Nevada senators call for saving health insurance credits

Nevada's Democratic Sens. Jacky Rosen and Catherine Cortez Masto are pushing to prevent the expiration of Affordable Care Act enhanced premium tax credits and the loss of Nevadans' health coverage.

Rosen and Cortez Masto held roundtable discussions Thursday and Friday with Nevada Health Centers representatives, insurance experts and tax credit recipients about impending financial costs and consumer burdens from cutoffs to Medicaid if the subsidies cease and premiums rise.

"It's all kinds of people across the spectrum, and in 2022, we fought to expand on the tax credits," Rosen said Thursday in Carson City. "So it's not just premiums that go up, but people get less insurance. Their deductibles may go up, so that's more out of pocket than that. They're getting hit and squeezed in a lot of ways."

The tax credits, or subsidies, benefit eligible individuals with incomes between 100% and 400% above the federal poverty level. The Biden administration supported legislation increasing expanded eligibility of tax credits in 2021. Marketplace enrollment saw a significant surge, doubling to about 24.2 million people this year while 90% of enrollees received the premium tax credits.

More than 100,000 Nevadans currently rely on coverage through the ACA marketplace and ultimately would feel the impacts, Rosen said during her introduction.

Cortez Masto on Friday said without the credits, more than 20,000 could lose their coverage, with an average Nevada family of four earning $56,000 a year and potentially see an increase of $205, or $2,460 per year, in insurance costs.

Panelists from both roundtables representing various health care organizations shared professional or personal experiences on the issue. Some were practitioners, policyholders or advocates working with customers who have been frustrated about coverage or missing enrollment windows for different circumstances.

Dr. Sangeeta Wagner, Nevada Health Centers chief integration officer, provides clinical management and research trials. Wagner said makes it challenging to provide patients who have manageable, preventable chronic illnesses with access to immediate care.

"It makes it harder for us providers to do our work," she told Rosen. "It makes it harder on the patients. It's overall a trickle-down effect in terms of then where do the patients go to get here? They're going to be going to the emergency room setting."

NHC is a federally funded nonprofit working in the state's urban and rural communities. The organization offers more than 20 locations, mobile health programs and seven Women, Infants and Children offices. NHC staff members told Rosen they won't turn anyone away despite inability to pay but loss of insurance affects patient health and creates hesitation to see doctors.

Self-employed attorney Sean McCoy, speaking with Cortez Masto on Friday, explained he previously worked in state and county government. However, his daughter was diagnosed with type one diabetes during the pandemic and his wife was diagnosed with a chronic illness. He described needing benefits flexibility that he couldn't receive from government work, so he entered the private sector and began using the Nevada Health Exchange.

Using the tax credits was his best option to access insulin and other medication his family depends on, he said.

"This is lifesaving medicine we're talking about," he said. "This isn't a luxury, you know. They need it to live. … I took the employer benefits for granted for years, and then having to come out on your own now, it's great to have the exchange and have that option, but without these credits, I don't see how families are going to be able to make that call and actually continue to get the insurance."

Latoschka Nether, Nevada senior grassroots advocacy manager for the American Cancer Society Cancer Action Network, shared with Cortez Masto the organization works to provide patients with access to essential coverage and affordable treatment. More than 700 cancer advocates this month gathered in Washington, D.C., to urge passage of the Multi-Cancer Early Detection Screening Coverage Act. Cortez Masto called it heartbreaking when patients with a diagnosis don't know what to do next after losing coverage.

Both senators also touched on the ongoing provider shortage to address greater access to services in outlying communities. Rosen this year has introduced legislation such as Specialty Physicians Advancing Rural Care (SPARC) Act supporting a student loan repayment program for specialist medical professionals and other acts to increase opportunities for graduates to enter medical residency slots when hospital closures take place in other parts of the country.

Rosen said it's important for advocates and those seeking coverage to keep sharing their stories to stress to keep from the tax credits expiring and access to resources for individuals and small businesses.

"We can't be silent when it comes to the dignity, kindness and compassion of giving people affordable health care," Rosen said.