Health Care

Areas of Interest

Fighting for the health and wellbeing of all Nevadans has always been a top priority for me. I championed the passage of the Affordable Care Act, commonly referred to as the health reform law, which is helping thousands of Nevadans and millions of Americans gain access to the affordable health care that they need and deserve. I am also committed to protecting and preserving Medicare for seniors, investing in critical biomedical research to advance promising new medical discoveries, and supporting our health care workforce through investing in education and recruitment.

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Health Care Reform Means
A Better Future for Nevada

The Affordable Care Act ensures that all Nevadans and Americans have access to quality, affordable health coverage. This reform is not only lowering costs, but improving choices, competition and offering more assistance to ensure that all Americans can afford health insurance. The law strengthens Medicare for Nevada’s seniors, extending the solvency of the program by more than a decade. In fact, the Medicare Trustees Report released in July of 2014 projects that the Medicare program will remain solvent until 2030 – thirteen years longer than what was projected in 2009.  This increase is due in part to the Affordable Care Act.  The health reform law can be improved, but with hundreds of thousands of Nevadans without health insurance, Nevada cannot afford to repeal it.

In 2014, the Affordable Care Act began ensuring a competitive insurance marketplace where individual Nevadans and our small businesses can purchase affordable health insurance coverage. Nevada has also expanded its Medicaid program to cover tens of thousands of additional people with the federal government covering all medical costs for the first three years. The law provides assistance to help small businesses retain insurance, preserves early retiree coverage, lowers costs for Medicare beneficiaries, and covers young people who cannot afford insurance.

The health reform law is a fiscally responsible approach to improving our health care system, lowering costs for businesses and consumers, and covering uninsured Americans. The Congressional Budget Office has determined that the law is fully paid for, will slow the growth of health care costs, and will actually reduce the deficit by more than a trillion dollars over the next two decades.

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Highlights of Benefits of Health Care Reform for Nevada

Bans Denials Due to Pre-Existing Conditions

  • Because of the health reform law, insurance companies are no longer allowed to deny coverage or charge more to cover people with pre-existing conditions. As many as 1,157,045 non-elderly Nevadans have some type of pre-existing health condition, including 162,452 children.
  • To bridge the gap to 2014, uninsured Nevadans with pre-existing conditions benefitted from $61.1 million to provide coverage through the Pre-Existing Condition Insurance Plan (PCIP), funded by the federal government.

Bans Dropping Patients When They Get Sick

  • Insurance companies are banned from dropping people from coverage when they get sick just because of a mistake in their paperwork. This protects individuals who purchase insurance in the individual market from dishonest insurance practices.

Ends Caps on Coverage

  • Insurance companies are no longer able to place lifetime limits on the coverage they provide. Already, 937,000 people in Nevada are free from worrying about their coverage running out and facing catastrophic out-of-pocket costs.
  • Insurance companies are no longer allowed to place annual limits on coverage.

Offers Free Preventive Care

  • 76 million Americans with private health insurance now have access to preventive service coverage such as mammograms and cancer screenings with no cost-sharing, including 633,000 in Nevada.
  • Since 2010, Nevada has received almost $15 million in grants from the Prevention and Public Health Fund, which was established by the Affordable Care Act to support effective policies in Nevada, and across the country so that all Americans can lead longer, more productive lives.

Increases the Value of Your Premium Dollar

  • Under the health reform law, insurance companies must provide consumers greater value by spending at least 80 percent of premium dollars on health care and quality improvements instead of non-health care costs, such as overhead, executive salaries, or marketing. Otherwise, they must provide consumers a rebate or reduce premiums.  This is known as the 80/20 rule, or the Medical Loss Ratio (MLR).  Because of this provision of the health reform law, close to 75,000 Nevadans received a total of $4,049,168 in rebates from insurance companies in 2013, for an average of $85 per family.

Supports Nevada’s Work on Policing Unreasonable Premium Increases

  • In every state, and for the first time under federal law, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. Nevada has received over $6 million under the new law to help fight unreasonable premium increases. We are already seeing the impact of these policies: nationwide, the average premium increase in 2012 was 30 percent lower than in 2010.
  • As of September 2013, because of this rate review, Americans have saved an estimated $1 billion on their health insurance premiums since the law was enacted.

Increases Support for Community Health Centers

  • The Affordable Care Act increases resources available to community health centers in all 50 states, including the 26 existing Community Health Center Sites in rural communities and cities across Nevada that provide care to 70,014 patients.
  • Health centers in Nevada have received nearly $23 million from the Affordable Care Act. These funds are being used to create new health center sites in medically-underserved areas, enable existing health centers to increase the number of patients served, expand preventive and primary health care services, and support major construction and renovation projects.

Increases the Health Care Workforce Shortage

  • Nearly 13 percent of Nevada residents live in an area with a shortage of doctors or nurses or lacking in health care facilities. The law includes new resources to boost the number of doctors, nurses, and health care providers in communities where they are needed most. These resources include grants, scholarships, loan repayment programs, as well as increased support for educational institutions that provide training for a range of health care careers.
  • The Affordable Care Act also ensured that Nevada received more graduate medical education training slots because physicians who train in our state are more likely to stay in Nevada to practice when they complete their educations.
  • As a result of the law, Nevada received more than 70 graduate medical education training slots.

Provides More Resources for Nevada

The law provides states resources to support their work to expand the health care workforce, crack down on fraud, and support public health. So far, Nevada has received millions of dollars from the Affordable Care Act to support these efforts, including funding:

  • To support the National Health Service Corps, by assisting Nevada in recruiting health care professionals to serve in areas with a shortage of doctors, nurses, and other health care workers in exchange for assistance with their educational loans. Due to the Affordable Care Act, the National Health Service Corps received $283 million in funding in 2014 alone.  Additionally, the number of primary care physicians participating in the National Health Service Corps in Nevada has increased from 12 in 2008 to 56 in 2014.
  • To help Nevada reduce health care fraud by identifying efficient and effective procedures for long-term care facilities to conduct background checks on prospective employees, thereby protecting their residents.
  • To support outreach to eligible Medicare beneficiaries about the benefits they have earned.
  • For Family-to-Family Health Information Centers, organizations run by and for families with children with special health care needs.
  • To support the Personal Responsibility Education Program, to educate youth on both abstinence and contraception for the prevention of pregnancy and sexually transmitted infections, including HIV/AIDS.
  • For disease demonstration projects, to test innovative health care approaches for Medicaid beneficiaries.
  • For Maternal, Infant, and Early Childhood Home Visiting Programs. These programs bring health professionals to meet with at-risk families in their homes and connect families to the support needed for a child’s health, development, and ability to learn – such as health care, early education, parenting skills, child abuse prevention, and nutrition. Nevada Home Visiting Programs received approximately $1.05 million in 2014 alone

Provides Tax Credits to Make Health Care More Affordable

  • New tax credits are now available to help middle class families afford health insurance coverage through the supported state based health insurance marketplace Nevada Health Link.  In fact, of the 45,390 Nevadans who enrolled in a plan through Nevada Health Link, 82 percent were eligible for these tax credits, which lower premium payments each month.
  • The tax credits are advanceable, meaning that you do not have to wait until tax time to benefit.
  • This tool from the Kaiser Family Foundation can help you determine if you qualify for this financial assistance.

Reduces the Deficit and Strengthens the Economy

  • The Congressional Budget Office projects that the Affordable Care Act will reduce the deficit by more than $1 trillion in the next two decades.
  • As a result of expanding Medicaid, Nevada will add an estimated 3,400 to 8,600 jobs.
  • The economy has created nearly 9.1 million private sector jobs nationwide since the law was signed in 2010. Experts predict that the law will create anywhere from 250,000 to 400,000 jobs each year.

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What the Health Reform Law Means For…

Seniors

  • The Affordable Care Act is taking strong steps to protect and preserve Medicare for current and future beneficiaries.
  • The law provides seniors on Medicare with free preventive services so they can stay healthy.  In the first half of 2014 alone, more than 125,000 Nevadans on Medicare received one or more free preventive services – such as mammograms and colonoscopies – or a free annual wellness visit with their doctor.
  • The health reform law lowers prescription drug costs for seniors.  Nationwide, more than 8.3 million people with Medicare have saved over $12billion on prescription drugs since 2010.
  • More than 25,077 Nevadans who hit the Medicare prescription drug coverage gap known as the “donut hole” received $250 tax-free rebates in 2010.
  • Nevadans who reached the Medicare donut hole have saved nearly $70 million on prescription drugs since the Affordable Care Act was enacted.
  • The savings for seniors will increase in the coming years, and by 2020, the law will close the donut hole completely.
  • Additionally, thanks to the Affordable Care Act’s Early Retiree Reinsurance Program, 24 employers in Nevada have been approved to receive support for continuing to provide health coverage to their early retirees.  By mid-2014, these employers received more than $4.46 million in reimbursements for claims for health benefits for early retirees age 55 and older.

Women

  • Millions of uninsured women are now eligible for comprehensive health coverage through the health insurance marketplaces and Medicaid expansion.
  • Because of the health reform law, women are guaranteed a set of health insurance consumer protections.  Women cannot be charged more for the same policy as men, and they cannot be denied coverage because they have a pre-existing condition.
  • As of August 1, 2012, new and renewed health insurance plans started providing women with access to a full range of preventive services without co-pays or deductibles. This includes important preventive services such as: annual well-women visits, prescription birth control, mammograms, HIV screening and counseling, sexually transmitted infection counseling, screening for gestational diabetes, breastfeeding consultation and supplies, and screening and counseling for domestic violence. Almost 400,000 women in Nevada now have guaranteed access to these additional preventive services without cost-sharing.

Children

  • Because of the Affordable Care Act, insurance companies are no longer allowed to deny coverage or charge more to cover people with pre-existing conditions. Therefore, plans can no longer exclude, limit, or deny coverage for the children in Nevada with pre-exiting conditions.
  • Insurance companies are also no longer allowed to place yearly or lifetime limits on coverage.  Due to this provision of the law, children who have complicated illnesses and injuries will not be denied care based on a yearly or lifetime limit.
  • The Affordable Care Act ensures that children have access to a range of preventive services without cost-sharing.  These services include: autism screening, behavioral assessments, developmental screening, certain immunization vaccines, obesity counseling, and vision screening for all children.  Read more about the preventive services for children here.
  • The health reform law also gives states the option to expand their Medicaid program.  In 2012, the Nevada State Assembly decided to expand Medicaid in the Silver State.
  • Children in families that earn up to $32,913 a year for a family of four may be eligible for Medicaid.
  • The health reform law also extended funding for the Children’s Health Insurance Program (CHIP) – known in the Silver State as Nevada Check Up.  CHIP covers children in families who earn too much to qualify for Medicaid, but cannot afford private health insurance.  Nevadans can find out if their children are eligible for Nevada Check Up through Nevada Health Link.
  • Because of Medicaid expansion and the extended CHIP funding, tens of thousands of previously uninsured children and families now have health insurance in Nevada.
  • Learn more about the Medicaid and CHIP programs here.
  • Find state-wide, in-person assistance applying for coverage

Young Adults

  • The Affordable Care Act allows young adults to remain covered under their parents plan until age 26.
  • As of the end of 2011, 33,000 young adults in Nevada gained insurance coverage as a result of this provision of the law.
  • Your school may also provide a health plan that would deem you covered under the health care law.
  • In addition, if you are under the age of 30, catastrophic health plans are available and provide coverage for the high costs of worst-cast scenarios.

Additional Resources:

Minorities

  • The Affordable Care Act is ensuring that racial and ethnic minorities have access to quality, affordable health insurance coverage either through the Health Insurance Marketplace, Medicaid, or the Children’s Health Insurance Plan.
  • Because of the health reform law, community health centers across Nevada have received more than $22 million in funding to improve their services.  These funds have been used to hire more providers, make infrastructure updates, extend hours of operations and offer more primary care services.  Over 37,000 Latinos and nearly 5,000 African Americans across Nevada receive their preventive and primary care services at community health centers.

Additional Resources:

Low and Moderate Income Individuals and Families

  • As part of the health reform law, Nevadans with household incomes up to 400 percent of the federal poverty level (up to approximately $46,680 per year for an individual or up to $95,400 per year for a family of four) will be eligible to receive an Advanced Premium Tax Credit (APTC) for coverage purchased through the health insurance marketplace.  APTCs are also sometimes referred to as “premium tax credits” or “premium subsidies.”
  • These premium subsidies are paid directly to your insurer on your behalf, to automatically lower the amount you pay in premiums each month.
  • Last year, 82 percent of Nevadans who enrolled in coverage on Nevada Health Link were eligible for this important financial help.
  • The Nevada State Legislature decided to expand the Silver State’s Medicaid program under the health reform law to cover individuals with incomes of up to $16,105 or $32,913 for a family of four. The federal government will cover 100 percent of the costs of expansion at the outset.
  • Your household size and income is used to determine the coverage options you may qualify for, but if you are unemployed, you can still get covered.  If you are unemployed, click here to learn more about your coverage options.
  • If you are unemployed and currently enrolled in COBRA continuation coverage, you may be able to find more affordable health insurance options on the health insurance marketplace.  This link explains how you can switch to a marketplace insurance plan during open enrollment or if you qualify for a special enrollment period.
  • Find state-wide, in-person assistance applying for Medicaid coverage

 Small Businesses

  • In 2014, the Affordable Care Act began ensuring a competitive insurance marketplace where individual Nevadans and our small businesses can purchase affordable health insurance coverage.
  • Small businesses in Nevada now may be eligible for the new small business tax credit that makes it easier for businesses to provide coverage to their workers by making premiums more affordable.
  • The health reform law is helping small businesses keep costs down in other ways as well: the average rate increase for small business health insurance premiums in 2013 was less than one-third of the average growth rate small businesses experienced in the decade before the Affordable Care Act was passed.  In fact, if health insurance premiums continued to grow at pre-Affordable Care Act rates, the average premium for family coverage offered by a small business would have been $800 more last year.
  • Small employers also saved more than $2.5 billion between 2011 and 2013, due to a provision of the law that requires health insurance companies to spend at least 80 percent of premiums on care instead of on profits or administrative costs.

Additional Resources:

  • Learn more about insurance options and new health care changes that may affect your business by clicking here.
  • Learn more about the small business health care tax credit.
  • Health coverage for the self-employed.

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Medicare

Seniors and people with disabilities know the value of the Medicare program, which is why I am proud the health reform law we passed in Congress is strengthening and extending Medicare’s solvency until 2030 – thirteen years long than what was projected in 2009.

The health reform law is also lowering prescription drug costs for seniors and people with disabilities now, and will close the Medicare prescription drug coverage gap known as the “donut hole” in 2010.

For more information on how the health reform law strengthens Medicare, please click here

I am committed to protecting and preserving Medicare for current and future beneficiaries, which is why I will continue to lead the fight against ending the program as we know it by turning it into a voucher program and increasing seniors’ costs.

If you need assistance enrolling in Medicare, please visit www.medicare.gov. If you have an issue that requires my help, please visit my Casework page.

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Women’s Health Care

Thanks to the Affordable Care Act, millions of uninsured women are now eligible for comprehensive health coverage. Women also cannot be charged more for the same policy as men, and cannot be denied coverage because they have a pre-existing condition. In addition, new health plans are now required to cover recommended preventive care like mammograms and prescription contraception without any co-pays or deductibles.  I have always been a strong supporter of women’s health care, and when a Supreme Court ruling threatened to hinder women’s access to prescription contraception, I co-sponsored legislation that would ensure that companies cannot deny coverage of federally mandated health benefits.

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Investing in Medical Research and Supporting Patients

Throughout my time in Congress, I have supported funding for lifesaving medical research and legislation to advance prevention, treatment and the development of cures for a wide range of illnesses.

National Institutes of Health

I have long supported increased funding for the National Institutes of Health (NIH), our nation’s premier medical research institution. Investments in the NIH advance research by our nation’s most promising researchers affecting a broad range of illnesses and conditions like cancer, Alzheimer’s disease, heart disease, diabetes, Parkinson’s disease, and spinal cord injuries.

Stem Cell Research

In 2006 and 2007, I supported legislation that passed both the Senate and House that would have lifted the ban on promising stem cell research and supported federal funding and regulation of this research. In 2009, President Obama implemented this policy through an Executive Order.

Cancer

In addition to directing federal funds to cancer research at the NIH, I have supported a number of bills dedicated to cancer research, prevention, and treatment which are now law, including: the Recalcitrant Cancer Research Act, which will intensify research efforts to cancers like pancreatic, lung, liver, and ovaries that are difficult to detect and treat; the Family Smoking Prevention and Tobacco Control Act, which is helping to prevent the high rate of death from lung cancer in Nevada; the Caroline Pryce Walker Conquer Childhood Cancer Act, which expands research programs aimed at preventing childhood cancer; the National Breast and Cervical Cancer Early Detection Act, which funds the Women’s Health Connection in Nevada and provides timely access to breast and cervical cancer screening for low-income, uninsured, and underserved women; and the Breast Cancer and Environmental Research Act, which is helping to establish a national strategy to study the potential links between the environment and breast cancer.  In 2013, the Interagency Breast Cancer and Environmental Research Coordinating Committee established by this law released their recommendations to identify and prevent the environmental causes of breast cancer.

Diabetes

I also supported the creation of the Special Diabetes Program in 1997 and its reauthorizations in 2000, 2002, 2008, 2012, and 2014. This program provides $150 million annually for research towards a cure for type 1 diabetes and $150 annually for diabetes treatment and prevention strategies targeted to Native American populations.

HIV/AIDS

I have repeatedly advocated for funding to fight HIV and AIDS and to treat those living with the disease. I supported the creation of the Ryan White CARE Act in 1990 and its reauthorizations in 1996, 2000, 2006, and 2009. Most recently, I led the Senate in passing the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act, which will help fight HIV/AIDS and other diseases in Africa and around the globe.

Mental Health

Throughout my time in Congress, I have fought to pass legislation that is improving the quality and availability of mental health services. I was instrumental in the creation of the first ever National Suicide Prevention Strategy, which created a framework to address the crisis of suicide in the United States. I also helped pass the Garrett Lee Smith Memorial Act, a law which provides additional funding for research, training, and technical assistance to target youth suicide, and I was the author of the Stop Senior Suicide Act. I also supported legislation that will lower Medicare coinsurance for outpatient mental health, and in 1996 and 2008, I helped to secure passage of mental health parity laws that are helping to ensure that mental illnesses are treated on par with other physical illnesses. And thanks to the Affordable Care Act, an estimated 62.5 million Americans, including 550,516 Nevadans, will have access to mental health and substance abuse benefits and federal parity protections.

Other

Throughout my time in Congress, I have championed many other bills that are now law, like the ALS Registry Act, a law that will help scientists find treatments or a cure for ALS (Lou Gehrig’s disease).  The first data set from the National ALS Registry created by the ALS Registry Act was released in July of 2014.  This data set offers the first-ever glimpse at population-based estimates of the overall prevalence of ALS as well as important patient demographic information that can help identify potential risk factors for this devastating disease.  Other bills that Senator Reid has championed include: the Genetic Information Nondiscrimination Act of 2008, which will help fulfill the promise of genetic research by ensuring that genetic information cannot be used to discriminate against individuals by their insurance companies and employers; the Inflammatory Bowel Disease Research Act, as well as funding for research and educational programs for illnesses like Interstitial Cystitis and Chronic Fatigue Syndrome, an illness which was first identified in Northern Nevada.