Nevada Public Option anticipated to generate significant savings to State

Carson City September 23, 2022

Nevada’s Public Option could generate anywhere from $300 to $400 million in health care savings over the first five years and nearly $1 billion by year 10 according to findings released today during an informational webinar by state officials at the Nevada Department of Health and Human Services (DHHS). Most of the projected savings could be passed back to Nevada through a federal waiver that Nevada Medicaid intends to submit for approval by March of next year.

According to experts, the specific amount received by the State will be dependent on how Nevada uses the new funding generated under the waiver to impact enrollment in the Silver State Health Insurance Exchange. Based on current projections, about 50,000 Nevadans are expected to enroll in the Public Option in 2026, which is the first year that the Public Option will be available for purchase by consumers. Experts also predict that enrollment in the Public Option could nearly double by 2030 depending on whether the State uses the savings it receives to further buy down premium costs for consumers in the Silver State Health Insurance Exchange.

“These findings show that health care reform is long overdue in Nevada,” said Governor Steve Sisolak. “This groundbreaking effort will set an example for other states nationwide, bringing future relief to families with more affordable health insurance for Nevadans.”

The early estimates from today’s webinar provide a glimpse into the State’s federal waiver application and actuarial study for the Public Option that is required to be submitted to the federal government under NRS 695K.210. The completed application and full actuarial report are expected to be released this November by DHHS for public review and comment. The anticipated savings discussed today reflect the likely effects of the new Public Option plans on reducing premium costs for health insurance and increased competition in Nevada’s marketplace. Federal savings received by Nevada as part of the new Public Option plans must be kept in a state trust fund to be used to improve the affordability of health care coverage for Nevadans.

The Nevada Public Option concept leverages the State’s largest purchasing authority through its Medicaid contracts, which are worth more than $2 billion to health plans. The new state law directs DHHS to require health plans wanting to participate in Nevada Medicaid to also offer a bid to participate in Nevada’s Public Option and meet specific guidelines, including offering lower premium costs, modernizing payments to providers, and strengthening provider networks statewide.

Senator Nicole Cannizzaro, who authored the establishing legislation for the Nevada Public Option, is one of the many leaders driving the effort along with Nevada Medicaid, Silver State Health Insurance Exchange, and the Division of Insurance.

“It is reassuring that health plans, providers and community advocates are coming together to bring down health care costs for Nevadans, bringing more money to Nevada, and keeping our workforce healthy,” said Senator Cannizzaro.

As required by federal law, DHHS must publicly post the 1332 waiver application and the final actuarial report for public comment before submitting it to the federal government. As announced at today’s webinar, DHHS expects to be ready for the formal public release in November. At this time, DHHS plans to provide for a 45-day state public comment period that includes at least two public hearings and tribal consultation. For more information, visit the Public Option website at


Kyril Plaskon
Public Information Officer, Division of Health Care Financing and Policy