LAS VEGAS (KTNV) — Nevada lawmakers on Wednesday heard from healthcare authorities in the state about the consequences of federal cuts to the state's Medicaid program, which could have significant effects on thousands of people.
On Tuesday, Republicans in Congress passed a budget resolution that calls for $2 trillion in cuts to federal spending.
One suggestion for where to find that money comes in cuts to Medicaid, the health care program jointly funded by the federal government and the states.
In Nevada, more than 800,000 people — one in four — are covered by Medicaid.
In Nevada, the costs of Medicaid are split, with 60 percent paid for by the federal government, and 40 percent picked up by the states. But when Medicare was expanded in 2012 to include more people under the Affordable Care Act, the government agreed to pick up 90 percent of the cost for people in the expanded program.
Now, however, one possible plan is to reduce that expanded coverage from 90 percent reimbursement down to the traditional 60 percent for regular Medicaid, leaving the state to either reduce benefits, kick people off the program or pay for the difference.
That would affect about 300,000 Nevadans, according to state estimates.
According to Stacie Weeks, Nevada's Medicaid administrator, that would cost the state $1.858 billion in the coming two-year budget.
Democratic Assembly Speaker Steve Yeager told reporters last week the state could not absorb that additional cost without significant cuts.
Another option could be to truncate optional benefits under the program, things such as prescription drug benefits, occupational therapy, podiatry, dental services, children's chiropractic service or hospice care.
Other services — including hospital stays, doctor's visits, lab and X-ray services and visits to health centers — are mandatory under the program and can't be cut.
Democrats have lamented the cuts. Members of the state's congressional delegation have denounced the Republican budget process and its potential effects on the state. And Nevada Democrats criticized Gov. Joe Lombardo for skipping a meeting of governors with a visit to the White House and President Donald Trump, saying he's failed to defend Nevada from the threat of cuts.
"Nevadans wondering why Joe Lombardo refuses to stand up against Medicaid cuts for working families should not be surprised," said Nevada State Democratic Party spokesman Tai Sims in a statement. "As Donald Trump and House Republicans prepare to rip away health care from more than 300,000 people – Lombardo has no contingency plan and refuses to do what’s right for Nevada.”
But the governor — in a letter to state lawmakers — said he has been in touch with Washington.
"I want to assure Nevadans that I am actively engaged in conversations with the White House and others in the federal government to relay our state's concerns," Lombardo wrote.
"Nevada remains committed to being a constructive partner in efforts to ensure fiscal responsibility at the federal level, but federal funding cuts to essential programs alone will not solve Washington's spending problem or the rising cost of health care," Lombardo added. "An abrupt reduction in federal funding would not only disrupt care for those who rely on Medicaid, but would destabilize public and private healthcare providers, leading to workforce reductions, service limitations and financial strain on already overburdened health care facilities."
Before Wednesday's hearing, state Sen. Jeff Stone, R-Clark County, sought to downplay the impact of cuts.
"The sky is not falling," he said. "This joint Health and Human Services hearing is premature political theater and a waste of staff resources."
Stone went on to say that Nevada has money to backfill any cuts that are made, and cited Trump's promise that entitlement programs would not be affected by cuts.
But Democrats on the committee peppered officials with questions about the loss of care. And hospital officials said any cuts made to Medicare would land on them, since they would have to pay for emergency care for people formerly covered by Medicaid, leading to hospital crowding and financial stress on that part of the system.
Lawmakers are now in a holding pattern, waiting until they hear from Washington, D.C. about a final decision on budget cuts.
