Nevada
‘Tremendous contributions:’ Southern Nevada’s top health official is retiring
Dr. Fermin Leguen’s family had expected him to become physician since he was a child growing up in Cuba.
He initially thought that he might study aviation technology. He wanted travel the world.
“Honestly, medicine wasn’t one of my top things to do,” he said in a recent interview. “But at the same time — like every other kid — you really have no idea about what any career is about.”
Leguen, 71, eventually made a choice he said he’s never regretted.
“Finally, I decided to go with medicine,” Leguen said.
Southern Nevada’s Health District top official is retiring at the beginning of March, marking an end to a decades-long career that dispatched him across the globe to serve in public health.
“I have never (spent) a long period of time doing nothing, so I don’t know what to expect,” he said about his upcoming retirement.
Leguen — who became the face of the valley’s COVID-19 response as acting chief health officer— said he will miss his team and their dedication.
He will simply miss “just being here.”
Leguen said he believes the Health District will remain in good hands, supported with a “very strong team.”
“We have very professional people here with a lot of skills, highly trained,” he said. “Regardless of who’s leading the organization, the biggest strength we have is the people we have here. And they are fully capable of responding to multiple public-health threats that we could face.”
The Health District board appointed Dr. Cassius Lockett — deputy district health officer — to succeed Leguen.
‘Tremendous contributions’
Leguen, who speaks softly and has a shy demeanor, was honored at Las Vegas City Hall earlier this month.
Shortly after the room cleared from the festivities that welcomed new Mayor Shelley Berkley and Councilwoman Shondra Summers-Armstrong, Councilwoman Olivia Diaz took the microphone to issue a proclamation honoring Leguen for his “tremendous contributions.”
“Dr. Leguen, gracias,” Diaz said. “I just want to say ‘thank you’ for everything that you have done.”
Leguen joined the health district in 2016 as director of clinical services. In October 2019 — a few months before the global pandemic broke out, he was named acting chief health officer.
“Little did we know when we selected him… what we were going to be reeling and dealing with as the world and as a community,” Diaz said. “I don’t think this man would get a shut eye.”
As the health district searched for a permanent agency head, “the board leadership just decided Dr. Leguen has already proven himself as the right leader for this agency.”
Leguen was officially promoted in early 2021.
During his tenure, he spearheaded the opening of two community health hubs that offer immunizations and primary health services for patients with no health insurance, Diaz noted.
He said he’s proud of his administration’s program that helps address a congenital syphilis crisis that’s “devastating” children.
During the pandemic, Leguen led the rollout of a bilingual education campaign for Spanish speakers at a time when Latinos accounted for 25 percent of COVID-19 deaths, Diaz said.
When Clark County commissioners faced backlash in the fall of 2021 over a resolution declaring vaccine misinformation a source of increased demand for unsafe treatments, Leguen supported the motion.
“While it is essential for public agencies to provide a forum for people to comment and give input on issues that impact them, it is critical that information impacting the health and safety of the public be based on proven science and accurate data,” he said at the time.
“He’s made it a priority for the Southern Nevada Health District to reflect the community it serves,” Diaz said. “And to forge partnerships with diverse community organizations in order to better reach and serve underserved residents.”
Diaz said Leguen headed the region’s response to other public health emergencies, such as the opioid epidemic and the West Nile virus.
“I wish COVID was the only one,” Diaz said.
A life of service
Leguen was born in Guantanamo, Cuba. His parents moved the family to the capital city of Havana when he was a toddler.
He studied medicine at the University of Havana.
Leguen worked for Cuba’s social services. He fled the communist country in 1991, eventually migrating to the U.S. where he began a residency in Puerto Rico before completing a pediatric residency at Johns Hopkins Hospital.
Throughout his career, he was a vaccination consultant in Africa, Caribbean countries and South America.
He credits vaccinations for saving lives during the pandemic.
“When you’re seeing the number of deaths increasing day by day and there is nothing telling you that this is going to get better, it’s very, very depressing,” he said.
While nobody can fully prepare for a future pandemic, Leguen said that the agency has learned lessons to hamper the impact. Community in Southern Nevada collaboration was crucial, he added.
“We must be ready to learn every single day,” he said. “Nobody has the 100 percent answer for anything. We must be willing to communicate with our peers and the public our concerns, our limitations. And also make sure our community is aware of the multiple threats that could be there.”
Leguen, who has a wife and a daughter, said he’s looking forward to having more time to read fiction and watch Korean movies.
Asked to reflect about being an immigrant of color in the U.S. with a life of service under his sleeve, Leguen spoke generally about living out a dream.
“What I would say to anybody is that you have to follow your dreams,” he said. “You must be consistent with your beliefs. You must be able to sacrifice yourselves and be confident.”
Contact Ricardo Torres-Cortez at rtorres@reviewjournal.com.
Nevada
How the strikes on Iran could impact gas prices in northern Nevada
The United States and Israel launched targeted attacks on Iran on Saturday. The move brought new uncertainty into global energy markets, as northern Nevadans could be paying more at the pump in the coming weeks.
Following the strikes, oil prices increased. Brent crude, the international benchmark, jumped to roughly $73 a barrel, while the national benchmark, West Texas Intermediate, traded above $67.
Much of the concern centers around the Strait of Hormuz, a narrow waterway between Iran and Oman. which carries about a fifth of the world’s oil supplies.
Patrick de Haan, head of petroleum analysis with GasBuddy, a price tracking company, spoke on the current questions in the region.
“The known would reduce oil prices if there becomes clarity, but it’s the unknown that is stoking fears…. If there is some sort of clarity in the days ahead, whether from Iran, the United States, or Israel, on how long this would last. We’d be able to put potentially an end date for the potential impacts that we’re seeing,” said de Haan.
Experts say for every $5 to $10 increase in oil prices, drivers could pay 15 to 25 cents more per gallon.
According to Triple-A, the average price of a gallon of gas in Nevada on Sunday comes in at $3.70, which comes in above the national average of roughly $2.98.
Over at the Rainbow Market on Vassar Street, prices sat just below four dollars a gallon on Sunday. Reno resident Abran Reyes talked about gas prices potentially going up.
“Whether it’s to work, to maybe run errands, to do stuff that helps you, gas is essential…. That gas price really hits, especially in today’s economy, where gas prices are extraordinary…. I just hope everyone’s safe. I hope our soldiers and all of our troops can be okay,” said Reyes.
Nevada
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.
Nevada
NEVADA VIEWS: Planning for a resilient economic future
Southern Nevada has a proud history of competing — and winning — through boldness and reinvention. We have developed a world-class tourism economy, built globally recognized brands and demonstrated our ability to rebound from significant disruptions. In today’s fiercely competitive global economy, however, we must intentionally design the next chapter of our economic story. Communities worldwide are continuously enhancing their sophistication, and we must keep pace.
Since joining the Las Vegas Global Economic Alliance in late August of last year, I have consistently heard from community partners that we must diversify and enhance Southern Nevada’s economy. Our goal is to build upon and complement the strengths we already possess.
To achieve this, the alliance, as Southern Nevada’s regional economic development organization and designated Regional Development Agency, is embarking on a comprehensive strategic planning process. This initiative will guide our economic development priorities both in the near and long term, ensuring that we focus on areas that will yield the most positive impact.
The alliance has a history of reinvention, having been established in 1958 as the Southern Nevada Industrial Foundation, later becoming the Nevada Development Authority, and since 2011, operating under its current name in partnership with the Governor’s Office of Economic Development.
Economic development extends beyond merely attracting companies. It encompasses the ability of local families to access high-wage careers, the opportunity for young people to build their futures at home and the resilience of our economy to withstand disruptions.
Over the past decade, Southern Nevada has made significant strides toward economic diversification, with investment outcomes in 2025 surpassing those of 2024. However, our work is far from complete. While tourism will always be a foundational strength and source of pride for our region, over-reliance on any single sector poses risks. A diversified economy enhances stability, and stability creates opportunities. We are united in our desire for more accessible housing, expanded health care and education, and greater upward mobility for our residents.
This strategic planning effort aims to ensure that the alliance and its partners concentrate on the right initiatives in the right manner. It will validate the region’s target industries and subsectors, narrowing our focus on areas where Southern Nevada has genuine competitive advantages and long-term potential. The planning process will include community interviews, focus groups and surveys to ensure our final strategy reflects the real opportunities and challenges facing Southern Nevada. We will establish flagship goals and a prioritized strategy matrix to direct our attention and resources toward meaningful outcomes.
A crucial aspect of this process involves clarifying roles within the broader economic ecosystem. Economic development is a team sport — when organizations replicate efforts, operate in silos or compete for recognition, the region loses valuable time and credibility, allowing opportunities to slip away. I have witnessed this behavior in various markets, serving as a red flag for prospective companies.
We have already made strides in building partnerships, exemplified by a Memorandum of Understanding signed in November 2025 with the Economic Development Authority of Western Nevada to jointly support economic development education and advocacy for community leaders statewide.
Our strategic work will also include a organizational assessment of the alliance, evaluating our mission, resource deployment and engagement model. Economic impact requires operational excellence and measurable execution. Most importantly, this plan — which we anticipate completing by late April — will feature a three-year road map with clear timelines, recommended actions and meaningful metrics to transparently track our progress. A longtime mentor of mine often said, “What gets watched gets measured, and what gets measured gets done.”
Las Vegas has always taken the initiative to shape its own future. This strategic plan presents an opportunity for us to do what we do best: come together, think bigger, act smarter and create something lasting. Together, we can build a purposeful and resilient economic future for Southern Nevada.
Danielle Casey is president and CEO of the Las Vegas Global Economic Alliance.
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