Nevada Medicaid-for-all Plan Is Increasingly Closer to Reality

Nevada’s plan for “Medicaid-for-All” as an approach to offering everyone in the state health insurance, and indirectly, health care, is increasingly closer to becoming reality. Let’s look at proposed Medicaid for All program and the pros and cons of such an approach.

The History of Nevada’s Medicaid for All Program Attempts

Nevada legislators have been working on various proposals to let everyone buy into Medicaid for years. The 2017 proposal would put Medicaid on the Nevada state health insurance exchange as “the public option”, assuming it is signed by Governor Brian Sandoval. Those who qualify for tax credits under Obamacare would, as per the four-page bill, be allowed to use those tax credits toward the cost of buying Medicaid coverage instead. It would offer very similar coverage to traditional Medicaid, except some services will be limited to those with a very low income.

The Pros of Medicaid for All

Expansion of Medicaid allows many low-income people who don’t currently qualify for Medicaid to do so, often at a lower cost than state-based high-risk pools.

The Medicaid-for-all model has already been legally tested in a number of other states that let the disabled with a low income buy into Medicaid. Medicaid for all is cheaper for the state than the “Medicare for all” model proposed for universal health coverage, though this is primarily due to lower reimbursement rates for doctors.

Expansion of Medicaid for all is simpler than trying to set up yet another government program, and there are already many medical practitioners enrolled in Medicaid ready to accept these patients. Integrating Medicaid into Obamacare would be relatively seamless, and transitioning from “Medicaid to all” to Medicare at retirement age is equally smooth because so many already do so each year. Expect those having earned an online master of healthcare administration in strategy and innovation to handle this task if the bill passes, as online MHA degree holders are well-placed to understand the intricacies of such a scheme.

The program would be optional since it would allow consumers to choose other health insurance plans on the state’s insurance exchange. It isn’t mandated like Canada’s health insurance program, driving many to receive privately paid-for care in the United States because of official and de facto rationing to save money. By setting the public option at the state level, Nevada can implement “Medicaid for All” regardless of Washington politics and adjust coverage to contain costs without going through Congress.

The Cons of Medicaid for All

Medicaid for all is expensive for the states. It indirectly incentivizes people not to work or take care never to pass the thresholds that qualify everyone below certain income limits to Medicaid.

Medicaid expansion crowds out private health insurance, leading to higher dependence on state coverage. Cost controls under Medicaid lead to more types of care shifted back to the individual, lower reimbursement rates that drive doctors out of the program, and de facto rationing. You don’t have health care if there are no health providers willing to accept your state’s health insurance program and Medicaid prevents you from paying out-of-pocket for anything else.


Medicaid for all offers a simple way to expand state health insurance to the poorest residents due to much of the necessary infrastructure and IT systems already being in place. The state retains control of the program but takes on the potentially high costs of the project. The quality of care patients receive depends on how many doctors and specialists are willing to accept Medicaid’s historically low reimbursement rates.

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