Under the Affordable Care Act, or ACA, more than 400,000 Nevadans have gained health care coverage over the last four years through the state insurance exchange or the expansion of Medicaid. The possible repeal and replacement of the ACA, also known as “Obamacare,” raises concerns about how Nevadans will be affected. Reno Public Radio’s Anh Gray talks with a Nevada health policy expert to learn more.
John Packham is an associate professor and also the Director of the of Health Policy Research at the University of Nevada, Reno, School of Medicine. He joins us today to talk about how the Affordable Care Act has impacted Nevadans over the last several years and what changes could mean for the state.
“That’s what makes all this talk about repeal and replacement very interesting, whatever one thinks about the Affordable Care Act, baked into the law are provisions which provide subsidies for very low income people. Those go away with most of the repeal plans currently being discussed,” Packham says.
Packham says the rate of uninsured Nevadans has dropped significantly over the last several years and that repealing the law would impact "the sick and the poor” the most.
“The insurance expansion has resulted in the most dramatic impacts. We’ve seen the uninsured rate in our state drop from 27 percent in 2013 to 17 percent in 2015,” Packham explains. “That’s largely been the result of about 200,00 people gaining coverage through the Medicaid expansion and another 90,000 this year gaining through the private health insurance exchange.”
Packham explains some people are still falling through the cracks and remain uninsured. Some of these people are middle-income families who do not qualify for subsidies and are still not able to afford insurance. High premiums and high deductibles are aspects of the health law, Packham says, that could be improved.
“Well, I think the insurance coverage expansion and the gains and access are important. I think that represents progress in our state,” Packham says. “Despite impressive gains in health insurance coverage and improved access for hundreds of thousands of Nevadans with the enactment of the Affordable Care Act, there still are about 10 percent of kids in our state and about 15 percent of adults in Nevada who remain uninsured.”
Packham says it’s still unclear what a repeal and replacement of the ACA will look like for now and creates uncertainty.
Governor Brian Sandoval wrote a letter to Congress in January urging them to keep state lawmakers engaged in their ongoing process of replacing the health law.