Nevada lawmakers approved legislation Tuesday to create a public health insurance plan, bringing the bill one step closer to becoming law.

Nevada Democratic Governor Steve Sisolak has said he intends to sign the public option bill. In 2017, then-governor Brian Sandoval, a Republican, vetoed a public option proposal that would have allowed anyone in the state to buy into a Medicaid-like system of health insurance. Since then, a public option has continued to be considered by the legislature.

The bill would mean that Nevadans who purchase their healthcare plans through the system that the bill creates would not be buying their insurance directly from the state. Nevada’s Public Option bill would be competing with the state-run system and would make Nevada only the second state, after Washington, with a public option.

The act will require insurers that bid to provide coverage of the state’s Medicaid population to offer a public option plan. The plan differs from the two prior proposals that lawmakers have considered so it is still uncertain the impact the bill will have on reducing costs and increasing access to health insurance.

The plan is reliant on participation from the state’s Medicaid organizations as the state will bid out the public option to insurance carriers as it tries to spur participation.

Nevada had 349,000 uninsured residents in 2019 and it ranked seventh in the nation for the highest percentage of uninsured, according to the Kaiser Family Foundation. The public option is planned to be available for purchase in 2026.