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 sell public option policies, and doctors and hospitals who participate in Medicaid or the state employee health program would have to join at least one network. Three insurers currently provide Medicaid plans in Nevada, said Heather Korbulic, executive director of Silver State Health Insurance Exchange, which runs the state's Affordable Care Act marketplace. Industry groups representing doctors, hospitals and insurers in the state attempted to derail the bill and have urged the Sisolak to veto it. "The public option provisions of the bill are neither a solution nor a benefit to Nevadans," they wrote in a May 31st letter to the governor, noting that the legislation would "add costs, increase burdens and damage both the health insurance market and health care provider network." Tough to achieve goals How successful these state-based public options will be at achieving their aims remains a question. In Washington, fewer than 2,000 people signed up for the Cascade Select plans during open enrollment, as of mid-January. That's less than 1% of total Obamacare exchange enrollment -- and the trend has largely continued during the special enrollment period currently underway, according to the Washington Health Benefit Exchange. Also, average premiums for the Cascade Select plans are 4% higher than those of 2020 average premiums. And, while five insurers are participating, policies are only available in 19 of the state's 39 counties, according to the exchange. States have dabbled in creating some type of public option for several years now, and Colorado and Oregon are currently

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