Nevada Insurance Commissioner Brett BarrattQ: What challenges do you anticipate your particular state running into with upcoming health care reform provisions?

BB: There are numerous challenges. One of particular concern is that beginning in 2011, insurance companies must meet new medical loss ratio requirements designed to ensure at least 80 or 85 percent of every insured’s premium dollar is spent on health care. I have sought public and industry feedback as part of my evaluation of whether the MLR requirement in the individual market will result in insurers exiting the Nevada market, and whether the division should ask the federal Health and Human Services Department to temporarily reduce the MLR requirement for some insurers to ensure that individual policyholders have access to insurance.

Other challenges include the lack of child-only health insurance coverage in Nevada. Additionally, Nevada is creating a health insurance exchange to ensure that consumers, including employers, have coverage choices when the full extent of the ACA becomes effective in 2014.

Q: Is your state doing anything differently or preparing in any special way for health care reform?

BB: The State of Nevada Department of Health and Human Services is taking the lead on implementing the Nevada Insurance Exchange, and the Division of Insurance is also involved in this effort. In addition, in September 2010, the division applied for and received a $1 million grant to improve its ability to review, monitor, analyze, and report health benefit plan rate increases. As a condition of receiving the grant, the division must meet the “maintenance of effort” requirements. The division will also seek increased authority to regulate rates charged for all group health benefit plans in the 2011 session of the Nevada Legislature.

Q: What are your goals for health care reform in your state?

BB: To implement the required provisions of the ACA to ensure Nevada’s compliance and that consumers receive the best product possible for their premium dollar while ensuring that carriers are solvent and able to meet their obligations. Our primary goal is a competitive health insurance market that provides viable health plan choices for consumers, as affordably as possible.

Q: How has your state progressed toward these goals?

BB: We have adopted a temporary regulation creating an open enrollment period each year to attract carriers back into the child-only market.

Through the federal rate review grant project, we are expanding our rate review process to ensure that consumers receive a fairly priced product for their premium dollar.

Q: For producers licensed to sell health insurance in your state, what developments might they look out for, both now and in the long run?

BB: Producers play a very important role in assisting individuals and employers, especially small employers, in selecting health plans that best meet their needs. Even after the creation of the insurance exchange, producers will continue to provide consumers with guidance in the selection and purchase of their health benefit plans.

Brett J. Barratt was named insurance commissioner on July 7, 2010. He served as acting commissioner upon the June 2, 2010, resignation of Commissioner Scott Kipper, and has committed his efforts to leading the Nevada Division of Insurance through this transition, ensuring that the agency will continue to provide efficient, responsive and consistent regulation of the state’s $12 billion insurance industry.

More state insurance regulator Q&As:

Alaska

Arkansas

Illinois

Indiana

Iowa

Kansas

Kentucky

Maryland

Minnesota

Nebraska

New Hampshire

North Carolina

North Dakota

South Dakota

South Carolina

Nevada Facts At-A-Glance

Nevada

United States

Demographics

Total population

2,601,000

303,343,300

Median annual income

$53,964

$49,945

Health costs and budget

Health spending per capita

$4,569

$5,283 (by state of residence)

Average employee contribution for family premium (% of total premium)

23%

27%

Health coverage

Uninsured population (% of total population)

20%

17%

Uninsured children (% of children)

17%

10%

Medicaid enrollment (% of total population)

10%

19%

Medicare enrollment (% of total population)

13%

15%

Monthly CHIP enrollment, June 2009

22,444

4,966,030

Health status

Infant mortality rate (per 1,000 live births)

6.2

6.8

Teen death rate (per 100,000 population)

71

62

AIDS diagnosis rate (per 100,000 population)

12.4

12.3

Overweight or obese children (% of children)

34.2%

31.6%

Adults who visited the dentist/clinic (% of adults)

63.7%

71.3%

Adults with disabilities (% of adults)

10.1%

12.1%

Source: Kaiser Family Foundation State Health Facts