Health care was a top issue for many voters in the Democratic primaries in Iowa and New Hampshire. As the Nevada caucus is quickly approaching, KUNR’s Anh Gray talked with John Packham, a state health policy expert, to break down how the national debate might shape issues of affordability and access in the state.

John Packham is the associate dean for the Office of Statewide Initiatives at the University of Nevada, Reno School of Medicine. He said there are various health care issues presidential candidates are bringing up on the campaign trail.

“There's a lot of things being bandied about. So one hears about repeal and replace [of the Affordable Care Act], which is kind of the nuclear option from the Republican side, to a sweeping change on the Democratic side. The most sweeping being the Medicare-for-all proposals,” Packham explained. “In between are actually a lot of proposed pieces of legislation that would basically deal with, again, some of the shortcomings of the Affordable Care Act — public options, public buy-ins, extension of Medicare coverage to those under the age of 65, say 50 to 64.”

The issue of health care affordability is one particular issue that Packham said affects many Nevadans.

“I wish there was more attention to affordability because even for those among us who enjoy insurance coverage, I keep hearing about deductibles, and copays, and other impediments to getting care when you need it,” Packham said, “simply because even though you may enjoy health insurance coverage, you still face cost and price barriers.”

A 2019 Commonwealth Fund report ranked Nevada 50th in the nation for access and affordability to health care and 48th for overall health care.

“Well, the upcoming election, I think for people is kind of a combination of improving health care access and insurance coverage, but protecting what a lot of us have, whether it's employment based insurance or a Medicare plan that provides benefits that you've come to count on,” Packham explained. “I think there's a kind of an uneasiness that more could be done for access, and insurance coverage, but kind of that lingering fear of a sweeping change that you're hearing from both parties.”

The 2020 Nevada Democratic caucus takes place on February 22.