Monday, Oct. 24, 2011 | 2 a.m.
A quarter of Nevadans under 65 did not have health insurance at some point in 2009, making the Silver State the third most uninsured state per capita in the United States, according to U.S. Census data released this month.
Nevada’s low rate of insured, which is not a surprise to state experts, is primarily the result of a lean state health care system compared with the rest of the country. Namely, Nevada has restricted Medicare access to the poorest of the poor, while other states offer public health care coverage to more residents.
The statistics also highlight a looming problem the state is facing: how to get all those uninsured people covered by the beginning of 2014. That’s when the federal Patient Protection and Affordable Care Act mandates individuals have health insurance.
The cost facing states with a high number of people who are uninsured, like Nevada, has many state health officials concerned.
In 2009, soon after President Barack Obama signed the federal legislation, a state analysis found that Medicaid expansion would cost $636 million from 2014 to 2019. The state’s board for the Silver State Health Insurance Exchange is scheduled to have its first meeting this month to prepare to implement the rules. (States including Nevada are seeking to throw out parts of the federal legislation, calling unconstitutional the mandate that all be covered.)
A separate analysis done for the state by contractor Public Consulting Group painted a picture of the uninsured. Among the findings released in August:
• 445,000 Nevada adults between 18 and 64 did not have health insurance.
• Almost 18 percent of children are uninsured, or 121,386. This is more than twice the national average.
The new federal law requires states to expand Medicaid to cover people making 138 percent of the federal poverty level, which equals about $30,000 a year for a family of four. About 43 percent of Nevadans at that level of income or less did not have health insurance, the highest rate in the nation. The federal government will pick up most of the costs for the first five years, but states think that they will have to shoulder administrative costs.
In addition, those who make up to 400 percent of the poverty level will qualify for help in buying health insurance.
Only Texas and Florida had higher percentages of uninsured under 65, the age at which people become eligible for federal Medicare coverage.
Clark County had 24.9 percent of its population under the Medicare eligible age uncovered. Washoe County, which includes Reno, had 23.9 percent of its population uncovered.
Sen. Sheila Leslie, D-Reno and chairwoman of the Senate Health and Human Services Committee, said right now, “We make it really difficult to get Medicaid. We have the leanest Medicaid program in the country.”