Nevada Public Option - Launch Date: January 1, 2026

Background, Structure, and Requirements

Passed during the 2021 Legislative Session and signed into law by Governor Steve Sisolak on June 9, 2021, Nevada Senate Bill 420 requires the Director of the Department of Health and Human Services (DHHS), in consultation with the Commissioner of Insurance and the Executive Director of the Silver State Health Insurance Exchange, to design, establish, and operate a public option health benefit plan in its nongroup markets.

  • All public option products are to satisfy state and federal standards required by insurance products sold in the Nevada Health Link (i.e., a qualified health plan under the Affordable Care Act).
    • This means low- and middle-income consumers qualifying for federal premium subsidies under the ACA could apply their subsidies to the new product if purchased through the Exchange.
  • The new law allows Nevada to require all health insurers that want to continue to participate in the State’s Medicaid managed care program to submit a good faith bid to also contract with the State to offer and administer products for the public option. The State may also invite non-Medicaid insurers to submit bids.
  • The Director of DHHS will oversee the bidding process, using a statewide competitive process in conjunction with the State’s next procurement process for Medicaid managed care, in order to align purchasing incentives and leverage existing provider networks.
  • State-contracted health insurers for the public option will be required to pay providers in-network reimbursement rates at least comparable to, or better than, Medicare rates for covered services.

    Actuarial Analysis

    This report provides the required actuarial analysis, economic analysis, and certification to support the State of Nevada's determination that the Public Option meets the requirements of a Section 1332 waiver.

    How to submit public comment

    Senate Bill 420, passed in the 2021 Nevada Legislative Session, mandates:

    • Submission of the 1332 waiver by January 1, 2024. 
    • Public Option products must be available by January 1, 2026.

    The implementation requires the application for a 1332 Waiver and accompanying Actuarial/Economic Analysis and Certification. The materials are available for review and can be found below. Questions may be sent to

    2022 Meetings & Materials

    Public Hearing - Premium Reduction Targets
    December 27th, 10 AM - Meeting Information & Agenda
    Office Hours - Stakeholder Engagement 
    Sessions were held in 2022 on October 13, 21, 27 and November 3, 4, 10, 11.
    Click here for answers to questions received during Office Hours
    Actuarial Study Informational Webinar - September 23, 2022 

     Watch the Video Recording of the Meeting

     Preliminary Actuarial Study Presentation

    Stakeholder engagement & waiver design public meetings - November 2021-January 2022 

    • Specific stakeholder meeting dates will be added to the Public Option Meetings page.
    • Join the notification list for the Public Option, simply click here and send the email
    • To submit questions or comments, write to 

      Meeting agendas, links and documents are available here
    • December 8, 2-3 PM - Video Recording
      • Goals and Guiding Principles 
      • Overview of Legislation and 1332 Waivers
      • Overview of Public Option Designs in Other States
    • December 22, 2-3 PM - Video Recording
      • Stakeholder Priorities for the Design of This Public Option (e.g., affordability, networks, access, provider reimbursement, etc.)
    • January 5, 2-3 PM - Video Recording
      • Target population
      • Affordability: Cost-Sharing and Premiums
    • January 13, 1-2 PM - Video Recording
      • Benefits
      • Value-Based Payment / Cost Containment
    • January 18, 12-1 PM - Video Recording
      • Health plan rate setting and rate review
      • Provider contracting and networks
      • Strengthening the Individual and Small Group Markets
    • January 28, 1-2 PM - Video Recording
      • Licensure and Oversight
      • Offering the Public Option in the small group market
      • Next Steps (actuarial analysis, subsequent opportunities for stakeholder feedback, waiver development)
    *Please note all of this information is tentative. For updates please join the Public Option ListServ mentioned above. 

      Additional Information

      SB420 requires the Director of the Department of Health and Human Services to apply for a Section 1332 State Innovation Waiver. For more information, the Centers for Medicare & Medicaid Services has a page dedicated to Section 1332: State Innovation Waivers.

      Stay Informed

      Sign up for the Public Option ListServ and receive emails regarding meetings, documents and presentations. We will not share your information and the number of emails is minimal.

    • To join the notification list for the Public Option, simply click here and send the email.

    • If you experience challenges signing up, write to Public Information Officer Ky Plaskon at


        If you would like to submit comments or questions, please use the following email.

        Bulletins (State Guidance)

        Requirements for the Public Option Premiums - 10/4/2022


          Coming soon