Nevada

Nevada debuts public option amid federal health care shifts

Published

3 days ago

March 1, 2026

Nevada debuts public option amid federal health care shifts

More than 10,000 people have enrolled in Nevada’s new public option health plans, which debuted last fall with the expectation that they would bring lower prices to the health insurance market.

Those preliminary numbers from the open enrollment period that ended in January are less than a third of what state officials had projected. Nevada is the third state so far to launch a public option plan, along with Colorado and Washington state. The idea is to offer lower-cost plans to consumers to expand health care access.

But researchers said plans like these are unlikely to fill the gaps left by sweeping federal changes, including the expiration of enhanced subsidies for plans bought on Affordable Care Act marketplaces.

The public option gained attention in the late 2000s when Congress considered but ultimately rejected creating a health plan funded and run by the government that would compete with private carriers in the market. The programs in Washington state, Colorado, and Nevada don’t go that far — they aren’t government-run but are private-public partnerships that compete with private insurance.

In recent years, states have considered creating public option plans to make health coverage more affordable and to reduce the number of uninsured people. Washington was the first state to launch a program, in 2021, and Colorado followed in 2023.

Washington and Colorado’s programs have run into challenges, including a lack of participation from clinicians, hospitals, and other care providers, as well as insurers’ inability to meet rate reduction benchmarks or lower premiums compared with other plans offered on the market.

Nevada law requires that the carriers of the public option plans — Battle Born State Plans, named after a state motto — lower premium costs compared with a benchmark “silver” plan in the marketplace by 15% over the next four years.

But that amount might not make much difference to consumers with rising premium payments from the loss of the ACA’s enhanced tax credits, said Keith Mueller, director of the Rural Policy Research Institute.

“That’s not a lot of money,” Mueller said.

Three of the eight insurers on the state’s exchange, Nevada Health Link, offered the state plans during the open enrollment period.

Insurance companies plan to meet the lower premium cost requirement in Nevada by cutting broker fees and commissions, which prompted opposition from insurance brokers in the state. In response, Nevada marketplace officials told state lawmakers in January that they will give a flat-fee reimbursement to brokers.

The public option has faced opposition among state leaders. In 2024, a state judge dismissed a lawsuit, brought by a Nevada state senator and a group that advocates for lower taxes, that challenged the public option law as unconstitutional. They have appealed to the state Supreme Court.

Federal Policy Impacts

Recent federal changes create more obstacles.

Nevada is consistently among the states with the largest populations of people who do not have health insurance coverage. Last year, nearly 95,000 people in the state received the enhanced ACA tax credits, averaging $465 in savings per month, according to KFF, a health information nonprofit that includes KFF Health News.

But the enhanced tax credits expired at the end of the year, and it appears unlikely that lawmakers will bring them back. Nationwide ACA enrollment has decreased by more than 1 million people so far this year, down from record-high enrollment of 24 million last year.

About 4 million people are expected to lose health coverage from the expiration of the tax credits, according to the Congressional Budget Office. An additional 3 million are projected to lose coverage because of other policy changes affecting the marketplace.

Justin Giovannelli, an associate research professor at the Center on Health Insurance Reforms at Georgetown University, said the changes to the ACA in the Republicans’ One Big Beautiful Bill Act, which President Donald Trump signed into law last summer, will make it more difficult for people to keep their coverage. These changes include more frequent enrollment paperwork to verify income and other personal information, a shortened enrollment window, and an end to automatic reenrollment.

In Nevada, the changes would amount to an estimated 100,000 people losing coverage, according to KFF.

“All of that makes getting coverage on Nevada Health Link harder and more expensive than it would be otherwise,” Giovannelli said.

State officials projected ahead of open enrollment that about 35,000 people would purchase the public option plans. Of the 104,000 people who had purchased a plan on the state marketplace as of mid-January, 10,762 had enrolled in one of the public option plans, according to Nevada Health Link.

Katie Charleson, communications officer for the state health exchange, said the original enrollment estimate was based on market conditions before the recent increases in customers’ premium costs. She said that the public option plans gave people facing higher costs more choices.

“We expect enrollment in Battle Born State Plans to grow over time as awareness increases and as Nevadans continue seeking quality coverage options that help reduce costs,” Charleson said.

According to KFF, nationally the enhanced subsidies saved enrollees an average of $705 annually in 2024, and enrollees would save an estimated $1,016 in premium payments on average in 2026 if the subsidies were still in place. Without the subsidies, people enrolled in the ACA marketplace could be seeing their premium costs more than double.

Insights From Washington and Colorado

Washington and Colorado are not planning to alter their programs due to the expiration of the tax credits, according to government officials in those states.

Other states that had recently considered creating public options have backtracked. Minnesota officials put off approving a public option in 2024, citing funding concerns. Proposals to create public options in Maine and New Mexico also sputtered.

Washington initially saw meager enrollment in its Cascade Select public option plans; only 1% of state marketplace enrollees chose a public option plan in 2021. But that changed after lawmakers required hospitals to contract with at least one public option plan by 2023. Last year the state reported that 94,000 customers enrolled, accounting for 30% of all customers on the state marketplace. The public option plans were the lowest-premium silver plans in 31 of Washington’s 39 counties in 2024.

A 2025 study found that since Colorado implemented its public option, called the Colorado Option, coverage through the ACA marketplace has become more affordable for enrollees who received subsidies but more expensive for enrollees who did not.

Colorado requires all insurers offering coverage through its marketplace to include a public option that follows state guidelines. The state set premium reduction targets of 5% a year for three years beginning in 2023. Starting this year, premium costs are not allowed to outpace medical inflation.

Though the insurers offering the public option did not meet the premium reduction targets, enrollment in the Colorado Option has increased every year it has been available. Last year, the state saw record enrollment in its marketplace, with 47% of customers purchasing a public option plan.

Giovannelli said states are continuing to try to make health insurance more affordable and accessible, even if federal changes reduce the impact of those efforts.

“States are reacting and trying to continue to do right by their residents,” Giovannelli said, “but you can’t plug all those gaps.”

Are you struggling to afford your health insurance? Have you decided to forgo coverage? Click here to contact KFF Health News and share your story.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — an independent source of health policy research, polling, and journalism. Learn more about KFF.

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Nevada

Earthquake swarm rattles central Nevada near Tonopah along newly identified fault

Published

9 hours ago

March 4, 2026

Press Room

Earthquake swarm rattles central Nevada near Tonopah along newly identified fault

A swarm of earthquakes has been rattling a remote stretch of central Nevada near Tonopah, including a magnitude 4.0 quake that hit near Warm Springs Tuesday morning.

Seismologists said the activity is typical for Nevada, where clusters of earthquakes can flare up in a concentrated area. “This is a very Nevada-style earthquake sequence. We have these a lot where we just see an uptick in activity in a certain spot,” said Christie Rowe, director of the Nevada Seismological Lab.

The latest magnitude 4.0 quake struck east of Tonopah near Warm Springs. The largest earthquake in the swarm so far has measured a 4.2.

What has stood out to researchers is the fault involved. Rowe said the earthquakes are occurring along a fault stretching along the southern edge of the Monitor and Antelope ranges — and that it was previously unknown to scientists. “We didn’t know this fault was there. It’s a new fault to us — not to the Earth, obviously — but it was previously unknown,” Rowe said.

For now, the earthquakes have remained moderate. Rowe said the lab would not deploy additional temporary sensors unless activity increases to around a magnitude 5 or greater.

Seismologists said they are continuing to watch the swarm closely as Nevada works to bring the ShakeAlert early warning system to the state. The program, already active in neighboring states, can send cellphone alerts seconds before shaking arrives. “For me, it’s a really high priority. That distance to the faults gives us enough time to warn people — and that can make a big difference in reducing injuries and damage,” Rowe said.

Seismologists encouraged anyone who feels shaking to report it through the U.S. Geological Survey’s “Did You Feel It” system, saying even small quakes can help scientists better understand Nevada’s seismic activity.

Experts said the swarm is worth monitoring but is not cause for alarm. They noted that earthquakes like the 5.8 that hit near Yerington in December 2024 typically happen in Nevada about every eight to 10 years, and said they will continue monitoring the current activity closely.

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Nevada

Kalshi Enforcement Action Belongs in Nevada Court, Judge Says

Published

22 hours ago

March 3, 2026

Press Room

Kalshi Enforcement Action Belongs in Nevada Court, Judge Says

Nevada state court is the proper venue for reviewing whether KalshiEX LLC is improperly accepting sports wagers without a license, a federal district court said.

The Nevada Gaming Control Board showed that the state statutes under which it seeks relief don’t require interpreting federal law, Judge Miranda M. Du of the US District Court for the District of Nevada said in a Monday order. The board’s action is now remanded to the First Judicial District Court in Carson City, Nev., the order said.

The board in 2025 urged Kalshi, a financial services company, to get a gaming license, but the …

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Nevada

EDITORIAL: Nevada still vulnerable as tourist downturn continues

Published

1 day ago

March 3, 2026

Press Room

EDITORIAL: Nevada still vulnerable as tourist downturn continues

Strip gaming executives can put their best spin on the numbers, but local tourism indicators remain a major concern. Casino operators seeking to draw more people through the door still have much work to do.

The Nevada Gaming Control Board released January gaming numbers Friday. The news was underwhelming. The state gaming win was down 6.6 percent from a year earlier. The Strip took the largest hit, an 11 percent drop. But the gloomy returns were spread throughout Clark County: Downtown Las Vegas was off 5.2 percent, Laughlin suffered a 3.3 percent decline and the Boulder Strip dipped by 7 percent.

For the current fiscal year, gaming tax collections are up a paltry
2.1 percent, below budget projections.

The red flags include more than gaming numbers. Recently released figures for 2025 reveal that visitation to Las Vegas fell nearly 8 percent from 2024, which represented the lowest total since the pandemic in 2021. Traffic at Reid International Airport fell more than 10 percent in December and was down 6 percent for the year. Strip occupancy rates fell 3 percent in 2025.

To be fair, this is not just a Las Vegas problem. International travel to the United States was down
4.8 percent in January, Forbes reported, the ninth straight month of decline. Travel from Europe fell 5.2 percent, and passenger counts from Asia fell 7.5 percent. Canadian tourism cratered by 22 percent.

No doubt that President Donald Trump’s blustery rhetoric has played a role in the decline, but there’s more at work. International tourism has been largely flat since Barack Obama’s last few years in office. But domestic travel has held relatively steady although it is “starting to cool,” according to the U.S. Travel Association. Las Vegas hasn’t been helped by high-profile complaints last year about exorbitant Strip prices for parking, bottled water and other staples. Casino operators responded by offering discounts, particularly for locals, and they’ll need to continue those policies into 2026.

The tourism downturn has ramifications for the state budget, which relies primarily on sales and gaming tax revenues to support spending plans. “Nevada’s employment and economic challenges reflect deep structural factors that extend beyond cyclical economic fluctuations,” noted a recent report by economic analyst John Restrepo. “The state’s extreme concentration in tourism and gaming creates unique vulnerabilities.”

The irony is that state and local politicians have been talking for the past half century about “diversifying” the state economy. In recent years, that effort has primarily consisted of handing out millions in tax breaks and other incentives to attract businesses to the state. A dispassionate observer might ask whether that approach has brought an adequate return on investment.

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