Monday, July 17, 2017

In an arid, lonely stretch out west, the health coverage that bloomed is now at risk

In this speck of high desert, along a stretch of highway that Life magazine once called the loneliest road in America, the only doctor in town comes just one day a week. In the past few years, though, health insurance has arrived in force. The county that includes Silver Springs now has more than 3,500 additional residents on Medicaid, because Nevada’s governor was the first Republican in the country to expand the program through the Affordable Care Act. Nearly 1,400 others have private plans through the law and the Silver State Health Insurance Exchange. Incomplete as it is, with many still falling through the cracks, such progress encouraged the health system that runs a little outpost in town to invest here in long-distance medicine. The new coverage has paid for back surgeries and brain surgeries for people who otherwise would have been left broke or unhealed. Yet 2,600 miles away, what Congress is now doing — or not doing — imperils these two strands of insurance that lately have cut Nevada’s uninsured population by half. Republican lawmakers would start to erase the money that props up Medicaid’s expansion. And even with a GOP health-care plan teetering in the Senate, months of uncertainty about the ACA’s future have heightened insurers’ qualms in Nevada about whether its marketplace is a financially safe space to be.

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