rolled back a 6 percent Medicaid rate decrease, approved by the Legislature during a budget-slashing special session. The Governor’s Finance Office also submitted a budget amendment to entirely undo the Medicaid budget reductions approved last summer.