On Monday night, Senate Majority Leader Mitch McConnell conceded that the GOP effort to repeal and replace Obamacare was not successful.
All eyes were on Nevada Senator Dean Heller and what his vote would be, but in the end, it was two other Republicans who declared they would oppose the Senate's health plans.
For now, the Silver State Health Insurance Exchange is safe. Well, at least if you live in a Nevada city. For rural residents, two insurance providers recently announced they would leave most of the rural counties in Nevada. That would place 8,000 Nevada residents without coverage.
Denise Tanata is the executive director of the Children's Advocacy Alliance. She told KNPR's State of Nevada that many people in rural areas in Nevada and other states are highly dependent on Medicaid and the Medicaid expansion under the Affordable Care Act allowed many to be on the health insurance rolls for the first time.
She said that getting a source of payment for health care is really the first step to improving health care in rural areas. Once money in the form of insurance is in place, advocates like herself can focus on improving access to care. However, with the health insurance system in limbo, they're back to square one.
“I feel like we’ve taken a huge step back because so much of what we’ve had to focus on now is going back and trying to sustain that first step with having access to health insurance," she said.
The second part of the Affordable Care Act, or Obamacare, is the health insurance exchanges for people who couldn't access insurance through their work place and didn't qualify for the Medicaid expansion.
Tanata said she can't say exactly why insurance companies pulled out of rural Nevada, but she did point out that they are for-profit companies that can't stay in a place where they're not making money. She said there are efforts underway now to bring in providers to fill that gap.
But, she said there are real problems with Obamacare that need to be addressed, including the rising cost of premiums and reimbursements for health care providers. Tanata believes it will take time to work through those issues.
“It's a heavy discussion about personal responsibility and what people need to pay on the individual level and then what the government needs to chip in to support that,” she said.
Denise Tanata, executive director, Children's Advocacy Alliance