By Pete Sepp, president of Nevada Taxpayers Union and Senator Robin L. Titus, MD, (R-Wellington, NV)
Across the state, Nevadans are rightfully worried about whether they can afford the cost of a major health event. But is a taxpayer-backed health insurance system, which will raise revenues and expenditures for the state in a constitutionally dubious way, really the best solution to the problem?
Nevada’s so-called “public option” will decrease patient access to health care while exposing taxpayers to unneeded and unwarranted risk – and state legislators rushed into the idea so quickly that it might not even be legal.
Whether measured by reducing uninsured rates or premiums, the other two states with taxpayer-backed public options – Colorado and Washington – have delivered poor results for consumers. An analysis published in the Journal of the American Medical Association Forum recently concluded that these states “offer cautionary tales” to others “entertaining public option proposals.”
Supporters of SB420, the bill creating the public option in Nevada, may have dismissed such problems three years ago, but they can’t easily do so now.
In 2021, Nevada lawmakers pushed this bill through the Legislature to create the public option despite warnings from health care leaders that it would hurt access and affordability and burden providers.
Taxpayers will suffer from SB420 and it violates the Nevada Constitution three times over.
First, since 1996, the Nevada Constitution has required a two-thirds majority in both the Assembly and the Senate to pass any bill that “creates, generates, or increases any public revenue in any form.” SB420 will generate public revenue and it was not passed by the necessary two-thirds majority in either legislative house. Some have suggested this protection only applies to direct tax hikes. But Nevada courts have never upheld such an argument, and Nevadans knew what they were voting for 30 years ago.
Second, SB420 contradicts the constitution’s appropriations clause by giving the state treasurer and executive agency officials unlimited discretion in deciding how to use an unspecified amount of funds for the vague purpose of increasing affordability.
Third, SB420 defies the separation-of-powers principle by giving away the legislative branch’s lawmaking authority to executive branch agency directors without sufficient direction.
With the bill moving toward implementation, it’s critical for Nevadans to understand that, in addition to the negative consequences SB420 will have for health coverage and care, it was also enacted in violation of the Nevada Constitution.
That’s why we recently joined together to file a lawsuit challenging SB420. Our lawsuit asks the court to stop the implementation of SB420 because it violates those aforementioned three provisions of the Nevada Constitution.
While Nevada’s current administration has proposed moving ahead with SB420’s implementation via a market stabilization program, this approach does not change the fundamental problems with the bill and how it was enacted.
As federal regulators consider the state’s proposal to move ahead with this risky, unaffordable new health insurance system, we will continue pursuing our case in court.
Nevadans deserve access to high-quality, affordable health coverage and care. They also deserve to have their constitutional rights upheld. SB420 fails on both fronts. Nevada can do better.
